Background: Extracranial metastases from meningioma are rare, and are reported to occur in less than 1 per 1000.
Case report: We report a 54-year-old man, who presented with a parasagittal meningioma with skull erosion and overlying soft tissue invasion. Tumour invading the superior sagittal sinus was not removed, and postoperative radiation was therefore delivered to the excision site. Histology was consistent with an atypical meningioma. The patient had a re-operation of a recurrence 3.5 years later, and after another year six tumours were detected close to pleura and in the lungs. A biopsy from the largest one demonstrated a metastasis having the same histology as the primary tumour.
Conclusion: Risk factors for metastasis of cerebral meningiomas have been suggested to be histological malignancy grade, venous sinus invasion, and local recurrences after previous craniotomy.