Intraparenchymal Meningioma, A Challenging Diagnosis: Case Report

Abstract

Background: Primary intraparenchymal meningiomas are extremely rare; their similarities to other intra-axial lesionsand thelack of dural adhesion make their presurgical diagnostic approach challenging. Case Description: A 27-year-old male, with no past medical history, presented to our emergency department for a first time grand mal seizure. Magnetic resonance imaging evidenced a 1,6×1,2 cm mass in the right temporo-parietal region. It was iso intense on T1WI, hyper intense on T2 WI, surrounded by large vasogenic edema and homogeneously enhanced on contrast magnetic resonance imaging with diffusion restriction. During surgery, the tumor was found to be located within the parenchyma with no dural attachment. It was removed en bloc. Histopathological examination confirmed the positive diagnosis of transitional meningioma (WHO Grade I). Conclusion: Intraparenchymal meningiomas are rarely reported in the literature. Their preoperative diagnosis is extremely difficult to make. Histopathological examination plays a key role for an accurate diagnosis.