THE VASCULAR MASQUERADE: A CASE OF ANGIOMATOUS MENINGIOMA

Abstract

Angiomatous meningioma is an uncommon, histologically distinct variant of World Health Organization (WHO) CNS Grade 1 meningioma, characterized by a predominant vascular component and a disproportionate tendency to provoke peritumoral brain edema (PTBE) despite its benign nature. We report the case of a 51-year-old woman who presented with headache, visual disturbance, and fatigue. Contrast-enhanced computed tomography of the brain revealed an extra axial mass in the right frontoparietal region with marked surrounding peritumoral edema, a radiological appearance often mistaken for a more aggressive lesion. The patient underwent craniotomy with gross total surgical excision. Histopathological examination revealed numerous variably sized, hyalinized vascular channels admixed with bland meningothelial cells, comprising more than half of the tumor volume, with immunohistochemistry confirming a diagnosis of angiomatous meningioma. The patient's presenting symptoms resolved in the postoperative period. This case highlights the importance of recognizing angiomatous meningioma as a cause of imaging findings that appear radiologically aggressive despite an entirely benign clinical course, and reinforces surgical excision as the definitive and generally curative treatment.