Unusual adrenal metastasis of anaplastic meningioma: A case report

Abstract

INTRODUCTION AND IMPORTANCE: Meningiomas are the most common primary intracranial tumors and are typically benign. However, high-grade variants are rare and have a greater risk of recurrence and distant metastasis. Recognizing these exceptional metastatic presentations is essential for accurate diagnosis and management. CASE PRESENTATION: We report the case of a 60-year-old female patient diagnosed with an anaplastic cerebellar meningioma. Follow-up imaging revealed a growing adrenal mass. Histopathological and immunohistochemical analyses confirmed that it was a metastasis from the primary meningioma. CLINICAL DISCUSSION: Distant metastases from meningiomas occur in less than 1 % of cases, most commonly involving the lungs, bones, or liver. Adrenal involvement is exceptionally rare. High-grade tumors, particularly after surgical manipulation, may disseminate via hematogenous or lymphatic routes. Diagnosis relies on histological and immunohistochemical confirmation. There is no standardized treatment, but surgical resection of metastases remains the preferred option when feasible. Systemic and targeted therapies may be considered in selected cases. Multidisciplinary management is essential given the rarity and complexity of such cases. CONCLUSION: Although extremely rare, adrenal metastasis should be considered in patients with high-grade meningiomas and new distant lesions. Early identification and tailored management strategies may improve outcomes.