Aggressive rhabdoid meningioma with osseous, papillary and chordoma-like appearance

Area of Science:

• Neuro-oncology
• Pathology
• Neurosurgery

Background:

• Meningiomas are common primary intracranial tumors, typically benign but can be malignant (WHO grade II/III).
• Rhabdoid meningioma (RM) is a rare, aggressive WHO grade III variant with a poor prognosis.
• Clinical management of RM is challenging due to its aggressive nature and limited treatment options.

Observation:

• A case of recurrent aggressive left occipital parasagittal rhabdoid meningioma is presented.
• The patient underwent four tumor resections over five years, initially declining radiation therapy.
• Histopathology revealed rhabdoid features with metaplastic, papillary, and chordoid differentiation.

Findings:

• The patient experienced local recurrences, invasion, and ultimately died of progressive disease six months after the fourth surgery.
• Rhabdoid meningioma demonstrates aggressive behavior, including local recurrence, leptomeningeal dissemination, and metastasis.
• Despite aggressive surgical management, the prognosis for rhabdoid meningioma remains poor.

Implications:

• This case underscores the aggressive clinical course and poor prognosis associated with rhabdoid meningiomas.
• Further research is needed to determine the efficacy of adjuvant therapies for this rare malignant meningioma subtype.
• Understanding the clinical presentation, radiological features, and pathological findings is crucial for managing rhabdoid meningioma.