Hypervascular osteolytic calvarial and dural metastasis from clear cell renal cell carcinoma mimicking meningioma: Case report and literature review

Background: Dural-based lesions are typically suggestive of meningiomas; however, metastatic tumors such as clear cell renal cell carcinoma (RCC) may closely mimic this presentation, posing diagnostic and surgical challenges. Case Description: A 68-year-old male presented with a progressively enlarging right parietal mass. Imaging demonstrated an extra-axial lesion with calvarial involvement and intracranial extension, initially suggestive of meningioma. The patient underwent surgical resection, which revealed a highly vascular lesion with bone destruction and no clear dural plane. Histopathological and immunohistochemical analysis confirmed metastatic clear cell RCC. Conclusion: Calvarial lesions with osteolysis and extracranial extension should raise suspicion for metastatic disease. RCC metastases may mimic meningiomas radiologically but differ significantly in intraoperative behavior, particularly due to their hypervascularity. Recognizing these features is essential for appropriate surgical planning and management.