Lung carcinoma presenting as metastasis to intracranial meningioma: case report and review of the literature.
Tumor-to-tumor metastasis is rare. The authors report a case of a 52-year-old man with a 1-year history of a right parasaggital meningioma, whose clinical signs were consistent with enlarging meningioma. In preparation for surgery, the routine preoperative chest radiograph revealed a lung mass. Fine-needle aspiration of the mass revealed adenocarcinoma. The patient underwent surgical excision of the intracranial mass, which was thought to be a meningioma. However, pathologic examination revealed a transitional meningioma extensively infiltrated with deposits of metastatic carcinoma from the patient's primary lung tumor. Metastasis to meningioma was therefore responsible for the rapid enlargement of the long-standing meningioma, and caused the first clinical manifestation of primary lung carcinoma. Recurrent metastasis developed at the surgical site 5 weeks later, requiring surgical excision and postoperative radiation to prevent further recurrence. This is a highly unusual presentation for lung carcinoma and, to the authors' best knowledge, is the first such case reported. A review of the published literature revealed 20 other cases of lung carcinoma metastatic to meningioma, which were incidentally discovered on surgery or autopsy.
Bhargava
P
P
Division of Hematology-Oncology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
McGrail
K M
KM
Manz
H J
HJ
Baidas
S
S
D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D008579:Meningioma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged