摘要：

Tumor-to-tumor metastasis is a rare phenomenon that is most likely under - recognized. Lung, breast carcinomas, and meningiomas have a high prevalence in their primary state. Additionally, both lung and breast carcinomas have a propensity to metastasize, in particular to bone, brain, and liver. Despite the tumor's predisposition to metastasize to the brain, radio logically and clinically, it is difficult to recognize this phenomenon, and likely to be misdiagnosed as solely primary meningioma or cerebral metastasis. We describe a unique case of a 74-year-old female with history of breast carcinoma and lung carcinoma, who presented with a brain mass demonstrating radiological features of a meningioma. More interestingly, a separate nasal mass was incidentally found intraoperatively. The complicated clinical history and radiological differential diagnosis made intraoperative frozen section consultation extremely difficult. The final diagnosis also required the aid of immunohistochemical studies. Pathologists should be mindful of the phenomenon of intratumoral metastasis and concurrent neoplasms. Sampling should also be adequate, and meticulous histopathologic examination of the suspected meningioma is of utmost importance. Detection of this rare event can provide more precise treatment options and prognosis. More importantly, it raises the question if genetic counseling is warranted in such a patient with multiple concurrent neoplasms.

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