Atypical xanthoastrocytoma presenting as a meningioma

A 15-year-old boy was admitted to excision of a large exophytic right parietal tumor, which, on computed tomography scans and angiograms, revealed marked contrast-medium enhancement in infusion studies. Angiographic studies showed meningeal feeders, which suggested a meningioma. Computed tomography scans demonstrated extensive erosion of the skull, which indicated a slowly growing process. Pathologically it shared many features with pleomorphic xanthoastrocytomas, suggesting that neoplasia of the glia limitans may have a wide range of clinicopathological manifestations, including a favorable long-term prognosis.