Summary
While several cases of cancer metastatic to cranial meningiomas have been reported, metastasis to spinal meningioma has been reported only once, and a mechanism for such metastases has not been investigated. We report a case of breast carcinoma metastatic to an epidural cervical meningioma, summarize the literature on metastases to central nervous system meningiomas, and suggest a possible mechanism. Our patient, a 55-year-old woman, presented with difficulty walking, back pain, and quadriparesis. Magnetic resonance imaging revealed an enhancing C3-4 epidural lesion and an L4 compression fracture. Because of concern that the fracture and epidural lesion might represent metastases, we performed a metastatic work-up, which revealed a right breast mass. The patient underwent C3-C4 laminectomies and an epidural lesion was encountered. Intraoperative frozen section revealed mixed meningioma and breast adenocarcinoma. A gross total resection was achieved and the patient subsequently received spinal irradiation and hormonal therapy. Whereas a literature review revealed numerous reports of metastases to cranial meningiomas, this represents only the second reported case of such pathology in the spine. Mechanisms of this unusual process likely include meningiomas’ vascularity, meningiomas’ slow growth providing nutrient availability, and perhaps, as suggested by our analysis, E-cadherin expression by both meningiomas and breast cancer. Metastasis to meningioma must be considered in an epidural spinal lesion in all patients with a known malignancy, with surgical aggressiveness tailored to the intraoperative pathologic diagnosis.
Similar content being viewed by others
Abbreviations
- GCDFP-15:
-
gross cystic disease fluid protein-15
- Ref. No.:
-
reference number
- TLSO:
-
thoraco-lumbo-sacral orthosis
References
M Salvati L Cervoni (1996) ArticleTitleAssociation of breast carcinoma and meningioma: report of nine new cases and review of the literature Tumori 82 491–493 Occurrence Handle9063531
I Elmaci G Ekinci O Kurtkaya A Sav MN Pamir (2001) ArticleTitleTumor in tumor: metastasis of breast carcinoma to intracranial meningioma Tumori 87 423–427 Occurrence Handle11989598
SA Bernstein (1933) ArticleTitleUber Karzinommetastase in einem Duraendotheliom Zentralbl Allg Pathol 58 163–166
J Lapresle MG Netsky HM Zimmerman (1952) ArticleTitleThe pathology of meningiomas. A study of 121 cases Am J Pathol 28 757–791 Occurrence Handle12976523
B Helpap (1965) ArticleTitleMammakarzinom Metastase in einem Meningiom Zentralbl Allg Pathol 108 242–245
FH Anlyan BR Heinzen R Carras (1970) ArticleTitleMetastasis of tumor to second different tumor: collision tumors JAMA 212 2124 Occurrence Handle10.1001/jama.212.12.2124 Occurrence Handle5467793
A Theologides JC Lee (1972) ArticleTitleTumor to tumor metastasis JAMA 219 384 Occurrence Handle10.1001/jama.219.3.384b
L DiBonito C Bianchi (1978) ArticleTitleMetastase d’un cancer mammaire dans un meningiome Arch Anat Cytol Pathol 26 175–176 Occurrence Handle749691
E Nunnery SuffixJr EB Kahn SA Rudnick (1980) ArticleTitleBreast carcinoma metastatic to meningioma Arch Pathol Lab Med 104 392–393
S Lodrini M Savoiardo (1981) ArticleTitleMetastases of carcinoma to intracranial meningioma: report of two cases and review of the literature Cancer 48 2668–2673 Occurrence Handle7306923
H Barz (1983) ArticleTitleZur Haufigkeit der Metastasierung maligner Tumoren in Meningiome Zentralbl Allg Pathol 127 367–374 Occurrence Handle6880445
LI Zon WD Johns PC Stomper WD Kaplan JL Connolly JH Morris JR Harris IC Henderson AT Skarin (1989) ArticleTitleBreast carcinoma metastatic to a meningioma. Case report and review of the literature Arch Intern Med 149 959–962 Occurrence Handle10.1001/archinte.149.4.959 Occurrence Handle2650648
A Bucciero MDB DeCaro L Vizioloi S Carraturo A Cerillo G Tedeschi (1992) ArticleTitleMetastasis of breast carcinoma to intracranial meningioma. Case report and review of the literature J Neurosurg Sci 36 169–172 Occurrence Handle1484305
LWC Chow KH Ho CM Fong (1992) ArticleTitleIntracranial meningioma with metastatic breast carcinoma Ann Oncol 3 409–410
