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Intrameningioma metastasis: A case-based literature review

      Highlights

      • Tumor-to-tumor metastasis is rare.
      • “Tumor-to-tumor metastasis” and “collision tumor” are not synonymous.
      • Lung and breast cancer are frequent sites of origin.
      • Vascularisation, metabolic milieu, and tumor microenvironment predispose for host-recipient-interaction.

      Abstract

      A tumor-to-tumor metastasis inside a meningioma is a rare phenomenon. Malignant neoplasms of the breast and lung are the most common primary tumors. Other sites of origin include prostate, renal and gastric neoplasms. The included case files were retrieved from the medical records of the University Hospital of Crete, Greece. A review of the literature was conducted in March 2020 via PubMed. Relevant search results were few. We report a case of a 66-year-old female, with known Small Cell Lung Cancer, who presented with left-sided hemiparesis. The Magnetic Resonance Imaging scan revealed a right frontal extra-axial mass. The patient underwent a craniotomy and a gross total removal of the tumor. Histological examination of the excised mass revealed metastatic adenocarcinoma deposits inside a meningioma: tumor-to-tumor metastasis. Reviewing the available literature, it has been hypothesized that the following factors play a role in the pathophysiology of this phenomenon: progesterone and estrogen receptors, cell-to-cell adhesion molecules, rich vascularization, favorable metabolic, micro-and immunological environment. Meningiomas seem to be the most common type of intracranial neoplasm to host a metastasis. There is a difference between tumor-to-tumor metastasis and collision tumors. The former implies a recipient role of the host tumor, and the latter refers to a co-localization of two different tumors that grow into one another, both being in the same organ. Tumor-to-tumor brain metastasis is a well-described phenomenon but with unclear pathophysiology. Deeper knowledge could be beneficial for its management.

      Keywords

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      References

      1. Greenberg MS. Handbook of neurosurgery. 2020.

      2. Nadeem M, Assad S, Nasir H, Mansoor S, Khan I, Manzoor H, et al. Intrameningioma metastasis: clinical manifestation of occult primary lung carcinoma. Cureus 2016;8:e704. https://doi.org/10.7759/cureus.704.

        • Sayegh E.T.
        • Henderson G.A.
        • Burch E.A.
        • Reis G.F.
        • Cha S.
        • Oh T.
        • et al.
        Intrameningioma metastasis of breast carcinoma.
        Rare Tumors. 2014; 6: 49-52https://doi.org/10.4081/rt.2014.5313
        • Greenberg M.S.
        • Abel N.
        • Meningeal A.S.
        Mesenchymal and melanocytic tumors.
        Handb. Neurosurg Georg Thieme Verlag. 2020; https://doi.org/10.1055/b-006-161147
        • Hamperl M.
        • Goehre F.
        • Schwan S.
        • Jahromi B.R.
        • Friedmann A.
        • Ludtka C.M.
        • et al.
        Tumor-to-tumor metastasis–bronchial carcinoma in meningioma.
        Clin Neuropathol. 2015; 34: 302-306https://doi.org/10.5414/NP300856
        • Greenberg M.S.
        • Abel N.
        • Agazzi S.
        Metastases to the brain.
        Handb Neurosurg Georg Thieme Verlag. 2020; https://doi.org/10.1055/b-006-161147
      3. Zerris VA, editor. 4.15 Cerebral Metastases (Table 4.15). Neurosurg. Rev. Dly. Clin. Use Oral Board Prep., Stuttgart: Georg Thieme Verlag; 2019, p. b-006-164725. https://doi.org/10.1055/b-006-164725.

