Abstract
Background and Importance: Cystic components in meningiomas are an infrequent finding and pose diagnostic and therapeutic challenges to neurosurgeons. This study aims to conduct a comprehensive assessment of the clinical characteristics and management approaches for cystic meningiomas (CMs). Case Presentation: The current research investigated rare cases of CM. In the first case (case 1), benign parasagittal CM showed malignant features, including brain swelling and midline shifting. In the second case (case 2), parafalcine CMs demonstrate rare histopathological analysis and have not been documented in previous studies. The third case involved a pregnant woman, while the fourth case showed improvement in an older patient after surgery and indicated that the removal of a CM can result in a good prognosis. All tumors were surgically removed at stage 1 (Simpson stage), and histopathology confirmed World Health Organization (WHO) grade 1 syncytial meningioma in cases 1, 3, and 4. Only case 2 showed grade 3 rhabdoid meningioma. Conclusion:We found that benign CM may cause more brain edema than high-grade meningiomas, especially when they invade the sinus. Parasagittal and parafalcine CM invade the superior sagittal sinus (SSS), making complete excision more challenging and riskier. The presence of the cyst facilitates the removal of the tumor and reduces the risks.
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