Abstract
Meningiomas rarely metastasize through the cerebrospinal pathway. The authors reported a case of cerebrospinal fluid(CSF)dissemination of malignant meningioma. A 49-year-old female was admitted to our hospital with progressive nausea and headache. MRI demonstrated a space occupying lesion in the right-mid frontal area which was homogeneously enhanced with Gd-DTPA. The tumor which was attached to the falx was resected subtotally. Because of the rapid tumor progression, a reoperation was done in 3 months after the initial operation. Pathohistological examinations revealed meningotheliomatous meningioma mixed with a sarcomatous component. Postoperative irradiation could not be performed because of patient's refusal. In 9 months after the initial operation, the patient developed tetraparesis, dysarthria, dysphagia, and disturbance of consciousness. MRI disclosed the metastatic tumor at the lower half of the fourth ventricle protruding into the medulla oblongata. This tumor in the fourth ventricle was totally removed and found to be consisted of only sarcomatous component pathohistologically. Although her neurological status improved postoperatively, she expired 3 weeks after operation. Seventeen reported cases and our case are summarized and reviewed. Malignant meningioma may have the high tendency for the CSF dissemination.