        • Başaran A.E.
        • Kiesel B.
        • Frischer J.M.
        • Furtner J.
        • Wöhrer A.
        • Dieckmann K.
        • et al.
        Intrameningioma metastasis: a wolf in sheep’s clothing? Experience from a series of 7 cases.
        World Neurosurg. 2019; 132: 169-172https://doi.org/10.1016/j.wneu.2019.08.097
        • Syed S.
        • Karambizi D.I.
        • Baker A.
        • Groh D.M.
        • Toms S.A.
        A comparative report on intracranial tumor-to-tumor metastasis and collision tumors.
        World Neurosurg. 2018; 116 (454.e2–463.e2)https://doi.org/10.1016/j.wneu.2018.04.109
        • Carr K.
        • He L.
        • Weaver K.
        • Nickols H.H.
        Renal cell carcinoma metastatic to meningioma: tumor-to-tumor metastasis.
        Clin Neuropathol. 2014; 33: 152-156https://doi.org/10.5414/NP300680
        • Iżycka-Świeszewska E.
        • Czapiewski P.
        • Szurowska E.
        • Borof D.
        • Wesołowski W.
        • Kloc W.
        Cancer metastases to meningioma: apropos two cases.
        Folia Neuropathol. 2013; 51: 340-346https://doi.org/10.5114/fn.2013.39725
        • Turner N.
        • Kaye A.H.
        • Paldor I.
        Metastases to meningioma-review and meta-analysis.
        Acta Neurochir (Wien). 2021; 163: 699-709https://doi.org/10.1007/s00701-020-04661-7
        • Liu N.
        • Guli Q.-R.
        • Ming X.-C.
        • Zhou H.-T.
        • Cui Y.-J.
        • Zhang D.
        • et al.
        Tumor-to-tumor metastasis: lung adenocarcinoma metastasizing to intracranial benign meningioma as a first clinical manifestation, with literature review.
        Int J Clin Exp Pathol. 2018; 11: 2852-2858
        • Ravnik J.
        • Ravnik M.
        • Bunc G.
        • Glumbic I.
        • Tobi-Veres E.
        • Velnar T.
        Metastasis of an occult pulmonary carcinoma into meningioma: a case report.
        World J Surg Oncol. 2015; 13: 292https://doi.org/10.1186/s12957-015-0714-3
        • How E.
        • Lee R.
        • Kasem K.
        • Withers T.
        Surprise within a meningioma: case report of signet ring cell carcinoma metastasis in a meningioma.
        ANZ J Surg. 2017; 87: E157-E158https://doi.org/10.1111/ans.13045
        • Das S.
        • Chaudhary N.
        • Ang L.-C.
        • Megyesi J.S.
        Papillary thyroid carcinoma metastasizing to anaplastic meningioma: an unusual case of tumor-to-tumor metastasis.
        Brain Tumor Pathol. 2017; 34: 130-134https://doi.org/10.1007/s10014-017-0289-5
        • Bhojwani N.
        • Huang J.
        • Gupta A.
        • Badve C.
        • Cohen M.L.
        • Wolansky L.J.
        Rectal carcinoid tumor metastasis to a skull base meningioma.
        Neuroradiol J. 2016; 29: 49-51https://doi.org/10.1177/1971400915624113
        • Pham J.T.
        • Kim R.C.
        • Nguyen A.
        • Bota D.
        • Kong X.-T.
        • Vadera S.
        • et al.
        Intracranial meningioma with carcinoma tumor-to-tumor metastasis: two case reports.
        CNS Oncol. 2018; 7: CNS09https://doi.org/10.2217/cns-2017-0022
        • Lanotte M.
        • Benech F.
        • Panciani P.P.
        • Cassoni P.
        • Ducati A.
        Systemic cancer metastasis in a meningioma: report of two cases and review of the literature.
        Clin Neurol Neurosurg. 2009; 111: 87-93https://doi.org/10.1016/j.clineuro.2008.07.011
        • Campbell L.V.
        • Gilbert E.
        • Chamberlain C.R.
        • Watne A.L.
        Metastases of cancer to cancer.
        Cancer. 1968; 22: 635-643https://doi.org/10.1002/1097-0142(196809)22:3<635::aid-cncr2820220320>3.0.co;2-o
        • Kumar V.
        • Abbas A.K.
        • Aster J.C.
        Robbins Basic Pathology E-Book.
        Elsevier, 2017
        • Bhargava P.
        • McGrail K.M.
        • Manz H.J.
        • Baidas S.
        Lung carcinoma presenting as metastasis to intracranial meningioma: case report and review of the literature.
        Am J Clin Oncol. 1999; 22: 199-202https://doi.org/10.1097/00000421-199904000-00022
        • Chambers P.W.
        • Davis R.L.
        • Blanding J.D.
        • Buck F.S.
        Metastases to primary intracranial meningiomas and neurilemomas.
        Arch Pathol Lab Med. 1980; 104: 350-354
        • Glass R.
        • Hukku S.R.
        • Gershenhorn B.
        • Alzate J.
        • Tan B.
        Metastasis of lung adenosquamous carcinoma to meningioma: case report with literature review.
        Int J Clin Exp Pathol. 2013; 6: 2625-2630
        • Pamphlett R.
        Carcinoma metastasis to meningioma.
        J Neurol Neurosurg Psychiatry. 1984; 47: 561-563https://doi.org/10.1136/jnnp.47.5.561
        • Bansil R.
        • Walia B.S.
        • Khan Z.
        • Abrari A.
        Metastasis to a spinal meningioma.
        Surg Neurol Int. 2017; 8: 102https://doi.org/10.4103/sni.sni_466_16
        • Sayegh E.T.
        • Burch E.A.
        • Henderson G.A.
        • Oh T.
        • Bloch O.
        • Parsa A.T.
        Tumor-to-tumor metastasis: breast carcinoma to meningioma.
        J Clin Neurosci. 2015; 22: 268-274https://doi.org/10.1016/j.jocn.2014.07.002
      4. Nowosielski M, Galldiks N, Iglseder S, Kickingereder P, von Deimling A, Bendszus M, et al. Diagnostic challenges in meningioma. Neuro-Oncol 2017;19:1588–98. https://doi.org/10.1093/neuonc/nox101.

