title: Anaplastic transformation of an atypical intraventricular meningioma with metastases to the liver: case report.
abstract: OBJECTIVE
  Malignant intraventricular meningiomas are very rare. To the best of our knowledge, only eleven cases have been reported thus far. Seven of them developed cerebrospinal fluid (CSF) metastases. We present herein the first case of a malignant intraventricular meningioma with extraneural metastases.
  
  
  METHODS
  We report a 44 year-old-man with a history of progressive headache and disorientation. Magnetic resonance imaging (MRI) revealed a 5-cm homogeneously-enhancing mass in the right trigone.
  
  
  METHODS
  The lesion was totally resected via a parietooccipital transcortical approach. Histological examination demonstrated an atypical meningioma. Thereafter, the tumor recurred twice. At first recurrence, the tumor was completely removed again and external radiotherapy was administered. At surgery at second recurrence, the tumor was more aggressive, invading the brain parenchyma. Histological examination showed anaplastic meningioma. The patient was readmitted to hospital with fever and pain in right hypochondrium. Abdominal ultrasound examination disclosed multiple hypoechoic liver lesions. Biopsy was consistent with liver metastases of a malignant meningioma. The patient died of acute liver failure seven months after initial diagnosis.
  
  
  CONCLUSIONS
  Malignant intraventricular meningiomas are prone to recur and develop metastases, mainly through the CSF. Nevertheless, our case shows that extraneural metastases are also possible. Therefore, when systemic deterioration occurs in a patient with a malignant intraventricular meningioma, metastases to extraneural organs such as the liver must be ruled out.
authors: Department of Neurosurgery, Hospital Universitario de Canarias, Tenerife, Spain.
authors: M
authors: M
authors: Garcia-Conde
authors: H
authors: H
authors: Roldan-Delgado
authors: D
authors: D
authors: Martel-Barth-Hansen
authors: C
authors: C
authors: Manzano-Sanz
mesh_terms: D000328:Adult; D000708:Anaplasia / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology*; D008579:Meningioma / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods