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Metastasis of Meningioma: A Rare Differential Diagnosis in Subcutaneous Masses of the Scalp

Alexander Lunger, Tarek Ismail, Adrian Dalbert, Kirsten Mertz, Thomas Weikert4, Dirk Johannes Schaefer and Ilario Fulco

Background: Subcutaneous masses of the scalp have a wide range of differential diagnosis. After removal of a meningioma in the patient’s history, scalp metastasis from the previously resected meningioma should be considered. Methods: A 86 year old patient presented with a local swelling on the left temporal forehead and no other clinical symptoms. Eleven years earlier an extra-axial meningioma was resected. The patient was receiving immunosuppressive therapy subsequent to kidney transplantation. After clinical examination and MRI, a lipoma was suspected. The mass was resected under local anesthesia. Results: Histopathology revealed a metastasis of the previously removed meningioma (WHO grade II). No further treatment was recommended. Clinical follow-up was without pathological findings so far. Conclusion: Scalp metastases of meningiomas are a rare finding. However, if patient history reveals removal of a meningioma, scalp metastasis must be a differential diagnosis for subcutaneous masses even years after the initial surgery.