From trauma to tumor: Primary pulmonary meningioma revealed

Primary pulmonary meningiomas (PPMs) are a rare type of meningioma that arises primarily in the lungs, outside the dura mater of the central nervous system. The majority of PPMs are benign and present as asymptomatic solitary pulmonary nodules incidentally diagnosed on imaging. A 32-year-old male presented to the hospital after a motor vehicle accident resulting in multiple injuries, including right apical pneumothorax, and underwent right upper lobe wedge resection. Surgical pathology of the VATS specimen revealed a 2 mm irregular nodule with morphologic and immunohistochemical features favoring a meningothelial nodule. CT of the head and the entire spine did not show any primary brain or spinal meningioma, and a diagnosis of PPM was made. Unlike most cases that are diagnosed incidentally on imaging, the PPM in our case was first noted only on the pathology specimen and found to be excised entirely on the biopsy specimen. When an isolated pulmonary nodule is seen incidentally on imaging or lung biopsy, primary pulmonary meningioma (PPM) should be considered as a differential. CNS imaging with CT or MRI is needed to confirm an isolated extracranial presence of PPM as opposed to a m