From the Research
Meningiomas rarely metastasize outside the central nervous system, and when they do, they most commonly spread to the lungs, followed by the liver, bones, and adrenal gland, as seen in the cases reported by 1. When metastasis does occur, which happens in less than 1% of cases, these metastases typically develop from higher-grade (WHO grade II or III) meningiomas or those with malignant histological features. The mechanism of metastasis likely involves invasion of blood vessels or surgical seeding during resection procedures. Some of the common sites of metastasis include:
- Lungs
- Liver
- Bones
- Adrenal gland Patients with atypical or anaplastic meningiomas should undergo systemic imaging during follow-up to monitor for potential distant metastases, particularly if they show aggressive local behavior or recurrence, as suggested by the cases reported in 1 and the review of metastatic patterns in 2. The rarity of meningioma metastasis reflects the generally benign nature of these tumors, as most meningiomas (about 80%) are WHO grade I and remain localized to their site of origin in the meninges surrounding the brain and spinal cord. It is essential to note that the prevalence of metastases in meningioma may be underreported, as mentioned in 2, and therefore, a high index of suspicion and regular follow-up are necessary to detect these rare events. In the context of real-life clinical medicine, it is crucial to prioritize the detection and management of metastatic meningiomas to improve patient outcomes, as highlighted by the multimodal treatment approach discussed in 1.