# Recurrence of Atypical Meningioma: A Case Report

## TL;DR

This case report details the recurrence of an atypical meningioma in a 57-year-old man, highlighting the tumor's aggressive nature and the need for close monitoring.

## Contribution

The paper contributes a specific clinical case illustrating the recurrence and management challenges of atypical meningiomas.

## Key findings

- Atypical meningiomas show aggressive behavior and higher recurrence rates compared to grade I tumors.
- Surgical resection is primary treatment, but adjuvant radiotherapy is often needed for high-risk cases.
- Multidisciplinary care and surveillance are essential for managing these tumors effectively.

## Abstract

Atypical meningiomas are classified by the World Health Organization (WHO) as grade II central nervous system tumors, representing an intermediate biological profile between benign (grade I) and anaplastic (grade III) variants. They are defined by elevated mitotic activity, invasive growth patterns, and distinct histopathological features such as hypercellularity, small cell morphology, prominent nucleoli, and areas of necrosis. Clinically, these tumors often manifest with neurological symptoms - headaches, seizures, focal neurological deficits, personality alterations, or visual impairment - depending on their anatomical location. On imaging, atypical meningiomas typically show either homogeneous or heterogeneous contrast enhancement, surrounding edema, and exert mass effect on adjacent brain structures. MRI and MR spectroscopy help in assessing these cases. Surgery tends to be the main treatment, but recurrence is more common than what’s typically seen in grade I meningiomas. Adjuvant radiotherapy is frequently recommended, particularly in cases of subtotal resection or when high-risk features are present. Given their aggressive behavior and propensity for recurrence or malignant progression, comprehensive multidisciplinary care and close surveillance are critical to achieving optimal clinical outcomes. In this case, we present a 57-year-old gentleman diagnosed with peritorcular meningioma.