• M Knoop, S Sola, R Hebecker, S Mann, H-G Bauer, and W Schmidt.
• Abteilung für Neurochirurgie, Klinik und Poliklinik für Chirurgie, Universität Rostock. michael.knoop@med.uni-rostock.de
• Dtsch. Med. Wochenschr. 2004 Sep 3;129(36):1854-7.

History And Clinical FindingsA 53-year-old sailor was admitted to our department with the history of severe headache, dysphasia and mild psychotic behavior. Routine chest X-rays several weeks before had shown a focal lung lesion in the lower lobe of the right lung. The patient was without pulmonary symptoms.InvestigationsBrain magnetic resonance imaging demonstrated a large intracranial extracerebral mass with perifocal brain edema in the right frontoparietal region.TherapyThe patient was suspected of having a metastasis of an unknown primary tumor. Craniotomy and total removal of the tumor was performed. Histological examination revealed a meningothelial meningioma without signs of malignancy. 6 weeks later thoracotomy and total removal of the lung tumor were performed. Histological examination revealed a meningioma with the same histological pattern as the intracranial lesion. Postoperatively there were no complications, the physical examination at discharge was normal without any pulmonary or neurological deficits. Two years later, we found no evidence of an intracranial or pulmonary tumor recurrence.ConclusionPulmonary metastases of benign intracranial meningiomas are rare but should be considered in the differential diagnosis, especially in cases with an undiscovered primary tumor.

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