May 2014
A 50-year-old woman with acute left-sided visual disturbance and altered facial sensation. Past medical history: hypertension, asthma, hypothyroidism, and polymyalgia rheumatica.
Synchronous Benign Brain and Multiple Lung Meningiomas
- Meningiomas are the most common extra-axial CNS tumors arising from meningo-epithelial arachnoid cells. Ectopic meningiomas result from differentiation of ectopic arachnoid cells. They occur outside the CNS in the neck, paraspinal soft tissues, lungs, mediastinum, foot, and skin.
- Clinical Presentation: Non-sepcific headache is the most common symptom
- Key Diagnostic Features: Hyperdense, homogenously enhancing extra-axial mass lesion. Enhancing dural tail is commonly seen and is not specific (only establishes extra-axial nature of the lesion). Presence of hyperostosis (and pneumosinus dilatans when adjacent to paranasal sinuses) is highly suggestive of meningioma. Pulmonary lesions are seen as well-defined soft tissue nodules. Psamoma bodies have been reported.
- DDx: Metastasis, lymphoma, granulomatous disorders
- Rx: Surgery and/or chemoradiotherapy of the brain lesion. The lung lesions have an indolent course.
