A huge cerebral parenchymal meningioma in sylvian fissure: case report and literature review.

Abstract

Background & introduction: Meningiomas are tumors that originate from non-neuroepithelial progenitor cells, meningothelial cells and the arachnoid cap cells, thus they usually appear with attachment to the dura mater. But sylvian fissure meningiomas are a rare type of meningioma that has no dural attachment.

Case presentation: A rare case of sylvian fissure meningioma is presented. The patient is a 34-year-old male with headache, and preoperative images showed a massive lesion in his right frontotemporal lobe that had no contact with the dura mater. Postoperative histopathological examination confirmed the diagnosis of a clear cell meningioma, which is a WHO grade 2 atypical meningioma and a rare subtype of meningioma that only accounts for less than 1% of all meningiomas.

Conclusion: Preoperative diagnosis of sylvian meningiomas can be challenging, leading to inappropriate operation plan and postoperative treatment. Thus, we present this case and a brief review of past cases reported, hoping to improve our understanding of the origin of meningiomas and accuracy in diagnosis of similar lesions.