Original Article

Pulmonary metastases in patients with recurrent, treatment-resistant meningioma†

Prognosis and identification by 111indium-octreotide imaging

  1. Daniela Alexandru MD1,
  2. Michael J. Glantz MD2,
  3. Lyndon Kim MD3,
  4. Marc C. Chamberlain MD4,
  5. Daniela A. Bota MD, PhD1,5,6,‡,*

Article first published online: 28 MAR 2011

DOI: 10.1002/cncr.26065

Issue

Cancer

Cancer

Volume 117, Issue 19, pages 4506–4511, 1 October 2011

Additional Information

How to Cite

Alexandru, D., Glantz, M. J., Kim, L., Chamberlain, M. C. and Bota, D. A. (2011), Pulmonary metastases in patients with recurrent, treatment-resistant meningioma. Cancer, 117: 4506–4511. doi: 10.1002/cncr.26065

Author Information

  1. 1

    Department of Neurological Surgery, University of California at Irvine Medical Center, Orange, California

  2. 2

    Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania

  3. 3

    Division of Neuro-Oncology, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania

  4. 4

    Department of Neurology, University of Washington, Seattle, Washington

  5. 5

    Department of Neurology, University of California at Irvine School of Medicine, Orange, California

  6. 6

    Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California

  1. ‡

    Fax: (714) 456-6894

*Department of Neurological Surgery, University of California at Irvine Medical Center, 101 The City Dr South, Shanbrom Hall, Ste 121, Orange, CA 92868

  1. †

    This article is a US Government work and, as such, is in the public domain in the United States of America.

Publication History

  1. Issue published online: 16 SEP 2011
  2. Article first published online: 28 MAR 2011
  3. Manuscript Accepted: 1 FEB 2011
  4. Manuscript Revised: 20 DEC 2010
  5. Manuscript Received: 2 SEP 2010

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Keywords:

  • atypical meningioma;
  • anaplastic meningioma;
  • pulmonary metastasis;
  • overall survival;
  • 111indium (111In)-octreotide scintigraphy

Abstract

BACKGROUND:

Meningioma is the most common extra-axial primary intracranial tumor in adults that rarely metastasizes outside of the central nervous system (CNS). Among recognized sites of metastases, the lung is the most common, but the importance of lung metastases relative to prognosis is unknown. 111Indium (111In)-octreotide scintigraphy (octreotide scanning) is a valuable imaging modality with which to evaluate intracranial meningiomas and their response to treatment with somatostatin analogues and has the potential to identify extracranial metastatic disease.

METHODS:

In this retrospective multicenter study, adult patients treated for recurrent meningioma were identified. These patients underwent 111In-octreotide positron emission tomography/computed tomography imaging (octreotide scintigraphy) and were found to have positive octreotide uptake in their lungs.

RESULTS:

Six cases were identified with recurrent meningioma (after surgery, radiotherapy, and at least 1 chemotherapy agent) and pulmonary lesions by octreotide scintigraphy. Biopsy of a pulmonary lesion in 1 patient confirmed the diagnosis of metastatic meningioma. Patients with metastatic pulmonary involvement identified by 111In-octreotide scintigraphy in this case series had an overall survival of 6 months, which is less than that reported from previously published series of patients with unknown systemic disease status.

CONCLUSIONS:

111In-octreotide scintigraphy is useful for assessing both CNS disease and extracranial metastases. The presence of pulmonary metastases appears to negatively affect survival in patients with recurrent meningioma. The usefulness of 111In-octreotide scintigraphy should be considered in staging patients with recurrent meningioma who are considered for further treatment. A prospective study to confirm this finding is warranted. Cancer 2011;. Published 2011 by the American Cancer Society.

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