Lung metastases from intracranial bleeding meningioma A case report

Rationale: Meningioma is slow-growing benign neoplasm that derived from the meningothelial cells of the arachnoid mater, and it is the most common type of primary brain tumor. Although cases of extracranial metastatic meningioma have been reported previously, few cases have reported the concurrent occurrence of primary meningioma with intratumoral bleeding and lung metastases. Here we report a case of meningioma with concurrent intratumoral bleeding and lung metastases. Patient concerns: The patient was admitted to our hospital with sudden left limb paralysis combined with complaints of headache and dizziness. Diagnoses: Histopathological results confirmed the lung metastases derived from intracranial bleeding meningioma. Interventions: The magnetic resonance imaging (MRI) of brain and computed tomography (CT) of brain and lung were performed. Outcomes: CT and MRI of brain showed an intracranial mass associated with intratumoral hemorrhage. Then, multiple lung metastases were observed in the right lung via CT images. The intracranial mass was excised through craniotomy firstly, and a thoracoscopic biopsy was performed 1 month later. The patient was hospitalized again after 1 year because of suddenly epilepsy and received effective symptomatic treatment until symptoms were relieved. Then the patient is lost to follow-up. Lessons: When meningiomas occurred nearby venous sinuses with aggressive behavior, a careful whole-body examination is recommended in order to find distant metastasis as early as possible.