A Rare Occurrence of a Metastatic Deposit of Meningioma in a Cervical Lymph Node

Meningioma is a common primary central nervous system (CNS) tumour, in which recurrences and local invasion can occur depending on the CNS World Health Organisation (WHO) grade. Extracranial spread of meningioma is rare and mostly includes metastasis to liver, lung, mediastinum and bone. Cervical lymph node involvement is extremely rare and only a few cases have been reported. This is a case of a 57-year-old man, with a diagnosis of CNS WHO grade 2 meningioma who presented with cervical lymph node (level II) enlargement. Microscopically whorls and sheets of cells resembling a meningioma were observed with diffuse EMA positivity. Although it is a rare occurrence, the possibility of metastatic meningioma should be considered in the differential diagnosis of cases of cervical lymph node metastasis, in patients with primary meningioma. Extracranial spread of meningioma carries a relatively poor prognosis. Early diagnosis is important as the excision of primary/secondary disease followed radiotherapy is the currently recommended treatment.