A Rare Case Report of Malignant Meningioma

Abstract

Aims & Objectives: Atypical and malignant meningiomas are uncommon tumors with aggressive behavior and higher mortality, morbidity, and recurrence compared with benign tumors. We report a case report of malignant meningioma. Materials & Methods: A 53 year old male patient, presented with history large ulcerative swelling over the scalp for the past 5 years, with complaints of altered and aggressive behaviour and headache. Patient gives history of operation for benign meningioma 4 years back.Patient underwent MRI & CT Brain plain and contrast. Result: Patient underwent MRI & CT Brain plain and contrast, showed a large heterogeneously enhancing extraxial mass lesion with irregular margins ,significant extracalvarial spread and mushrooming into the brain parenchyma in the temporal & parietal regions. The lesion showed intratumoral cysts within it. On MRS significant choline,lipid and lactate peaks with near total dampening of NAA, Cr , MI peaks. The mean ADC values were (0.5 0.8 × 10−3 mm2/s) was suggesting a high grade cellular lesion. Conclusion: Anaplastic or malignant meningioma (MMen) corresponds histologically to WHO grade III. Frankly malignant meningiomas are rare, representing only 1-3% of all meningiomas. MMens have a striking male predominance. The imaging triad of extracranial mass, osteolysis, and “mushrooming” intracranial tumor is present in most but not all cases of Malignant meningiomas. Key-words: Malignant meningioma, mushrooming,extra-axial