Recurrent lumbosacral metastases from intracranial meningioma. Report of acase and review of the literature

We report a case of a 31 year-old woman who in 1991 presented a clinical hi story of headaches, nausea and vomiting. CT scan showed a right frontotempo ral meningioma. The first operation achieved a macroscopically complete res ection. The tumour was histologically classified as a transitional meningio ma. There were recurrences of the intracranial meningioma in 1994, 1996, 19 97 and 1998. These recurrences were accompanied by differentiation to atypical and anapl astic meningioma. In all of these operations, a macroscopically complete re section of the turnout was performed. In 1996 adjuvant radiation therapy wa s given. In 1998 therapy with bromocriptine was adopted. In April 1999, the patient presented with lumbosacral pain associated with L5 bilateral sciatica. MRI showed a gadolinium enhancing mass lesion at L5- S1 level. Complete turnout resection was performed. The histological findin gs were the same as in 1998. In December 1999 the patient presented with pe rineal pain and MRI showed a L4 and S3 recurrence and the tumour was resect ed. The histological findings were those of a malignant meningioma. In February 2000 an intracranial recurrence was detected and operated on. T he histological diagnosis was malignant meningioma. A review of the literature was undertake and is discussed.