L Cervoni M Salvati D Gagliardi R Delfini (1994) ArticleTitleMetastasis of breast carcinoma to intracranial meningioma: case report Neurosurg Rev 17 233–236 Occurrence Handle10.1007/BF00418442 Occurrence Handle7838405
A Lee C Wallace B Rewcastle G Sutherland (1998) ArticleTitleMetastases to meningioma Am J Neuroradiol 19 1120–1122 Occurrence Handle9672023
L DiBonito L Giarelli G Falconieri D Bonifacio-Gori G Tomasic P Vielh (1993) ArticleTitleAssociation of breast cancer and meningioma: report of 12 new cases and review of the literature Pathol Res Pract 189 399–404 Occurrence Handle8351240
K Makoto T Fukutomi S Akashi-Tanaka T Hasegawa (2001) ArticleTitleAssociation of breast cancer with meningioma: report of a case and review of the literature Jpn J Clin Oncol 31 510–513 Occurrence Handle10.1093/jjco/hye109 Occurrence Handle11696622
AD Hockley (1975) ArticleTitleMetastatic carcinoma in a spinal meningioma J Neurol Neurosurg Psychiatr 38 695–697 Occurrence Handle1159441
JJ Kepes (1976) ArticleTitleCellular whorls in brain tumors other than meningiomas Cancer 37 2232–2237 Occurrence Handle177186
VM Joglekar CH Davis CG Blakeney (1981) ArticleTitleMetastasis of carcinoma to meningioma and glioma Acta Neurochir 58 67–74 Occurrence Handle10.1007/BF01401684
Y Doron J Gruskiewicz (1987) ArticleTitleMetastasis of invasive carcinoma of the breast to an extradural meningioma of the cranial vault Cancer 60 1081–1084 Occurrence Handle3300947
HP Schmitt (1984) ArticleTitleMetastases of malignant neoplasms to intracranial tumors: the “tumor-in-a tumor” phenomenon Virchows Arch 405 155–160 Occurrence Handle10.1007/BF00694933
PW Chambers RL Davis M Blanding SuffixJr. FS Buck (1980) ArticleTitleMetastases to primary intracranial meningioma and neurilemomas Arch Pathol Lab Med 104 350–354 Occurrence Handle6893121
G Cserni R Bori E Huszka AC Kiss (2002) ArticleTitleMetastasis of pulmonary adenocarcinoma in right Sylvian secretory meningioma Br J Neurosurg 16 66–68 Occurrence Handle10.1080/026886902753512646 Occurrence Handle11926470
BM Fried (1930) ArticleTitleMetastatic inoculation of a meningioma by cancer cells from a bronchogenic carcinoma Am J Pathol 6 47–52
DT Hope L Symon (1978) ArticleTitleMetastasis of carcinoma to meningioma Acta Neurochir 40 307–313 Occurrence Handle10.1007/BF01774755
TD Weems JH Garcia (1977) ArticleTitleIntracranial meningioma containing metastatic foci South Med J 70 503–505 Occurrence Handle191937
PV Best (1963) ArticleTitleMetastatic carcinoma in a meningioma: report of a case J Neurosurg 20 892–894 Occurrence Handle14186085
CB Wilson EP Jenevein LR Bryant (1967) ArticleTitleCarcinoma of the lung metastatic to falx meningioma: case report J Neurosurg 27 161–165
AH Wolintz A Matri (1970) ArticleTitleMetastasis of carcinoma of lung to sphenoid ridge meningioma NY State J Med 70 2592–2598
BA Zoos (1970) ArticleTitleNeoplastic metastasis into a tumor Russ Arch Pathol 32 68–70
E Gyori (1976) ArticleTitleMetastatic carcinoma in meningioma South Med J 69 514–517 Occurrence Handle1265521
KL Ho (1980) ArticleTitleMetastasis of carcinoma to meningioma Arch Pathol Lab Med 104 394–395 Occurrence Handle6893130
HS Han EY Kim JY Han YB Kim TS Hwang YC Chu (2000) ArticleTitleMetastatic renal cell carcinoma in a meningioma: a case report J Korean Med Sci 15 593–597 Occurrence Handle11069000
TP Stortebecker (1951) ArticleTitleMetastatic hypernephroma of the brain from a neurosurgical point of view: a report of 19 cases J Neurosurg 8 185–197 Occurrence Handle14824981
DH Osterberg (1957) ArticleTitleMetastases of carcinoma to meningioma J Neurosurg 14 337–343 Occurrence Handle13429401
L Doring (1975) ArticleTitleMetastasis of carcinoma of prostate to meningioma Virchows Arch A Pathol Anat Histol 366 87–91 Occurrence Handle10.1007/BF00438681 Occurrence Handle804761
M Van Zandijcke J Casselman (1996) ArticleTitleMR imaging of a metastasis in a meningioma Acta Neurol Belg 96 329–331 Occurrence Handle9008785
WB Peison I Feigin (1961) ArticleTitleSuprasellar meningioma containing metastatic carcinoma: report of a case J Neurosurg 18 688–689 Occurrence Handle13733931
