Multiple Primary Pulmonary Meningiomas. Case report and literature review.

Background: Primary pulmonary meningioma (PPM) is a very rare tumor, while multiple PPMs are even more exceptional and herein, we report the sixth case, focusing on the clinicopathological and radiological features of the tumor. Case presentation Herein, we report a case of an asymptomatic 51-year-old female, who presented three solid nodules in both lungs who underwent video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper lobe. The third lesion was followed-up and resected three years later due to its slow but significant growth, alongside two new lesions. All lesions revealed morphological and immunohistochemical profile of meningioma. Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging scans. Conclusions: PPM is mostly benign and slow-growing tumor with an excellent prognosis, it does not present specific radiological characteristics and it is difficult to differentiate it from other lung tumors, surgical resection with subsequent histopathological examination being essential. A causal connection between sex hormones and meningiomas has long been debated and we hypothesize a causal connection between the PPM and her hormonal therapy with progesterone analogue.