Extremely delayed renal cell carcinoma metastasis mimicking convexity meningioma

Cerebral extra-axial metastases mimicking meningioma are extremely rare. Imaging characterictics may not always differentiate between meningioma and metastatic tumors. A 68-year-old-woman who had been operated for renal cell carcinoma 20 years ago presented with new symptoms of an intracranial mass lesion. A large extra-axial convexity mass destroying the calvarium and dura was excised with Simpson Grade I removal. The pathology examination revealed metastatic carcinoma. Such tumors that satisfy several criteria for a diagnosis of meningioma, but prove instead to be metastatic carcinoma form the focus of our discussion. A meticulous clinical evaluation and histopathological diagnosis is essential in patients with an intracranial mass whether the lesion looks like a primary or metastatic tumor on the first evaluation.