Single-Stage Resection and Reconstruction of Intraosseous Meningioma: The First Reported Case at Our Hospital.

Abstract

In neurosurgery services worldwide, the resection of benign and malignant tumors continues to pose a challenge due to the need to preserve neurological function, especially when these lesions are located in eloquent areas. Among central nervous system oncologic lesions, meningiomas are the most common. Based on the criteria of the World Health Organization, they are classified into three grades according to their malignancy. In this report, we present the case of a 46-year-old female patient with no relevant medical history, who had experienced headaches for a year, which intensified 24 hours prior to her visit to the emergency department, without aggravating or relieving factors. Physical examination revealed no neurological deficits. A contrast-enhanced computed tomography (CT) scan showed a frontoparietal bony prominence measuring 4.41 x 6.2 cm. Due to its size, a wide surgical resection was performed, followed by histopathological analysis, which confirmed the diagnosis of a primary intraosseous meningioma, WHO grade 1. To repair the bone defect, a cranioplasty with a low-profile titanium mesh was performed. At the 12-month follow-up, the patient presented with full recovery and resolution of symptoms, with no evidence of recurrence. This case represents a rare entity with no previous reports in Nicaragua, which may be due to its low incidence and limited awareness among the medical community, often leading to underdiagnosis. Since this is the first case report in this institution, we consider it important to document and share it, aiming to contribute to the development of a diagnostic and therapeutic guideline for low-resource settings and developing countries.