Atypical intraosseous osteolytic meningioma mimicking calvarial metastasis

SummaryMeningiomas are common benign intracranial neoplasms. Among the subtypes of the meningiomas, primary intraosseous meningiomas are the most uncommon. The authors report a 68-year-old woman who has had headache, dizziness, and a progressively enlarged mass in the forehead for 2 months. Computed tomography of the brain showed an osteolytic skull lesion with brain and scalp invasion. A complete systemic survey for metastatic tumors was negative. The patient underwent Simpson grade I tumor resection via the frontotemporal approach, followed by cranioplasty with bone cement. The pathologic examination revealed atypical meningioma. Postoperatively, she received adjuvant fractionated conformal brain radiotherapy. The result was satisfactory. In this report, in addition to presenting the clinical manifestation and treatment of the patient, the authors emphasize the importance of considering atypical intraosseous meningioma in the differential diagnosis of osteolytic skull tumors.