Primary pulmonary meningioma: a case report and literature review

Introduction and importance: We report the case of a 40-year-old asymptomatic woman with incidentally detected primary pulmonary meningioma (PPM), underscoring its relevance in the differential diagnosis of solitary pulmonary nodules. Case presentation: A 40-year-old asymptomatic woman was found to have a left subpleural pulmonary nodule (11 × 9 × 8 mm) on routine follow-up imaging. Computed tomography findings and a preoperative needle biopsy suggested a diagnosis of meningioma. Video-assisted thoracoscopic resection of the left lower lobe was performed, and histopathological examination confirmed PPM. The postoperative course was uneventful, and no recurrence or metastasis was observed during follow-up. Clinical discussion: Given the tumor's location and histological appearance, alternative diagnoses - including inflammatory myofibroblastic tumor - were excluded through immunohistochemical analysis. Surgical resection remains the definitive treatment for PPM, whereas the benefit of adjuvant therapy is unclear due to limited available evidence. Conclusion: PPM usually presents as an asymptomatic, solitary, or occasionally multiple, well-circumscribed pulmonary nodule. Needle biopsy alone may result in misdiagnosis due to sampling limitations. Definitive diagnosis requires a combination of immunohistochemical analysis (e.g., SSTR2) and evaluation of the complete surgical specimen.