A80-4-50 Mind Over (Lung) Matter: A Unique Case of Pulmonary Meningioma

Abstract Primary pulmonary meningiomas are exceedingly rare with only 67 cases reported in the English language medical literature. They are often benign and treated with conservative surgical excision. Primary is a designation that has been assigned when there is no evidence of intracranial meningioma, otherwise this would be assigned as ectopic. The proposed mechanism for the development of meningiomas outside of the CNS is from multipotent neural crest cells. We present a rare case of pulmonary meningioma found on pulmonary nodule biopsy. This is a 79-year-old male with medical history of atrial fibrillation with previous ablation who initially presented to the hospital for complaints of dizziness and found to be symptomatic from bradycardia. During his workup in the ED, he had a CT Chest performed and was incidentally found to have a nodule in the right upper lobe measuring 2.0cm x 2.4cm. The nodule itself was contiguous with the pleura. He underwent ion navigational bronchoscopy with fine needle aspiration of lesion as well as cryobiopsy with pathology results revealing Grade 1 meningioma. This patient was discussed at our multidisciplinary thoracic conference, and the consensus opinion was surgical excision. To establish a diagnosis of primary pulmonary meningioma, transbronchial biopsy is frequently used. MRI intracranial imaging is recommended to rule out dissemination from an intracranial source. If there is evidence of intracranial meningioma as well, this would be an example of malignant pulmonary meningiomas. Although for our patient, the histologic features suggest grade 1 meningioma. The prognosis of benign PPM is good and in a review of the literature of 35 benign cases, at follow up there were no documented instances of relapse or metastatic lesions. This is an important case as it is exceedingly rare in the literature, and we are yet to fully understand the implications of this disease. Although surgical excision is typically first line, we do not fully understand the implications of monitoring these lesions. This abstract is funded by: None