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Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment
  1. Cristiano Antunes,
  2. Rui Ramos,
  3. Maria João Machado and
  4. Miguel Afonso Filipe
  1. Neurosurgery, Hospital de Braga, Braga, Portugal
  1. Correspondence to Dr Cristiano Antunes, cristianoantunesneuroc{at}


Posterior fossa lesions may present with behavioural changes and/or progressive neurological deficit. Patients may have symptoms for long periods which may be attributed to other causes such as psychiatric diseases. We report a case of a 44-year-old woman with behavioural changes lasting for 5 years who lost her job, marriage and the guard of her sons. Latterly, she developed neurological deficit, hydrocephalus and intracranial hypertension. A giant left pontocerebellar angle mass was diagnosed. A retrosigmoid craniotomy was performed with total removal and cranial nerve function’s preservation. Histology revealed a grade I meningioma. The surgical approach for such huge lesions on pontocerebellar angle is controversial concerning patient’s positioning and surgical route. A brief revision is made. Since nowadays medical imaging is more easily accessible, it is mandatory to have a brain image in patients with behavioural changes and/or neurological deficit to exclude potential structural and curable causes such as in this case.

  • neurooncology
  • neuroimaging
  • CNS cancer
  • screening (oncology)
  • neurosurgery

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  • Contributors CA conducted patient follow-up and surgery, work planning, conception and writing, and interpretation of data. RR contributed in work planning and discussion. MJM contributed in work planning and discussion. MAF conducted patient follow-up and surgery, review of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.