Primary pulmonary meningioma: a case report and literature review.

Abstract

Introduction: Primary pulmonary meningioma is a rare disease. There have been only a little over 50 cases of primary pulmonary meningioma (PPM) reported in previous literature. The pathogenesis of PPM is still unclear. We report a case of PPM cured by thoracoscopic right middle lobe wedge resection and systematically review previously reported cases in previous literature.

Case report: A 57-year-old male patient was found to have a nodule in the right middle lobe of about 1.8 cm in diameter on a chest-enhanced CT scan performed more than 7 years ago. A re-examination in 2023 found the subpleural nodule in the right middle lobe had grown larger than before. Considering surgical treatment, the patient underwent a thoracoscopic right middle lobe wedge resection after a thorough examination. The final pathological diagnosis was primary pulmonary meningioma. Regular follow-up CT scans showed no recurrence.

Conclusion: Primary pulmonary meningioma is a rare tumor that occurs in sites similar to lung cancer. Most cases are solitary, presenting as ground-glass nodules (GGO), and can occur in multiple lobes, involving the mediastinum and pleura with multiple nodules. Clinical and radiological diagnoses are often challenging, especially distinguishing from primary lung cancer. Surgery remains the optimal choice for the diagnosis and treatment of PPM. Most cases are benign with a good prognosis, and wedge resection is usually the preferred surgical approach. A small proportion of malignant cases may require lobectomy and adjuvant radiotherapy and chemotherapy due to tumor invasiveness.