Atypical Convexity Meningioma

MRI with gadolinium confirmed the likely diagnosis of convexity meningioma, a benign neoplasm of the meninges. Given the location of the tumor, angiography and embolization were deemed unnecessary prior to resection. Stereotactic c-guided craniotomy was performed by Dr. Jonathan Brisman and the tumor was carefully excised from the surrounding brain. A gross total resection was achieved. He was discharged from the hospital to his home, neurologically intact with a slow improvement of his gait. Postoperative MRI showed no evidence of residual tumor.

Pathologic analysis revealed a meningothelial tumor consistent with a meningioma with atypical features (immunocytochemical positive staining for vimentin, EMA, and Ki67 at 23%), and the lesion was graded an Atypical Meningioma, WHO grade 2. Neuro-oncology consultation was obtained and a decision was made to monitor conservatively, with radiation therapy indicated for tumor recurrence only. The patient has since returned to normal neurologic function with no evidence of tumor recurrence