title: Visceral and bone metastases of a WHO grade 2 meningioma: A case report and review of the literature.
abstract: Meningiomas represent the most common tumours of the central nervous system in adults. Risk factors include ionizing radiation, female hormones exposure, head trauma, cell phone use, breast cancer and family history of meningioma. Despite complete surgical resection, natural history of meningiomas often includes local recurrence but very few metastatic meningiomas have been reported. Here, we report the case of a metastatic meningioma. A 43-year-old woman was firstly treated for a symptomatic parietal meningioma WHO grade II by surgical resection followed by an irradiation of the surgical bed. After surgical resection and irradiation, the patient recovered incompletely. Two months after the end of the radiation treatment, the patient presented at the emergency unit for sciatic pain revealing bone metastases that has been histologically confirmed. Moreover, imaging led to the diagnosis of liver and lungs metastasis. Despite lack of guidelines for metastatic meningioma, few treatments have been used and published for recurrent and multiple meningioma management. In case studies, some partial responses have been seen with mifepristone and improved progression-free survival rates have been obtained with hydroxyurea and sunitinib. Metastasis in meningioma is very uncommon and no specific management has been described. Hydroxyurea, sunitinib and mifepristone could be options if no clinical trial data is available.
authors.affiliation: Radiotherapy department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Paix
authors.affiliation: Radiotherapy department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France.
authors.forename: W
authors.initials: W
authors.lastname: Waissi
authors.affiliation: Radiotherapy department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Radiobiology laboratory EA 3430, federation of translational medicine in Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France.
authors.forename: D
authors.initials: D
authors.lastname: Antoni
authors.affiliation: University of Virginia School of Medicine, 200 Jeannette Lancaster Way, VA 22903 Charlottesville, USA.
authors.forename: R
authors.initials: R
authors.lastname: Adeduntan
authors.affiliation: Radiotherapy department, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Radiobiology laboratory EA 3430, federation of translational medicine in Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France. Electronic address: gnoel@strasbourg.unicancer.fr.
authors.forename: G
authors.initials: G
authors.lastname: Noël
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging; D007211:Indoles / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D060787:Neoplasm Grading; D011758:Pyrroles / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012272:Ribs / Q000000981:diagnostic imaging; D013117:Spinal Cord Compression / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D013131:Spine / Q000000981:diagnostic imaging; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Meningioma; Metastasis; Méningiome; Métastase; Radiotherapy; Radiothérapie; Targeted treatment; Thérapie ciblée