Skull bone erosion in a silent atypical meningioma: A case report and literature review.

INTRODUCTION AND

IMPORTANCE

Meningiomas are the most common primary tumors of the central nervous system. Atypical meningiomas, classified as World Health Organization (WHO) grade II, are relatively rare, accounting for 5-7 % of cases, and are known for their aggressive behaviour, including higher recurrence rates and potential brain invasion. Early detection and intervention are crucial, even in asymptomatic patients.

CASE PRESENTATION: We report a case of a 45-year-old male presenting with a two-year history of painless, progressive swelling over the left parietal region. Neurological examination was normal. Imaging revealed a well-defined extra-axial lesion with bone erosion suggestive of atypical meningioma. Surgical resection via craniotomy was performed, and histopathology confirmed a WHO grade II atypical meningioma. The postoperative course was uneventful, and the patient remained asymptomatic with no recurrence on follow-up imaging.

CLINICAL DISCUSSION: Although often asymptomatic, atypical meningiomas can exhibit invasive features requiring prompt diagnosis and surgical management. MRI findings and histological markers, including mitotic activity and focal brain invasion, aid in accurate grading. Close follow-up is recommended due to the higher recurrence potential compared to benign subtypes.

CONCLUSION

This case highlights the importance of considering atypical meningioma in patients with isolated skull swelling. Timely diagnosis and surgical management are essential to prevent complications and ensure a favorable prognosis.