This case elegantly demonstrates a number of the different appearances which meningiomas can have. 

The patient went on to have a retrosigmoid craniotomy and excision of the tumor. 

HISTOLOGY

MICROSCOPIC DESCRIPTION:

The sections show a moderately cellular meningioma. The tumor comprises whorls and fascicles with psammoma bodies (psammomatous meningioma). The tumor cells have ovoid nuclei with no significant nuclear pleomorphism. Mitoses are inconspicuous. Several blood vessels contain foreign body material, in keeping with preoperative embolization. There is a small amount of necrosis, which is likely to be associated with the embolization. No brain parenchyma is included in the biopsy. There is no atypical or malignant change.

FINAL DIAGNOSIS: Meningioma (WHO Grade I).