Incidence of metastatic meningiomas and recommendations for screening of high-risk patients

The presence of extracranial metastasis is quite rare, accounting for only 0.1%-0.76%The literature reports that the organs of meningioma metastasis include the lungs, liver, lymph nodes and bones; Because the incidence of extracranial metastasis is very low, the follow-up of patients after excision is mostly concerned only with the tumor status of the original site of CNS, and does not screen for the distant site- Excerpted from the article chapter
(Ref: Dalle Ore CL), et alJ Neurosurg2019 Apr 5:1-9Doi: 10.3171/2019.1.JNS181771meningioma is a common primary tumor in the cranial system, accounting for more than 30% of primary tumors of the central nervous system (CNS)The vast majority of meningioma is benign, surgical lycing or radiotherapy can be well controlledThe presence of extracranial metastasis is quite rare, accounting for only 0.1%-0.76%The literature reports that the organs of meningioma metastasis include the lungs, liver, lymph nodes and bones; Because the incidence of extracranial metastasis is very low, the follow-up of patients after excision is mostly concerned only with the tumor status of the original site of CNS, and does not screen for the distant siteTo this end, there are clinical questions: What kind of patients need to be screened for remote site transfer? What is the choice of screening and at what interval? Cecilia LDalle Ore of neurosurgery at the University of California, San Francisco (UCSF) and others retrospectively analyzed the prognosis and screening of metastatic meningiomasThe paper was published online in April 2019 in J Neurosurgthe authors reviewed patients with meningioma treated with primary or recurrent, surgical lycilloleavel, or gamma knife treatment at UCSF between 2009 and 2017, especially those who were "diagnosed with extracranial metastasis by imaging examination" or "imaging screening for metastasis." Full-body imaging screening, including CHEST, abdominal and pelvic CT scans, or full-body PET-CT scans, was performed in patients with symptoms of extracranial related areas or recurrence of intracranial meninges more than twicestudy included 1,193 patients with meningiomaOf these, 922 were WHO I, 236 were WHO II and 35 were WHO III The average follow-up time after surgery was 4.3 years, and in 207 patients, the average number of relapses was 1.8 For 28 patients with an average recurrence of 3 tumors, including 5 cases of symptoms of the relevant site, screening for metastasis The 28 cases of meningioma pathology were graded: 1 at THE WHO I, 16 in WHO II and 11 in WHO III whole body imaging examination results indicate that 10 cases of suspicious extracranial metastasis, respectively, liver transfer 5 cases, lung 3 cases, 1 case of progenitor and 1 case of bone (Figure 1) 8 cases were confirmed by biopsy as meningioma metastasis, 1 case was other malignant tumors withnonmenades, and 1 case was lost before biopsy a 75-year-old female patient who surgically removed parallel 54Gy radiation therapy five years ago from a sinus side meningioma A.5 years later, MRI-T2 axon phase indicates a high signal of tumor and tumor-perimeter edema, the recurrence of the sabre-shaped sinus side tumor attack and blocking the upper sinus; Chiropractic meningioma; C 3 years after second surgery, intracranial tumors were found to recur; whole body PET-CT scans revealed high intake lesions of FDG in the lower left lung; d puncture biopsy confirmed as metastatic meningioma overall, , there were 8 cases of extracranial metastasis in 1193 patients with meningioma, with an incidence rate of 0.67% Five (2%) excranial metastases were WHO II and 3 (8.6%) were WHO III It can be seen that patients with multiple intracranial recurrences of meningioma, there is a possibility of extracranial transfer, should be regularly screened throughout the body study showed that patients with high levels of pathology and multiple recurrences of meningioma were at high risk for extracranial metastasis Whether or not there are symptoms associated with the remote area, a full-body imaging examination should be performed to facilitate early detection and early treatment.