Combined Endovascular and Surgical Treatment of High-Grade Meningioma - Case Report

Surgical resection of hypervascular meningiomas is often complex and may be accompanied by blood loss, followed by incomplete resection and tumor recurrence. We present a case of successful combined endovascular and surgical treatment for a large, complex, transcalvarial meningioma that is successfully resected. A 52-year-old male is admitted to our hospital with large left fronto-parietal tumefaction. Magnetic resonance imaging revealed extra-axial, transcalvarial fronto-temporal-parietal space occupying lesion with vivid contrast enhancement. Preoperative embolization was done using microspheres and coils. Surgical resection of tumor was done and pathohistology report showed Grade III meningioma. The patient recovers completely after the surgery and at first clinical follow-up 30 days later mRS was 0. Preoperative embolization of grade III meningioma reduces the surgery time, intraoperative blood loss and allows better resection without significant increase of perioperative complications. Reports on the association between embolization and tumor recurrence are insubstantial and require more research in future.