Abstract Details

Title Meningioma with leptomeningeal dissemination

Topic Neuro-oncology

Presentation(s) Neuro-oncology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 044

Objective To present a case of meningiomas with leptomeningeal dissemination post-surgery and radiation

Background Intracranial tumors, including meningioma, are long term complications of radiation therapy. Although the median latency of meningioma development has been reported to be as long as 25 years after radiation, the variability in time to occurrence is not well understood. However, leptomeningeal dissemination of intracranial meningiomas has been reported to occur within shorter period after radiation.

Design/Methods Here we report a 75-year-old man with a meningioma who developed multifocal extra axial lesions within 1 year of surgical resection and adjuvant radiation therapy to the original lesion.

Results The patient initially presented with a generalized seizure. MRI showed a left frontal, parasagittal lesion, which was then resected. Pathology demonstrated atypical meningioma, WHO grade 2 with parenchymal invasion, TERT mutation not detected, STAT6 negative, and estimated MIB-1 proliferative index up to 30-40% focally. He was treated with radiation therapy to the location of the original lesion: total dose 5940 cGy in 33 fractions. Eleven months after surgical resection he presented with at least 4 extra-axial lesions in the bilateral cerebral convexities, radiographically suggestive for meningiomas. These lesions were not present in the original presentation. There was no recurrence of the original tumor. Due to the presence of multiple lesions and recent radiation, medical management was favored. He was started on an mTOR inhibitor (everolimus) and had stable disease after 5 months (the last follow-up visit).

Conclusions

Although multiple meningiomas can occur after radiation, a short latency could suggest leptomeningeal dissemination as an etiology for such presentation. The behavior and response to treatment of such tumors are difficult to predict.

Authors/Disclosures
Orwa Aboud, MD, PhD (University of California Davis) PRESENTER	Dr. Aboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Servier.
	No disclosure on file
Orin Bloch (University of California Davis)	Orin Bloch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Monteris Medical. Orin Bloch has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BrainLab. The institution of Orin Bloch has received research support from NIH.
Han Lee (University of California Davis Medical Center)	An immediate family member of Han Lee has stock in Gilead.
Ruben Fragoso (UC Davis)	Ruben Fragoso has nothing to disclose.

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