# Atypical Imaging Features of an Incidentally Discovered Intracranial Meningioma: A Case Report

## TL;DR

This case report describes an unusual meningioma with atypical imaging features that led to a more aggressive tumor diagnosis.

## Contribution

The study emphasizes the diagnostic importance of atypical imaging features in identifying higher-grade meningiomas.

## Key findings

- The case exhibited atypical imaging characteristics not commonly seen in meningiomas.
- Histopathology confirmed a WHO grade II atypical meningioma with increased cellularity and nuclear atypia.
- Atypical imaging features may indicate more aggressive tumor behavior and influence management decisions.

## Abstract

Intracranial meningiomas are the most common primary brain tumors, typically presenting with well-defined imaging characteristics. This case report focuses on a 56-year-old female patient who was referred due to a history of head trauma and an incidental space-occupying finding to investigate the atypical imaging appearances of intracranial meningiomas, focusing on a specific case with distinct radiological findings. Meningiomas are commonly associated with specific radiological features, such as contrast enhancement, dural tail, and hyperostosis. However, this particular case exhibited atypical imaging characteristics that raised concerns about the underlying tumor type.

In-depth analysis and subsequent histopathological examination revealed a World Health Organization (WHO) grade II atypical meningioma. This variant of meningioma demonstrated increased cellularity, nuclear atypia, and a high mitotic index, indicating more aggressive tumor behavior.

The study highlights the importance of recognizing atypical imaging appearances in meningiomas, as they may indicate higher-grade tumors with a potentially different clinical course and management approach. Accurate identification of these atypical features can contribute to improved diagnostic accuracy and guide appropriate surgical decision-making for patients with intracranial meningiomas.