Abstract

A 51-year-old woman underwent resection of a parasagittal mass. Histology revealed a transitional meningioma graded as atypical on the basis of a mitotie index of up to found mitoscs per 10 high-power fields. A recurrence 20 months later displayed focal rhabdoid morphology, an increased mitotic index, and brain invasion. Despite surgery and adjuvant radiation therapy, a second recurrence necessitated resection 3 months later. Histologically the rhabdoid component had become more prominent and features of frank anaplasia were seen. Despite the surgeon's impression that a gross total resection was achieved, a third recurrence was detected after only 3 months. The recently recognized rhabdoid meningloma variant and histologic features of prognostic significance in meningioma grading are discussed.

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