✓ The classification of spinal meningeal cysts (MC's) in the literature is indistinct, confusing, and in certain categories histologically misleading. Based on a series of 22 cases, the authors propose a classification comprising three categories: spinal extradural MC's without spinal nerve root fibers (Type I); spinal extradural MC's with spinal nerve root fibers (Type II); and spinal intradural MC's (Type III). Although water-soluble myelography may disclose a filling defect for all three categories, computerized tomographic myelography (CTM) is essential to reveal communication between the cyst and the subarachnoid space. Communication demonstrated by CTM allows accurate diagnosis of a spinal MC and rules out other mass lesions. Magnetic resonance imaging appears useful as an initial study to identify an intraspinal cystic mass. Final characterization is based on operative inspection and histological examination for all three categories.

Updated assessment and current classification of spinal meningeal cysts.

The relative frequencies of cutaneous metastases are similar to those of the primary cancers; breast, colon, and melanoma are the most frequent in women and lung, colon, and melanoma are the most common in men. Cutaneous metastases represent an opportunity to detect a potentially treatable cancer before other evidence of it is present, to modify therapy as appropriate to the tumor stage, or possibly to use the cutaneous lesion as a source of easily accessible tumor cells for specific therapy. Cutaneous metastatic disease as the first sign of internal cancer is most commonly seen with cancer of the lung, kidney, and ovary.

Cutaneous metastatic disease.

Two cases of intracranial gliomas with extraneural metastases are described. Case 1, studied with biopsy material only, was a left malignant astrocytoma from the area of the rolandic fissure with right cervical lymph nodes metastases in a 43-year-old man. Case 2 was a left temporal malignant astrocytoma in a 21-year-old woman. Fifteen days after craniotomy, a left submandibular lymph node metastasis appeared. Forty days after surgery, a ventriculoperitoneal shunt was performed. Fifty-four days after surgery, the patient died. Autopsy revealed three liver metastases. Our review of the literature consists of 72 autopsy cases with extraneural deposits. Thos metastases occurred mainly in adults (63/72) and among men (46/72). The primary glioma was supratentorial in 67 cases. Metastases were mainly pulmonary and pleural. The majority of patients (82.8%) died within 2 years after onset of symptoms. In 8 of the cases, metastasis developed without any craniotomy and in 8 other cases, through a shunt.

Extraneural metastases of astrocytomas and glioblastomas clinicopathological study of two cases and review of literature

E XTRACRANIAL METASTASIS Of central nervous system gliomas occurs rarely following surgical intervention, 1,12,1s but spontaneous metastasis has been reported only once? ~ Earlier reports emphasize this rarity of metastasis outside the neuraxis by gliomas, and most examples have entered the literature as single case reports. 4,~'s'13'~'21'2-~''~~176 Since many such cases have been seen at the Armed Forces Institute of Pathology ( A F I P ) , a clinicopathologic review was made of the 35 well-documented examples in the files. Only three of these cases have been previously reported. 19,27'3~

Metastasizing neuroectodermal tumors of the central nervous system.

Twenty‐five cases of cutaneous meningioma and related processes were reviewed. Three types of meningioma cutis were noted. Type I occurs in the scalp, face, or paravertebral region of children and young adults, is usually present at birth, and generally has a benign course. This primary cutaneous meningioma bears similarities to developmental defects and probably originates from arachnoid cell rests displaced during embryogenesis into the cutis or subcutis. Type II occurs around sensory organs of the head and along the course of cranial and spinal nerves. It generally appears in adults as a de novo lesion and represents a cutaneous extension from an ectopic soft tissue meningioma, probably arising from arachnoid cell rests displaced along nerve sheaths. Type III represents an extension into the skin from a central nervous system meningioma infiltrating across bone or a bone defect. Prognosis for Types II and III is less favorable than for Type I. Clinically, cutaneous meningiomas resemble a variety of common skin lesions. The histopathologic appearance is usually but not always characteristic.

https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/1097-0142%28197409%2934%3A3%3C728%3A%3AAID-CNCR2820340332%3E3.0.CO%3B2-U

Cutaneous meningiomas--a clinicopathologic study.

I N RECENT years m a n y repor t s of i n t r a c ran ia l t u m o r s wi th ex t rac ran ia l me tas tases have a p p e a r e d in the l i t e ra ture . M o s t of these cases have been a d e q u a t e l y d o c u m e n t e d his to logical ly . L e y et al. 52 in a r ecen t r e p o r t have p resen ted a good review of i n t r ac r an i a l t u m o r s wi th me ta s t a se s ou t side the c ran ium. W e were s t i m u l a t e d b y this rev iew to r e p o r t a case of our own occurr ing in a child. L i t t l e emphas i s has been p laced upon the occurrence of ex t racran ia l me ta s t a se s in ch i ldren in p rev ious repor t s t h a t have appea red in t he l i t e ra ture . I n severa l of t he r epor t s va r ious t y p e s of i n t r ac ran i a l t u m o r s have been summar i zed , b u t no a t t e m p t has been m a d e to ana lyze t h e m in g rea te r deta i l . I t is our i n t en t ion to review the l i t e r a tu re of ex t r ac ran ia l me ta s t a se s wi th respec t to t y p e s of tumors , age groups, and the i r preference for si tes of me tas tases .

Franz E. Glasauer

Papers

Intracranial tumors with extracranial metastases. case report and review of the literature.

Lumbar extradural cyst. Case report.