A Case of Recurrence of Benign Convexity Primary Intraosseous Meningioma

Meningiomas originating within the bones of the skull are rare and have been reported as primary intraosseous meningiomas (PIOM). Moreover, PIOMs with a skull base location or malignant pathology are predisposed to recurrence; however, recurrence is quite rare among PIOMs characterized by a convexity location and benign pathology. Here, we present a case of extensive recurrence of a convex intraosseous meningioma with benign pathology. A 72-year-old woman presented with a headache to our hospital. Gd contrast-enhanced magnetic resonance imaging revealed an enhanced tumor in the left frontal to the parietal region extending through the calvarial bone and invading the subdural space and subcutaneous tissue. Skull radiograph and computed tomography identified a remarkable osteolytic change in the lesion. Macroscopic complete resection (MCR) of the tumor and the surrounding tissues was performed. The tumor was histopathologically diagnosed as a transitional meningioma (World Health Organization grade 1). Seven years after the surgery, the patient presented with dysarthria, and the recurrence of the tumor was identified as massive lesions extending through the calvarial bone to the orbital bone, partially protruding into the brain and scalp. MCR was performed again, with the reconstruction of the skull for an extensive calvarial area using a titanium plate. This case is unique due to the extensiveness of the recurrent tumor and its rarity. Here, we report the details of the clinical course and discuss the characteristics of this case.