title: Rare presentation of metastatic prostate adenocarcinoma as a meningioma mimic.
abstract: Background Dural lesions in the anterior skull base may occur secondary to benign or malignant pathology that may be difficult to differentiate on imaging. Detailed clinical evaluation in many cases will narrow the differential diagnosis. In spite of using all the available information, in certain cases the underlying etiology of a lesion remains unclear. Participant We report a rare case of metastatic prostate adenocarcinoma to a meningioma in a 67-year-old-man who presented with progressive confusion and mental status alterations with no prior history of malignancy. Neuroimaging revealed a large anterior skull base lesion. Results The lesion was surgically resected, and histopathology revealed a collision tumor, in which prostate adenocarcinoma was found admixed with a World Health Organization grade I meningioma. Conclusion Anterior dural skull base lesions can be either benign or malignant. Although infrequently reported, a benign-appearing dural-based lesion may be a manifestation of an underlying malignancy, and a thorough clinical, radiologic, and pathologic examination may be necessary, especially in the elderly.
authors.affiliation: Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, the Neurological Institute, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Gazanfar
authors.initials: G
authors.lastname: Rahmathulla
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prayson
authors.affiliation: Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, the Neurological Institute, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Weil
keywords: anterior skull base; collision tumor; meningioma; prostate cancer
references.citation: Rev Neurol (Paris). 2001 Dec;157(12):1543-5
references.pmid: 11924453
references.citation: N Engl J Med. 2004 May 27;350(22):2239-46
references.pmid: 15163773
references.citation: Surg Neurol. 1979 Sep;12(3):253-8
references.pmid: 515927
references.citation: Am J Roentgenol Radium Ther Nucl Med. 1971 Aug;112(4):774-8
references.pmid: 5562744
references.citation: J Clin Neurosci. 2005 Aug;12(6):720-3
references.pmid: 16115558
references.citation: Can Urol Assoc J. 2009 Jun;3(3):E4-E6
references.pmid: 19543455
references.citation: Ann Diagn Pathol. 2002 Feb;6(1):44-8
references.pmid: 11842378
references.citation: Arch Pathol Lab Med. 1980 Jul;104(7):350-4
references.pmid: 6893121
references.citation: Neurologist. 2006 Jan;12(1):48-52
references.pmid: 16547447
references.citation: J Oncol. 2012;2012:723541
references.pmid: 22481931
references.citation: Cancer. 2003 Jul 15;98(2):363-8
references.pmid: 12872358
references.citation: Surg Neurol. 2002 Sep-Oct;58(3-4):241-5
references.pmid: 12480230
references.citation: Neurosurgery. 1986 Nov;19(5):820-3
references.pmid: 3785633
references.citation: Virchows Arch A Pathol Anat Histol. 1975;366(1):87-91
references.pmid: 804761