SPINAL METASTASES OF MALIGNANT INTRACRANIAL MENINGIOMA

BACKGROUND Spinal metastasis of intracranial meningiomas has rarely be en reported. Three out of ten previously reported cases of malignant m eningioma metastasizing to the spine had undergone surgical debulking with no neurological improvement. The authors retrospectively reviewed the treatment course of three patients with malignant meningioma meta stasizing to the spine who underwent early magnetic resonance imaging (MRI) and radiotherapy without surgical debulking. CASE DESCRIPTION Th ree patients with intracranial malignant meningiomas underwent multipl e resections of intracranial lesions, and developed spinal intradural metastases an average of 64 months (range, 27-102 months) from their i nitial presentation. All three patients had at least two operations fo r recurrent intracranial tumors. All had localized back pain with moto r weakness, and MRI scans demonstrated spinal involvement. No surgical exploration was performed for the spinal lesions; rather, all patient s received steroids and radiotherapy for the spinal lesions. All three patients improved neurologically after the steroid and radiation trea tments, and went on to survive from 3 to 18 months. CONCLUSION Early M RI should be performed in patients with spinal symptoms and signs afte r the treatment of intracranial meningiomas. Radiotherapy is an effect ive palliative treatment for spinal metastases. (C) 1998 by Elsevier S cience Inc.