Meningioma metastatic to the lung detected by FDG positron emission tomography

A 48-year-old man presented with a meningioma of the right middle cranial fossa and skull base. After initial subtotal resection and radiation therapy, he underwent 5 operations for tumor recurrence over the next 2 years. Twenty-three months after the initial presentation, fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) demonstrated a hypermetabolic focus in the right lung. Computed tomography of the chest demonstrated multiple pulmonary nodules with the largest nodule (2.0 × 2.1 cm) corresponding to the abnormal pulmonary activity on PET imaging. Fluoroscopy-guided fine-needle aspiration (FNA) yielded tissue "consistent with meningioma" and similar to the specimen of recurrent meningioma of the skull base.