Rare pulmonary manifestation of an intracranial meningothelial meningioma

History and clinical findings: A 53-year-old sailor was admitted to our department with the history of severe headache, dysphasia and mild psychotic behavior. Routine chest X-rays several weeks before had showna focal lung lesion in the lower lobe of the right lung. The patient was without pulmonary symptoms. Investigations: Brain magnetic resonance imaging demonstrated a large intracranial extracerebral mass with perifocal brain edema in the right frontoparietal region. Therapy: The patient was suspected of having a metastasis of an unknown primary tumor. Craniotomy and total removal of the tumor was performed. Histological examination revealed a meningothelial meningioma without signs of malignancy. 6 weeks later thoracotomy and total removal of the lung tumor were performed. Histological examination revealed a meningioma with the same histological pattern as the intracranial leasion. Postoperatively there were no complications, the physical examination at discharge was normal without any pulmonal or neurological deficits. Two years later, we found no evidence of an intracranial or pulmonal tumor recurrence. Conclusion: Pulmonary metastases of benign intracranial meningiomas are rare but should be considered in the differential diagnosis, especially in cases with an undiscovered primary tumor.