Rhabdoid Meningioma Arising Concurrent in Pulmonary and Intracranial with a Rare Malignant Clinical Progression: Case Report and Literature Review

World Neurosurg. 2017 Nov:107:1046.e17-1046.e22. doi: 10.1016/j.wneu.2017.07.181. Epub 2017 Aug 7.

Abstract

Background: Rhabdoid meningioma (RM) is an unusual variant of meningioma, classified as World Health Organization grade III. Although its recurrence is common, extracranial metastasis is rare and usually misdiagnosed. The transfer mechanism and pathway are ambiguous; once the metastasis occurs, the prognosis is poor, and there is no effective management. The present case is the first report of concurrent intracranial and pulmonary RM with rapid and widespread metastasis. We hope this report can serve as a helpful reference for clinicians and radiologists.

Case description: A 39-year-old woman presented to our hospital complaining of headache and memory disturbances. Magnetic resonance imaging (MRI) of the brain revealed a well-defined, inhomogeneous signal tumor with intense enhancement and severe peritumoral edema. Postoperatively, RM (grade III) was confirmed by histopathology. A chest CT performed 2 weeks later revealed an isolated lung mass, which was confirmed as RM on subsequent surgery. Three months after the first radiotherapy, the cancer had progressed uncommonly rapidly with widespread metastasis to the cerebellum, lung, kidney, and thigh. Gamma knife radiosurgery, chemotherapy, and molecular-targeted therapy were performed; however, the patient's condition continued to worsen, and she died 1 year after the initial operation.

Conclusions: Intracranial RM is a relatively rare tumor with the potential for wide intracranial and extracranial transfer. Cystic components and necrosis can be seen in this type of meningioma. Metastatic meningioma should be kept in mind when dealing with isolated lung lesions. This case report may serve as a helpful reference for clinicians and radiologists.

Keywords: Meningioma; Neoplasm metastasis; Pulmonary; Rhabdoid.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brain Neoplasms / complications
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / surgery
  • Disease Progression*
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / surgery
  • Meningeal Neoplasms / complications
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / surgery
  • Meningioma / complications
  • Meningioma / diagnostic imaging*
  • Meningioma / surgery
  • Rhabdoid Tumor / complications
  • Rhabdoid Tumor / diagnostic imaging*
  • Rhabdoid Tumor / surgery