Atypical convexity meningioma presenting with photophobia and skull erosion

A 41-year-old man presented with photophobia. The patient showed a choked disc and right-sided quadrantanopia with an intact sphincter reaction to light stimulation. Computed tomography revealed an isodense mass in the right frontal convexity, accompanied by extensive perifocal brain edema and smooth-contoured skull erosion. On cerebral magnetic resonance imaging, the tumor was dural-based, appeared inhomogeneous intensity on both T1- and T2-weighted sequences, and was intensely enhanced. Magnetic resonance angiography revealed unusually ectatic right-sided middle meningeal and superficial temporal arteries. The tumor, which was elastic hard, highly vascular, and severely adhered to the frontal cortices, was completely resected. The microscopic findings of the resected specimen were consistent with angiomatous meningioma. The patient's photophobia resolved after surgery, with resolution of the optic chiasm compression. Meningiomas arising in the frontal convexity may cause photophobia. Angiomatous meningioma should be considered when a broad-based tumor is found in the cerebral convexity accompanied by skull erosion and extensive perifocal edema.