        • Greenberg H.
        • Chandler W.F.
        • Sandler H.M.
        Brain tumors.
        Oxford University Press, New York1999
      5. Huang RY, Bi WL, Griffith B, Kaufmann TJ, la Fougère C, Schmidt NO, et al. Imaging and diagnostic advances for intracranial meningiomas. Neuro-Oncol 2019;21:i44–61. https://doi.org/10.1093/neuonc/noy143.

      6. Tonn J-C, Tonn-Westphal-Rutka, editors. Oncology of CNS tumors. 2. ed. Berlin: Springer; 2010.

        • Goldbrunner R.
        • Minniti G.
        • Preusser M.
        • Jenkinson M.D.
        • Sallabanda K.
        • Houdart E.
        • et al.
        EANO guidelines for the diagnosis and treatment of meningiomas.
        Lancet Oncol. 2016; 17: e383-e391https://doi.org/10.1016/S1470-2045(16)30321-7
      7. Fukushima Y, Ota T, Mukasa A, Uozaki H, Kawai K, Saito N. Tumor-to-tumor metastasis: lung adenocarcinoma metastasizing to vestibular schwannoma suspected on preoperative [18F]-fluorodeoxyglucose positron emission tomography imaging. World Neurosurg 2012;78:553.e9-553.e13. https://doi.org/10.1016/j.wneu.2011.10.031.

      8. Fuller C. A little piece of mind: best practices for brain tumor intraoperative consultation. Mod Pathol 2019;32:44–57. https://doi.org/10.1038/s41379-018-0147-y.

        • Somerset H.L.
        • Kleinschmidt-DeMasters B.K.
        Approach to the intraoperative consultation for neurosurgical specimens.
        Adv Anat Pathol. 2011; 18: 446-449https://doi.org/10.1097/PAP.0b013e3182169934
        • Tofte K.
        • Berger C.
        • Torp S.H.
        • Solheim O.
        The diagnostic properties of frozen sections in suspected intracranial tumors: A study of 578 consecutive cases.
        Surg Neurol Int. 2014; 5: 170https://doi.org/10.4103/2152-7806.146153
        • Richter B.
        • Harinath L.
        • Pu C.
        • Stabingas K.
        Metastatic spread of systemic neoplasms to central nervous system tumors: review of the literature and case presentation of esophageal carcinoma metastatic to meningioma.
        Clin Neuropathol. 2017; 2017: 60-65https://doi.org/10.5414/NP300980
        • Moody P.
        • Murtagh K.
        • Piduru S.
        • Brem S.
        • Murtagh R.
        • Rojiani A.M.
        Tumor-to-tumor metastasis: pathology and neuroimaging considerations.
        Int J Clin Exp Pathol. 2012; 5: 367-373
        • Watanabe T.
        • Fujisawa H.
        • Hasegawa M.
        • Arakawa Y.
        • Yamashita J.
        • Ueda F.
        • et al.
        Metastasis of breast cancer to intracranial meningioma: case report.
        Am J Clin Oncol. 2002; 25: 414-417https://doi.org/10.1097/00000421-200208000-00019
        • Okada E.
        • Nakamura M.
        • Koshida Y.
        • Mukai K.
        • Toyama Y.
        • Matsumoto M.
        Breast carcinoma metastasis to meningioma in the thoracic spine: A case report and review of the literature.
        J Spinal Cord Med. 2015; 38: 231-235https://doi.org/10.1179/2045772314Y.0000000201
        • Zerris V.A.
        Neurosurgical review: for daily clinical use and oral board preparation.
        Thieme, New York2020
      9. Giridhar P. Brain Metastases. In: Mallick S, Giridhar P, Rath GK, editors. Evid. Based Pract. Neuro-Oncol., Singapore: Springer Singapore; 2021, p. 363–71. https://doi.org/10.1007/978-981-16-2659-3_35.

        • Le Rhun E.
        • Preusser M.
        • van den Bent M.
        • Andratschke N.
        • Weller M.
        How we treat patients with leptomeningeal metastases.
        ESMO Open. 2019; 4: e000507https://doi.org/10.1136/esmoopen-2019-000507
      10. B.J. Scott N.A. Oberheim-Bush S. Kesari Leptomeningeal metastasis in breast cancer - a systematic review Oncotarget 7 2016 3740 7 https://doi.org/10.18632/oncotarget.5911

        • Eren B.
        • Guzey F.K.
        • Gulec I.
        • Tufan A.
        Metastatic gallbladder carcinoma in meningioma: a case report.
        Turk Neurosurg. 2019; 29: 297-299https://doi.org/10.5137/1019-5149.JTN.20824-17.0