An Unusual Case of Atypical Meningioma Mimicking as High-Grade Astrocytoma: A Case Report

Background: Meningiomas are the most common non-glial primary tumors of the central nervous system and extra-axial neoplasms. The annual incidence of meningioma is around 1,28 and 7,8 of 100.000 based on the worldwide data registries. Meningiomas vary based on the clinical findings, imaging, and histopathology from benign to malignant types. Case presentation: A 63-year-old female presented with progressive headache and visual disturbances in the last two months before admission. She also complained of a limp on the left side in the previous two weeks. General physical examination revealed bilateral visual acuity 1/300, cranial nerve deficits, motor deficits shown as left flaccid hemiparesis, and positive Babinski reflex on the left foot. CT Scan was done suggesting primary brain tumor suspect high-grade astrocytoma while the histopathological study showed atypical meningioma (WHO grade II). Discussion: The most frequent clinical findings in grade II and III meningiomas, respectively, are motor deficit, cranial nerve deficits, seizures, protrusion of the skull, intracranial hypertension, superior cortical function deficits, headache, and incidental. The imaging of meningiomas WHO grade II and WHO grade III is extra-axial mass with irregular demarcation, intratumorally necrotic areas, extensive brain edema, and changes of the bone. Conclusions: The imaging of atypical meningiomas WHO grade II and anaplastic meningiomas WHO grade III are various. Histopathology analysis is the gold standard to define it.