FP Smith M Slavik JS Macdonald (1978) ArticleTitleAssociation of breast cancer with meningioma: report of two cases and review of the literature Cancer 42 1992–1994 Occurrence Handle213189
T Watanabe H Fujisawa M Hasegawa Y Arakawa J Yamashita F Ueda M Suzuki (2002) ArticleTitleMetastasis of breast cancer to intracranial meningioma: case report Am J Clin Oncol 25 414–417 Occurrence Handle10.1097/00000421-200208000-00019 Occurrence Handle12151976
IJ Fidler (2003) ArticleTitleThe pathogenesis of cancer metastasis: the ‘seed and soil’ hypothesis revisited Nat Rev Cancer 3 453–458 Occurrence Handle10.1038/nrc1098 Occurrence Handle12778135
R Soffietti R Ruda R Mutani (1970) ArticleTitleManagement of brain metastases J Neurol 249 1357–1369 Occurrence Handle10.1007/s00415-002-0870-6
D Figarella-Branger JF Pellissier P Bouillot N Bianco M Mayan F Grisoli G Rougon (1994) ArticleTitleExpression of neural cell-adhesion molecule isoforms and epithelial cadherin adhesion molecules in 47 human meningiomas: correlation with clinical and morphologic data Mod Pathol 7 752–761 Occurrence Handle7824509
Y Ogawa K Hirakawa B Nakata T Fujihara T Sawada Y Kato K Yoshikawa M Sowa (1998) ArticleTitleExpression of intracellular adhesion molecule-1 in invasive breast cancer reflects low growth potential, negative lymph node involvement, and good prognosis Clin Cancer Res 4 31–6 Occurrence Handle9516949
A Zoltowska J Stepinski B Lewko et al. (2001) ArticleTitleNeural cell adhesion molecule in breast, colon, and lung carcinomas Arch Immunol Ther Exp 49 171–174
SM Arnold AB Young RK Munn RA Patchell N Nanayakkara WR Markesbery (1999) ArticleTitleExpression of p53, bcl-2, E-cadherin, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinases-1 in paired primary tumors and brain Metastasis Clin Cancer Res 5 4028–4033 Occurrence Handle10632335
AF Chambers AC Groom IC MacDonald (2002) ArticleTitleDissemination and growth of cancer cells in metastatic sites Nat Rev Can 2 563–572 Occurrence Handle10.1038/nrc865
M Rohringer GR Sutherland DF Louw et al. (1989) ArticleTitleIncidence and clincopathological features of meningioma J Neurosurg 71 665–672 Occurrence Handle2809720
FX Roux F Nataf M Pinaudeau G Borne B Devaux JF Meder (1996) ArticleTitleIntranspinal meningiomas: review of 54 cases with discussion of poor prognosis factors and modern therapeutic management Surg Neurol 46 458–463 Occurrence Handle10.1016/S0090-3019(96)00199-1 Occurrence Handle8874546
K Schwechheimer L Zhou W Birchmeier (1998) ArticleTitleE-Cadherin in human brain tumours: loss of immunoreactivity in malignant meningiomas Virchows Arch 432 163–7 Occurrence Handle10.1007/s004280050151 Occurrence Handle9504862
H Haft H Shenkin (1963) ArticleTitleSpinal epidural meningioma: case report J Neurosurg 20 801–804 Occurrence Handle14185000
D Zevgaridis C Thome (2002) ArticleTitlePurely epidural spinal meningioma mimicking metastatic tumor: case report and review of the literature Spine 27 E403–E405 Occurrence Handle10.1097/00007632-200209150-00021 Occurrence Handle12634576
D Schiff B O’Neill S Vera (1997) ArticleTitleSpinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach Neurology 49 452–456 Occurrence Handle9270576
C Majos J Alonso C Aguilera M Serrallonga J Perez-Martin JJ Acebes C Arus J Gili (2003) ArticleTitleProton magnetic resonance spectroscopy ((1)H MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization Eur J Radiol 13 582–591
FJ Cooke AM Blamire DM Manners P Styles Rajagopalan (2004) ArticleTitleQuantitative proton magnetic resonance spectroscopy of the cervical spinal cord Magn Reson Med 51 1122–1128 Occurrence Handle10.1002/mrm.20084 Occurrence Handle15170831
JD Eastwood DA Turner RE McLendon JM Provenzale (2001) ArticleTitleDiffusion-weighted MR imaging in a patient with spinal meningioma Am J Neuroradiol 177 1479–1481
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Aghi, M., Kiehl, TR. & Brisman, J.L. Breast Adenocarcinoma Metastatic to Epidural Cervical Spine Meningioma: Case Report and Review of the Literature. J Neurooncol 75, 149–155 (2005). https://doi.org/10.1007/s11060-005-1408-4
Issue Date:
DOI: https://doi.org/10.1007/s11060-005-1408-4