Multiple pulmonary metastases in recurrent intracranial meningioma: Case report and literature review

Multiple pulmonary metastases from meningioma are rare. We report here a 59-year-old man with multiple pulmonary metastases from a recurrent intracranial meningioma. The primary intracranial tumour in the left occiput was totally excised in 2009. Pathological examination confirmed the diagnosis of atypical meningioma and adjuvant radiotherapy was given to help prevent recurrence. However, recurrence occurred in the left occipital region in 2011 and the meningioma was re-excised in 2012. At the same time, multiple metastases in the right pulmonary lobe were found and excised 3 months after the second craniotomy. The patient has not developed any further recurrence or metastases to date. Neurosurgeons should be aware of the occurrence of pulmonary metastases in patients with intracranial meningioma; potential predictive factors include atypical meningioma, venous sinus invasion, recurrence or previous intracranial surgery, and loss of heterozygosity.