MS-26 EXTRA CRANIAL METASTASIS IN A CASE OF CEREBRAL MENINGIOMA: A RARE CASE REPORT

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2014-11, Vol.16 (suppl 5), p.v132-v132
• Main Authors: Syed, F., Lachi, P., Chakravarthy, P., Uppin, S., Syed, A., Nair, D., Joseph, D., Irrakula, M., Pamidighantam, S., Naidu, K.
• Format: Article
• Language: English
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nou260.25

Thirty one year aged male presented in Apr 2010 with complaints of headache and seizures. MRI brain showed a well defined extra axial lesion situated on right side of the coronal suture extending posteriorly in the parasagittal region which is hypointense to isointense on T1 W, & T2 W showing heterogenously enhancement on contrast administration. He underwent right frontal paramedian pericoronal craniotomy and total excision of the lesion. Intra operatively a large highly vascular firm dural based lesion attached to right frontal cortex. Post operative histopathology was - Grade 1 Fibroblastic Meningioma. After one year he presented with complaints of headache, vomiting and weakness of left upperlimb and lower limb. CT Brain showed a well defined hyper intense lesion with central hypodensity with perilesional edemaand features suggestive of recurrence. Second surgery done was right fronto parietal craniotomy and total excision of lesion. Intra operatively large highly vascular firm to soft suckable tumor attached at junction of falx and sinus embedding into right frontal cortexfound and gross total excison of tumor done. Post operative histopathology was grade III Meningioma. Post operatively he received adjuvant radiation therapy to Brain by 3Dimensional conformal radiotherapy on Linear accelerator to a dose of 60Gy [at] 2Gy per fraction. He tolerated radiotherapy well and was on regular follow-up. In November 2013, he presented with complaints of chest pain and cough. CT Chest - Multiple inhomogenously enhancing lesions, involving both lungs, largest measuring 5 x 4.8 cm. CT guided biopsy - lung: Morphology and IHC with Vimentin- positive, EMA - positive, P63 - focally positive, TTF - negative, Ki 67 - 7%, suggestive of multiple pulmonary metastases in a diagnosed case of anaplastic meningioma. Now patient on palliative chemotherapy with Vincristine, Adriamycin and cyclophosphamide and he is doing well.