Late Metastasis of an Intracranial Meningioma to the Hard Palate:

Prognostic factors for first recurrence following meningioma surgery

The present study investigated the role of the Simpson grade system, MIB-1 immunohistochemical marker, meningioma location and grade in the risk of recurrence. Between January, 2008 and January, 2018, the present study retrospectively evaluated all patients undergoing craniotomy for the resection of a histopathologically confirmed meningioma. Patients with neurofibromatosis, acoustic neurinomas and radiation treatment prior to surgery were excluded. After applying the exclusion criteria, 103 patients were included in the study. Following a mean follow-up period of 67.3±33 months, there were 12 cases (11.6%) of tumor recurrence. No significant association between meningioma recurrence and age, sex, or tumor location was found. When comparing the risk of recurrence between Simpson grades I, II, III and IV excisions, and between Simpson grade V, the difference was statistically significant. When comparing WHO grade I and II meningioma vs. grade III, the difference was significant. MIB-1 LI >3% exhibited a trend towards a significant association with the risk of recurrence. On the whole, the present study demonstrates that the Simpson grade is associated with the risk of recurrence. Patients with tumors with an MIB-1 index >3% may also be at a risk of recurrence. Notably, the present study proposed that in the case of recurrence, this is more likely to occur in an interval of 5.5 years following surgical intervention.

Metastasis to the Jawbones: A review of 453 cases

The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.

Paraneoplastic symptoms caused by extracranial meningioma metastases?

BACKGROUND

There are only few reports on distant metastases of cranial meningiomas WHO I. In one-third of the cases, distant metastases seem to be clinically silent. This is the first case of distant metastases which may have manifested with a paraneoplastic syndrome.

CASE DESCRIPTION

A 52-year-old white male patient was diagnosed with distant metastases to the bones and liver 11 and 12 years following craniotomy and removal of a tentorial meningioma WHO I. At that time, the patient had developed paresthesia, unsteady gait, and a slight cognitive impairment, which in retrospect had no other explanation than that of a paraneoplastic syndrome. Eighteen years following craniotomy, a small intracranial tumor rest is under control following two single session radiosurgery treatments. At present, the patient has a multitude of bone and liver metastases, which seem to cause his paraneoplastic symptoms.

CONCLUSION

Screening for malignancies in patients with paraneoplastic symptoms and a history of cranial meningioma should include screening for distant metastases from the meningioma.

Recurrent intracranial meningioma with multiple pulmonary metastases: A case report

Meningiomas are slow-growing tumors, which are generally considered to be benign and rarely metastasize. Although cases of extracranial metastatic meningioma have previously been reported, multiple pulmonary metastases from a benign intracranial meningioma is particularly rare. In the present report, a case of recurrent transitional meningioma with multiple lung nodules, which were demonstrated to be metastatic meningioma, is presented. A 54-year-old female patient received surgical resection of the tumor located in the left base of the middle cranial fossa in 2006. Post-surgery pathological examination indicated a transitional meningioma of World Health Organization grade I. The tumor recurred at the original site 1 year and 3 months later and was completely surgically removed once again. Radiotherapy was administered following the second surgery. Gamma Knife was used to remove the recurrent tumor 18 months following the second surgery. Simultaneously, a chest computed tomography scan revealed multiple pulmonary nodules, which were demonstrated to be metastatic meningioma following wedge resection of the superior lobe of the right lung. The clinical behavior of meningioma does not always correlate with the classification of meningioma. A higher rate of cellular proliferation is not essential for extracranial metastasis, and an individual meningioma of any type may metastasize. Comprehensive examinations should be performed for patients with a history of recurrent intracranial meningioma to detect any distant metastases as early as possible, even when the primary tumor is benign.