Gigantic Exteriorized Frontal Meningioma: An Exceptional Clinical Entity

Abstract

Background and Importance: Meningiomas are usually benign tumors. Depending on their location and size, dealing with them can be problematic. We report an exceptional case of gigantic frontal meningioma. Its diagnosis was misleading and the excision laborious. Case Presentation: A 29-year-old patient who presented gradually over 5 years, developed behavioral disorders then swelling of the vertex at the frontal level and decreased visual acuity. Physical examination on admission revealed a median frontal swelling slightly lateralized to the left axis of approximately 10 cm, hard, covered with the healthy, severe frontal syndrome, and decreased visual acuity. Computerized tomography (CT) scan showed a voluminous medial frontal lesion lateralized to the left, with irregular limits, superior sagittal sinus invasion, brain engagement under the scythe, heterogeneous contrast taking, and significant osteolysis first evoking tumor metastasis. Magnetic resonance imaging (MRI) suggested a meningioma. The resection was macroscopically complete. Dural and cranial plasty was performed. The postoperative follow-up was simple. Histology concluded that the meningioma was grade 1 based on the world health organization (WHO) classification. Conclusion: Late-diagnosis meningiomas can take on very large proportions and pose management problems while seriously engaging the patient functional and vital prognosis.

Keywords

• meningioma
• exteriorized
• excision
• duroplasty
• cranioplasty