Turkish Neurosurgery 2005 , Vol 15 , Num 3
Seeding Metastasis in the Scalp After Removal of the Meningioma: A Case Report
Müslüm GÜNEŞ1, Bekir TUĞCU1, Ömür GÜNALDI1, Utku ADİLAY1, Çiçek BAYINDIR2, Semih BİLGİÇ1
12nd Neurosurgery Clinic, Bakırköy Mental Health and Nervous Diseases Education and Research Hospital, İstanbul, Turkey
2Department of Neuropathology, School of Medicine, İstanbul University, İstanbul, Turkey
INTRODUCTION: Meningiomas originate from meningothelial cells. Meningioma is a common neoplasm in the CNS, representing about 15-20 percent of all primary intracranial tumors. Although malignant forms may spread via blood, lymphatic drainage and cerebrospinal fluid to distant sites, metastasis from a low-grade meningioma is very unlikely.

CASE REPORT: A 19-year-old female was admitted to our hospital in 2001, with a one-month history of headache and two episodes of convulsions. Physical and neurological examinations were normal. Computed tomography and magnetic resonance imaging revealed an intracranial, extra-axial spaceoccupying lesion at the left frontal region. After total removal of the tumor, histopathology revealed WHO grade 1 meningioma. There was no neurological deficit after surgery. Three years after the tumor resection, subcutaneous metastasis developed on the scalp just behind the scar left by the previous surgery. Histopathology of the second lesion also revealed a WHO grade 1 meningioma.

CONCLUSION: Isolated distinct metastasis from malignant meningioma has been mentioned in two reports previously. This is the first report that shows the seeding metastasis from low-grade meningioma to the surgical trajectory in the subcutaneous tissue of the scalp. Keywords : Meningioma, metastasis, scalp

Corresponding author : Bekir Tuğcu, deniztugcu@superonline.com