
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.054
vdae090.054
Final Category: Multimodality Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
MMOD-10 BRAIN METASTASIS, MENINGIOMA, AND GLIOMA: A RARE CASE OF MULTIPLE PRIMARY MALIGNANCIES
Li Boyi University of North Carolina, Chapel Hill/NC, USA

Higgins Dominique University of North Carolina, Chapel Hill/NC, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i17i17
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

Multiple primary malignancies is a rare occurrence in which a single patient has multiple tumors of different origins. This occurs more commonly in patients with genetic conditions such as Li- Fraumeni disease or NF1. Here we present a case of a 78 year-old woman with no known family history of cancer or underlying genetic condition, who was found to have three different types of brain tumors, two of which presented simultaneously. The patient initially underwent resection of a right frontal WHO grade 2 meningioma in 2021. She elected not to pursue adjuvant radiation and subsequent serial MRIs up to September 2023 showed no recurrence. The patient was also found to have stage IIIa serous endometrial carcinoma, with genetic profile revealing a TP53 mutation. She underwent a hysterectomy in March 2023 and 6 cycles of paclitaxel/carboplatin with good systemic control. She then presented in March 2024 with status epilepticus and was found on new MRI to have two new lesions: an irregular enhancing cortical right occipitotemporal lesion with leptomeningeal involvement and a small round well-circumscribed heterogeneously enhancing periventricular mass along the atrium of the left lateral ventricle. The patient was taken for stereotactic biopsy of both lesions given the difference in radiologic appearance. Pathology results revealed the left lesion to be metastatic high-grade serous carcinoma and the right lesion an infiltrating high grade glioma, positive for TERT promotor mutation and MGMT promotor methylation positive. Germline testing is pending. To our knowledge, this is the first case of a patient with three distinct types of brain tumors: meningioma, metastasis, and glioma. Further understanding of this patient’s unique presentation and genetic profile will contribute to our understanding of the diagnosis and treatment of patients with multiple brain tumors.
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