title: Intraspinal meningioma with malignant transformation and distant metastasis.
abstract: Meningioma is typically considered to be a benign tumor. Malignant transformation and metastasis of meningiomas are rare. Moreover, most meningiomas are intracranial, and there are few reports on intraspinal meningiomas. This report aimed to describe the clinical features and pathological findings of a case of malignant transformation and distant metastasis of intraspinal meningioma, with a review of the literature. A 44-year-old man with a bilateral lower limb paresis was diagnosed with an intradural extramedullary tumor of the thoracic spine. Primary tumor resection was performed, and the histological findings revealed atypical meningioma. The meningioma recurred 2 years after the primary surgery, and a second resection was performed, but only partial resection was possible because of decreased motor evoked potential. At age 48, the patient's lower limb weakness returned, and a third resection was performed, and the histological finding remained atypical meningioma. At age 54, the tumor increased and stereotactic irradiation was performed. At age 60, the patient was diagnosed with metastatic tumors of the rib, lumbar vertebra, cervical spine, and sacrum. Biopsy of the rib metastatic tumor was performed, and the histological findings revealed anaplastic meningioma. This case is the first report of an intraspinal meningioma that transformed from atypical to anaplastic meningioma with distant hematogenous metastasis.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kenyu
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Shido
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Yoshida
authors.initials: Y
authors.lastname: Go
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Arima
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kanbara
authors.affiliation: Department of pathology, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Hirose
authors.affiliation: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis*; D009362:Neoplasm Metastasis; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis*
keywords: atypical; intraspinal; malignant transformation; meningioma; metastasis