[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-440280-105":59,"doc-detail-440280-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","intracranial-atypical-meningioma-with-multiple-pulmonary-metastases-illustrative-case","Intracranial atypical meningioma with multiple pulmonary metastases - illustrative case","","Intracranial atypical meningioma with extracranial spread to the lungs is rare, and this case report illustrates how atypical behavior can challenge diagnosis and long-term management. A 33-year-old man with WHO grade II atypical meningioma developed multiple pulmonary metastases seven years after initial intracranial treatment. Despite minimal progression and lack of symptoms, management emphasized structured surveillance with regular brain MRI and chest CT. Imaging later showed stable postoperative intracranial disease after recurrences and adjuvant radiotherapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/intracranial-atypical-meningioma-with-multiple-pulmonary-metastases-illustrative-case/440280/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/intracranial-atypical-meningioma-with-multiple-pulmonary-metastases-illustrative-case/440280.png","ImageObject",300,407,{"name":92,"@type":93},"Blue Pony","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How rare is extracranial metastasis from meningiomas, and where is it most commonly seen?","Question",{"text":112,"@type":113},"Extracranial metastatic meningiomas are exceedingly rare, occurring in less than 1% of cases. Among extracranial metastases, pulmonary involvement is the most frequently reported site.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What prompted evaluation for pulmonary disease in this patient?",{"text":117,"@type":113},"Approximately seven years after diagnosis, the patient developed gradually progressive shortness of breath and a dry cough. Chest imaging was pursued because no prior thoracic studies had been performed.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the management approach for pulmonary metastases in the absence of symptoms?",{"text":121,"@type":113},"Because the patient had no symptoms and pulmonary lesions showed minimal progression over follow-up, conservative management with structured surveillance was used, including regular cranial MRI and chest CT imaging.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},440280,1790960885,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","JOURNAL OF NEUROSURGERY:  \nCase Lessons  \nJ Neurosurg Case Lessons 11(1): CASE25761, 2026  \nDOI: 10.3171/CASE25761  \nIntracranial atypical meningioma with multiple pulmonary metastases: illustrative case  \nSerdar Solmaz, MD, and Cafer Ikbal Gulsever, MD  \nDepartment of Neurosurgery, Hakkari State Hospital, Hakkari, Turkey  \nBACKGROUND Extracranial metastasis from meningiomas is rare, with pulmonary involvement being the most frequent metastatic site. The authors present this case to highlight the diagnostic and management challenges associated with atypical meningiomas that metastasize outside the CNS, and to emphasize the importance of long-term surveillance even in patients with radiologically stable disease.  \nOBSERVATIONS A 33-year-old male was initially diagnosed with an intracranial atypical meningioma (WHO grade II, 2007 classification) characterized by increased cellularity, mild nuclear atypia, and a mitotic index ≥ 4 mitoses per 10 high-power fields, without brain invasion. Seven years later, he developed multiple pulmonary metastases confirmed by histopathological analysis. Given the absence of symptoms and minimal progression of pulmonary lesions over a 7-year follow-up period, the patient was managed conservatively with structured surveillance, including regular cranial MRI and chest CT imaging.  \nLESSONS This case demonstrates that long-term stability of pulmonary metastases from atypical meningioma is possible under conservative management. Structured surveillance with periodic cranial and thoracic imaging may be appropriate for asymptomatic patients, while reserving surgical or radiotherapy options for those with progressive or symptomatic disease.  \n[https://thejns.org/doi/abs/10.3171/CASE25761](https://thejns.org/doi/abs/10.3171/CASE25761)  \nKEYWORDS meningioma; neoplasm metastasis; lung neoplasms; case reports  \nMeningiomas are tumors that arise from meningothelial cells of the arachnoid mater, accounting for approximately 30% of all intracranial tumors in adults.1 Typically, these tumors are solitary, slow-growing lesions associated with favorable prognoses. However, a subset demonstrates atypical or malignant behavior characterized by aggressive growth patterns, recurrence, and rare extracranial metastases.2,3  \nExtracranial metastatic meningiomas represent an exceedingly rare clinical phenomenon, occurring in \u003C 1% of all meningioma cases. Among extracranial metastases, pulmonary involvement is most frequently reported; however, other sites, including bones, the liver, and lymph nodes, may also be involved. The precise mechanisms underlying extracranial metastases remain poorly understood, contributing to diagnostic and therapeutic challenges.4,5  \nThis report presents a unique case of atypical meningioma with multiple pulmonary metastases. The rationale for documenting this case is to highlight the diagnostic and management challenges of extracranial meningioma metastases, to emphasize the role of structured long-term surveillance, and to contribute to the limited literature regarding conservative management strategies for asymptomatic pulmonary lesions.3–6  \nIllustrative Case  \nA 33-year-old male presented 13 years ago with progressive headaches lasting several months. The neurological examination at admission revealed mild cognitive slowing, but no focal motor or sensory deficits. MRI of the brain showed a left frontal extra-axial lesion, and he underwent craniotomy with resection of the mass. Histopathologal analysis confirmed atypical meningioma (WHO grade II) according to the 2007 WHO classification, based on increased cellularity, mild nuclear atypia, and a mitotic count of ≥ 4 mitoses per 10 high-power fields. At that time, brain invasion was not identified. While the tumor was graded according to the 2007 criteria, its features would also meet the diagnostic threshold for WHO grade 2 under the 2021 classification system. Over the following years, the patient experienced two episodes of local recur","cbCainGnknkinTsJ","https://ap.wps.com/l/cbCainGnknkinTsJ","pdf",956369,"English","# Case Lessons\n## Background\n## Observations\n## Lessons\n## Illustrative Case\n## Abbreviations\n## Publication and submission details","[{\"question\":\"How rare is extracranial metastasis from meningiomas, and where is it most commonly seen?\",\"answer\":\"Extracranial metastatic meningiomas are exceedingly rare, occurring in less than 1% of cases. Among extracranial metastases, pulmonary involvement is the most frequently reported site.\"},{\"question\":\"What prompted evaluation for pulmonary disease in this patient?\",\"answer\":\"Approximately seven years after diagnosis, the patient developed gradually progressive shortness of breath and a dry cough. Chest imaging was pursued because no prior thoracic studies had been performed.\"},{\"question\":\"What was the management approach for pulmonary metastases in the absence of symptoms?\",\"answer\":\"Because the patient had no symptoms and pulmonary lesions showed minimal progression over follow-up, conservative management with structured surveillance was used, including regular cranial MRI and chest CT imaging.\"}]","Intracranial atypical meningioma with multiple pulmonary metastases - illustrative case | PDF",1790691706,13]