Posttraumatic meningioma: explanation of an epidemiologic dichotomy

A 23-year-old soldier sustained a penetrating gunshot wound to the right frontoparietal region of the head in 1971 while serving in Vietnam. In 1984, he developed headaches and seizures, and a meningioma was found at the cranioplasty site. Recurrent meningiomas, requiring resection, developed at this site in 1988 and 1990. In 1994, he developed right proptosis. An extensive mass involving the right intraorbital region and the anterior and middle cranial fossa was found. Pathological examination of this tumor demonstrated malignant meningioma. Although antecedent head trauma has been implicated as a risk factor for meningioma, epidemiological studies of this association have yielded divergent conclusions. An explanation for this epidemiologic dichotomy is suggested.