title: Metastatic meningioma in the sacrum: a case report.
abstract: METHODS
  This report describes a 51-year-old woman with a sacral metastatic meningioma that originated from an intracranial meningioma.
  
  
  OBJECTIVE
  To describe an unusual presentation of a metastatic meningioma in the sacrum.
  
  
  BACKGROUND
  Extracranial metastases of meningioma are very rare. The phenomenon of metastasis may have more to do with the ability to invade the wall of a blood vessel than with the mitotic activity of a tumor. Therefore, metastases of the meningioma can occur even with a benign histologic picture in the original intracranial meningioma.
  
  
  METHODS
  A 51-year-old woman had experienced low back pain and sciatica of the left leg for several months. Plain radiographs of the lumbosacral spine showed an osteolytic lesion with an irregular margin that occupied the left side of the sacrum. Magnetic resonance imaging revealed a soft mass invading the left sacrum, ilium, and presacral space.
  
  
  RESULTS
  Surgical removal of the sacral tumor via an anterior-posterior-anterior approach was done. Histopathologic examination revealed a metastatic meningioma with a meningotheliomatous histologic composition. Sixteen months after excision of the metastatic sacral lesion, the patient was ambulating freely and experiencing mild constipation and urine retention.
  
  
  CONCLUSIONS
  In this case of metastatic meningioma in the sacrum, which is the first such report to the authors' best knowledge, total excision of the tumor was successful.
authors.affiliation: Colon & Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
authors.forename: Yan-Yaw
authors.initials: YY
authors.lastname: Lee
authors.forename: Robert
authors.initials: R
authors.lastname: Wen-Wei Hsu
authors.forename: Tsung-Jen
authors.initials: TJ
authors.lastname: Huang
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
authors.forename: Jeng-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008579:Meningioma / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012086:Reoperation; D012445:Sacrococcygeal Region / Q000000981:diagnostic imaging / Q000601:surgery; D012585:Sciatica / Q000209:etiology; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D014057:Tomography, X-Ray Computed