Multiple intracranial meningiomas do not imply neurofibromatosis

Abstract

A 27-year-old female presented with a 6-month history of occasional mild to moderate headache. There was no history of NF2 or meningiomatosis in the family and the patient was neurologically intact. There were no features of neurofibromatosis such as cafe-au-lait spots, subcutaneous neurofibromas, axillary freckling, Lisch nodules, or bony dysplasias. Contrast magnetic resonance imaging (MRI) of the brain revealed more than 20 meningiomas in various locations [Figures 1-3]. Both the CP angles also contained meningiomas. The Patient underwent removal of the anteriorly located olfactory groove, falcine, and parasagittal meningiomas and is presently on follow up. Though there are various criteria for the diagnosis of NF2, [1] all require either a family history of NF2 or presence of a vestibular schwannoma. Our patient did not have either. Families with multiple meningiomas have been reported, without chromosome 22q deletions, and it is hypothesized that this disorder may result from alterations in other negative growth regulators important for meningeal cell growth and differentiation. [2] It is likely that our case too belonged to this category.