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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2021; 40(02): e174-e178
DOI: 10.1055/s-0040-1722247
Case Report | Relato de Caso

Extracerebral Pterional Metastasis from Malignant Meningioma: A Case Report

Metástase pterional extracerebral de meningioma maligno: Relato de caso
Edmundo Luís Rodrigues Pereira
1   Department of Neurosurgery, Universidade Federal do Pará, Guamá, Belém, PA, Brazil
,
Diego Arthur Castro Cabral 
2   Instituto de Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Pará, Guamá, Belém, PA, Brazil
,
Fernanda Myllena Sousa Campos 
2   Instituto de Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Pará, Guamá, Belém, PA, Brazil
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Abstract

Anaplastic or malignant meningiomas that are classified as World Health Organization (WHO) grade III account for less than 1% of all meningiomas diagnosed. Despite the aggressive course, distant metastases are a rarity, occurring in only 0.1% to 0.2% of cases. We report the case of a 56-year-old woman who presented with parasagittal benign meningioma that underwent malignant transformation along with metastasis into the right orbitosphenoid region. The clinical, radiological, and histopathological aspects are highlighted, with an emphasis on the natural history of meningiomas.

Resumo

Meningiomas anaplásicos ou malignos classificados como grau III da Organização Mundial da Saúde (OMS) representam menos de 1% de todos os meningiomas diagnosticados. Apesar do curso agressivo, as metástases à distância são raras, ocorrendo em apenas 0,1% a 0,2% dos casos. Relatamos o caso de uma mulher de 56 anos que apresentou meningioma benigno parassagital que sofreu transformação maligna e metástase para a região orbito esfenoidal direita. São destacados os aspectos clínicos, radiológicos e histopatológicos, com destaque para a história natural dos meningiomas.

Keywords

atypical meningioma - malignant meningioma - metastasis

Palavras-chave

meningioma atípico - meningioma maligno - metástase


Publication History

Received: 09 July 2020

Accepted: 16 November 2020

Article published online:
15 February 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro-oncol 2017; 19 (Suppl. 05) v1-v88
    Google Scholar
  • 2 Claus EB, Bondy ML, Schildkraut JM, Wiemels JL, Wrensch M, Black PM. Epidemiology of intracranial meningioma. Neurosurgery 2005; 57 (06) 1088-1095 , discussion 1088–1095
    CrossrefPubMedGoogle Scholar
  • 3 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016; 131 (06) 803-820
    CrossrefPubMedGoogle Scholar
  • 4 Galani V, Lampri E, Varouktsi A, Alexiou G, Mitselou A, Kyritsis AP. Genetic and epigenetic alterations in meningiomas. Clin Neurol Neurosurg 2017; 158: 119-125
    CrossrefPubMedGoogle Scholar
  • 5 Cimino PJ. Malignant progression to anaplastic meningioma: Neuropathology, molecular pathology, and experimental models. Exp Mol Pathol 2015; 99 (02) 354-359
    CrossrefPubMedGoogle Scholar
  • 6 Wang J, Wang L, Luo B. et al. Recurrent meningioma with malignant transformation: a case report and literature review. Int J Clin Exp Med 2015; 8 (09) 16845-16849
    PubMedGoogle Scholar
  • 7 Hortobágyi T, Bencze J, Varkoly G, Kouhsari MC, Klekner Á. Meningioma recurrence. Open Med (Wars) 2016; 11 (01) 168-173
    CrossrefPubMedGoogle Scholar
  • 8 Graffeo CS, Leeper HE, Perry A. et al. Revisiting Adjuvant Radiotherapy After Gross Total Resection of World Health Organization Grade II Meningioma. World Neurosurg 2017; 103: 655-663
    CrossrefPubMedGoogle Scholar
  • 9 Hasan S, Young M, Albert T. et al. The role of adjuvant radiotherapy after gross total resection of atypical meningiomas. World Neurosurg 2015; 83 (05) 808-815
    CrossrefPubMedGoogle Scholar
  • 10 Sun SQ, Hawasli AH, Huang J, Chicoine MR, Kim AH. An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas. Neurosurg Focus 2015; 38 (03) E3
    CrossrefPubMedGoogle Scholar
  • 11 Rogers L, Barani I, Chamberlain M. et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg 2015; 122 (01) 4-23
    Google Scholar
  • 12 Asioli S, Senetta R, Maldi E. et al. “Benign” metastatic meningioma: clinico-pathological analysis of one case metastasising to the lung and overview on the concepts of either primitive or metastatic meningiomas of the lung. Virchows Arch 2007; 450 (05) 591-594
    CrossrefPubMedGoogle Scholar
  • 13 Sughrue ME, Sanai N, Shangari G, Parsa AT, Berger MS, McDermott MW. Outcome and survival following primary and repeat surgery for World Health Organization Grade III meningiomas. J Neurosurg 2010; 113 (02) 202-209
    CrossrefPubMedGoogle Scholar
  • 14 Sanai N, Sughrue ME, Shangari G, Chung K, Berger MS, McDermott MW. Risk profile associated with convexity meningioma resection in the modern neurosurgical era. J Neurosurg 2010; 112 (05) 913-919
    Google Scholar
  • 15 Fouad YA, Aanei C. Revisiting the hallmarks of cancer. Am J Cancer Res 2017; 7 (05) 1016-1036
    PubMedGoogle Scholar
  • 16 Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000; 100 (01) 57-70
    CrossrefPubMedGoogle Scholar
  • 17 Satoh Y, Ishikawa Y. Multiple primary pulmonary meningiomas: 20-year follow-up findings for a first reported case confirming a benign biological nature. Int J Surg Case Rep 2017; 31: 58-60
    CrossrefPubMedGoogle Scholar
  • 18 Cho BR, Yoon WS. Pulmonary metastases from benign calvarial meningioma: a case report. Br J Neurosurg 2017; 31 (02) 276-278
    CrossrefPubMedGoogle Scholar
  • 19 Surov A, Gottschling S, Bolz J. et al. Distant metastases in meningioma: an underestimated problem. J Neurooncol 2013; 112 (03) 323-327
    CrossrefPubMedGoogle Scholar
  • 20 Marciscano AE, Stemmer-Rachamimov AO, Niemierko A. et al. Benign meningiomas (WHO Grade I) with atypical histological features: correlation of histopathological features with clinical outcomes. J Neurosurg 2016; 124 (01) 106-114
    CrossrefPubMedGoogle Scholar
  • 21 Kanthan R, Senger JL. Distant metastases from meningiomas–A myth or reality?. Ann Clin Pathol 2013; 1 (01) 1001
    PubMedGoogle Scholar
  • 22 Egemen E, Solaroglu I. Anatomy of Cerebral Veins and Dural Sinuses. In: Primer on Cerebrovascular Diseases. 2nd ed.. 2017: 32-36
    CrossrefGoogle Scholar
  • 23 Adachi K, Hasegawa M, Hirose Y. Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery. Neurol Med Chir (Tokyo) 2017; 57 (10) 505-512
    CrossrefPubMedGoogle Scholar
  • 24 Pavelin S, Becic K, Forempoher G. et al. Expression of ki-67 and p53 in meningiomas. Neoplasma 2013; 60 (05) 480-485 https://www.researchgate.net/publication/241690536_Expression_of_Ki-67_and_p53_in_meningiomas
    CrossrefPubMedGoogle Scholar
  • 25 Heald JB, Carroll TA, Mair RJ. Simpson grade: an opportunity to reassess the need for complete resection of meningiomas. Acta Neurochir (Wien) 2014; 156 (02) 383-388
    CrossrefPubMedGoogle Scholar