Sporadic Multiple Meningiomas Presenting With Drug-Resistant Seizures in a Young Adult: A Case Report

Abstract

Meningiomas represent the most common benign primary intracranial tumors. However, multiple meningiomas (MMs) are relatively rare and can be challenging to manage, often requiring repeated surgical interventions and long-term follow-up. Here, we present the case of a 28-year-old woman who was operated on in 2019 for a right parasagittal MM, WHO grade 1. Her initial presentation was characterized by seizures and left-sided hemiplegia. Seven years later, she presented with recurrent seizures that were resistant to medical treatment. Neurological examination revealed residual left-sided spastic pyramidal syndrome. Brain MRI revealed multiple extra-axial dural-based lesions, including a large right frontal parasagittal mass. Subtotal resection of the largest lesion was performed. Histopathology confirmed the diagnosis of WHO grade 1 mixed meningothelial and fibroblastic MM. The postoperative course was uneventful. This case highlights the challenges associated with sporadic MMs, particularly long-term surveillance, tumor recurrence, and the potential need for repeated surgical interventions.