Primary intraosseous meningioma: a case of early symptomatic calvarial origin meningioma

Primary intraosseous meningiomas are rare extradural tumors. They are typically slow-growing, painless, and asymptomatic until they cause a mass effect. We report a case of a calvarial primary intraosseous meningioma, which became symptomatic despite a very small size. A 67-year-old female with a history of precancerous breast tissue presented with right-sided stroke-like symptoms. Computed tomography showed right parietal convexity irregularity without hemorrhage or infarct. MRI indicated a right parietal calvarial signal abnormality and dural thickening, suggesting metastases or primary osseous neoplasm. A PET scan revealed heterogeneous uptake in the right parietal skull with no other abnormalities. Histology confirmed the diagnosis of primary intraosseous meningioma. Histopathological examination is crucial to avoid misdiagnosis and treatment planning, which may involve wide-margin skull resection, radiation, or both.