Low grade intracranial meningioma presenting with pulmonary metastasis: Case report and literature review

Meningioma is a common neoplasm in the central nervous system. Even though most meningiomas tend to have a benign, indolent clinical course, metastasis can occur. We describe a case of a 59-year-old woman who presented with an incidental finding of multiple lung masses. The patient underwent a wedge lung excision, and a diagnosis of meningioma was rendered. Magnetic resonance imaging of the brain revealed an extra-axial mass with left transverse venous sinus involvement, supporting the diagnosis of metastatic meningioma to the lung. Metastatic meningioma can be a challenging diagnosis in a patient with no previous diagnosis of an intracranial lesion. Thus, it should be considered in the differential diagnosis when encountering a spindled cell proliferation with a whorled pattern and psammoma bodies. Positive immunohistochemical staining with epithelial membrane antigen (EMA) and vimentin may be helpful in achieving the diagnosis.