Metastatic Atypical and Anaplastic Meningioma: A Case Series and Review of the Literature

World Neurosurg. 2017 May:101:47-56. doi: 10.1016/j.wneu.2017.01.070. Epub 2017 Jan 29.

Abstract

Background: Atypical (World Health Organization grade II) and anaplastic (World Health Organization grade III) meningiomas are rare, accounting for less than 5% of all meningiomas. Histologic grading has a significant impact on prognosis, risk of recurrence, and the need for adjuvant radiation or chemotherapy. Extracranial metastases are even more infrequent and occur in 0.1% of all cases.

Methods: Retrospective chart review of 168 patients with diagnosis of WHO grade II and III meningiomas was performed. Six patients with histologically confirmed metastatic disease were identified.

Results: We discuss the clinical, radiologic, and histopathologic clinical course of 6 patients with metastasis to the lung, liver, and spine from all patients with atypical or anaplastic meningioma treated at Johns Hopkins Hospital from 1993 to 2014.

Conclusions: We reviewed the literature pertaining to this phenomenon and subsequently assessed the clinical benefits of adjuvant chemotherapeutic agents in patients with meningioma with metastatic disease.

Keywords: Anaplastic; Atypical; Meningioma; Metastasis; Resection.

Publication types

  • Review

MeSH terms

  • Aged
  • Disease Progression
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / drug therapy
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / surgery
  • Meningioma / diagnostic imaging
  • Meningioma / drug therapy
  • Meningioma / pathology*
  • Meningioma / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / secondary*
  • PubMed / statistics & numerical data
  • Retrospective Studies
  • Tomography Scanners, X-Ray Computed
  • Young Adult