[Metastatic meningiomas: a case series and literature review].

Abstract

Background: The probability of meningiomas metastasizing is 0.18%, and the causes are unclear. The most common localizations of extracranial metastases are lung (37.2%), bones (16.5%) and liver (9.2%). There are no effective treatment algorithms for metastatic meningiomas. Treatment tactics consists of symptomatic surgery and radiotherapy.

Material and methods: We present 3 patients including a 75-year-old woman with grade 1 meningioma and metastasis to occipital lymph node, a 59-year-old man with meningioma grade 2 and lung metastasis, a 45-year-old woman with grade 2 meningioma with extracranial component and lung metastasis.

Results and discussion: A female patient with grade 1 meningioma and occipital lymph node metastasis showed clinical stabilization after surgical treatment. The follow-up was 14 months. Treatment with nitrosourea was ineffective for metastatic lung lesions in a patient with grade II meningioma. Combination of bevacizumab and everolimus in a patient with G2 meningioma within craniovertebral junction and metastatic lung lesion achieved stabilization in all foci. The follow-up was 6 months.

Conclusion: It is necessary to continue accumulation of clinical experience due to rarity of meningioma metastasizing. Treatment of such patients remains individual.