IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 2012;5(4):367-373

Case Report
Tumor-to-tumor metastasis: pathology and neuroimaging considerations

Patricia Moody, Kevin Murtagh, Sarat Piduru, Steven Brem, Reed Murtagh, Amyn M Rojiani

Department of Pathology and Cell Biology, University of South Florida; Departments of Radiology, Departments of Neuro-Oncology,
Departments of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL; Department of Pathology, Medical College of Georgia - Georgia
Health Sciences University, Augusta, GA, USA.

Received March 20, 2012; accepted April 3, 2012; Epub April 16, 2012; Published May 30, 2012

Abstract: The phenomenon of tumor-to-tumor metastasis has been reported in the literature for over a century. However, it remains fairly
uncommon with fewer than 100 cases being described during that time. Virtually any benign or malignant tumor can be a recipient, but
meningiomas have been implicated as the most common intracranial neoplasm to harbor metastasis. The donor neoplasm is most frequently
lung or breast carcinoma, while rare cases of metastasis from other primary tumors have been reported. We report here three examples of
such rare metastases. This case series reports the first documented instance involving rectal adenocarcinoma. In addition, we report two
cases of metastatic prostate adenocarcinoma to a meningioma; to date of which only three cases have been published. The terms “tumor-to-
tumor metastasis” and “collision tumor” are addressed, as are details of the pathology. The limitations of standard radiological imaging
techniques, such as standard CT and MR, which cannot reliably identify the presence of metastasis within a meningioma are compared with
physiology-based neuroimaging methods, such as perfusion MR and MR spectroscopy, which may be more useful in noninvasively
differentiating tumor histology.

Keywords: Tumor-to-tumor metastasis, meningioma, adenocarcinoma, neuroimaging, pathology

Address all correspondence to:
Dr. Amyn M Rojiani
Department of Pathology BF-104
Medical College of Georgia – GHSU
1120 Fifteenth Street, Augusta, GA 30912, USA.
Tel: (706) 721-2923; Fax: (706) 721-2358
E-mail: arojiani@georgiahealth.edu