Metastatic meningioma to the lung with multiple pleural metastases

Meningiomas with both malignant clinical behavior and cytology are rare. Meningiomas comprise approximately 15% of the primary brain tumors. The majority are benign; less than 1% metastasize, most commonly to the lung (61%) followed by liver, lymph node, and bone. Approximately 130 cases of extracranial metastatic meningiomas have been described. Only 13% had more than three metastases, with few cases reported with extensive pleural involvement. We report an interesting case of a malignant meningioma that invaded through the skull in the frontal sinus that later metastasized to the left lung with multiple pulmonary and pleural nodules.