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Meningioma association with Three Different Cell Types Tumors: Report of Clinical Cases and Review of the Literature

Most primary intracranial tumors occur as solitary lesions; multiple locations of one tumor, the occurrence of two different tumors or even collision tumors have been described only in a few patients. Multiple primary brain tumors rarely originate in different tissues. Cases not associated with von Recklinghausen's neurofibromatosis constitute only 0.3% of all primary brain tumors. The association of two primary intracranial tumors of different histogenesis in the same individual is rare, except in cases of phakomatosis or radiation-induced tumors. We present three cases with simultaneous occurrence of meningioma with glioblastoma, pituitary adenoma, and acoustic schwannoma respectively, as shown by MRI on admission. In two cases (meningioma/glioblastoma, and adenoma/meningioma associations) both tumors have been approached in one operation, both tumors being completely removed. In the meningioma/acoustic schwannoma association case only the schwannoma was approached surgically due to poor patient status and meningioma being completely clinically silent. Postoperative recovery was good for all three patients and the 1 year follow up showed no growth for the remnant meningioma. Although the particular tumors diagnosed in all three presented cases represent common primary intracranial tumors, the simultaneous occurrence of each two tumors is rare. Previous reported results failed to consistently show a common genetic mark that could explain the development of two different tumors. However, based on our cases and previous literature, we believe that increased research effort could provide significant insights in the appearance and development of multiple brain tumors.