Wallenberg syndrome caused by CSF metastasis from malignant intraventricular meningioma.

A 34-year-old male developed a malignant transitional meningioma of the left lateral ventricle at the trigone. Over a 12-month period, he underwent three apparently complete excisions and one course of radiation therapy, but each time developed rapid local recurrence. The tumor recurred a fourth time seven months following the third operation, was excised, and the patient referred for intracarotid chemotherapy infusion. A left Wallenberg syndrome was noted on exam and CT scan demonstrated a posterior fossa mass. He died two weeks post-infusion from bronchopneumonia, 21 months after initial presentation. At autopsy, the tumor appeared more sarcomatous and had metastasized via the cerebrospinal fluid to the left dorsal medulla as well as to the surface of the pineal gland, the left cerebellar surface, and to several levels of the spinal cord. No extraneural metastases were found.