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Adjuvant radiotherapy in a case of atypical meningioma after gross total resection: an unresolved issue
  1. Abhijith Bhaskaran1,
  2. Pooja Sethi1,
  3. Kumar Muthulingesh1 and
  4. Ramesh Ananthakrishnan2
  1. 1Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Pooja Sethi; docpujasethi{at}


We present a case of a 48-year-old man diagnosed with parasagittal atypical meningioma (AM) involving biparietal bones with intracranial and extracranial extension up to galea aponeurotica of the scalp. The patient underwent Simpson’s grade 2 resection (GTR (gross total tumour resection) with coagulation of dural attachment). Currently, in AMs, the role of adjuvant radiotherapy is controversial after GTR. Here, through this case, we have discussed in detail issues related to tumour origin, that is, primary versus secondary extradural meningioma and controversial topics regarding the role of adjuvant radiotherapy in the management of AMs. We have presented our radiation treatment strategy addressing the high-risk zones related to tumour extension in this case.

  • radiotherapy
  • radiology
  • cancer intervention

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  • Contributors AB and PS—case content and review of the literature. AR and PS—image selection and description. AB, PS and KM—script editing and final review. AB—obtained patient consent.

  • 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.