Recurrence of an olfactory groove meningioma: clinical and radiological findings from a six-year follow-up Opis przypadku

Abstrakt

Introduction and importance: Surgical resection of olfactory groove meningioma remains the cornerstone of treatment, with the goal of gross total resection (GTR) to minimize the risk of recurrence. This study details the presentation, surgical management, and long-term (six-year) follow-up of a 45-year-old female patient with large olfactory groove meningioma.

Case presentation: A 45-years female presented urinary and fecal incontinence, apathy, disinhibition, and progressive visual decline. Preoperative MRI revealed an extra-axial mass in the left frontal region measuring 4.5 × 5.7 × 5.7 cm, producing significant mass effect. The tumor was successfully resected via a bicoronal subfrontal approach, and histopathological analysis confirmed a WHO Grade I meningioma. Serial postoperative MRI and CT scans over a six-year follow-up period (2019– 2025) demonstrated marked initial tumor regression. However, a small residual lesion visible on the first postoperative scan showed gradual regrowth, culminating in a substantial recurrence by September 2025. At that time, the recurrent mass measured 5.2 × 3.4 × 4.55 cm and exhibited aggressive radiological features, including bone invasion and hyperostosis.

Clinical discussion: This case underscores the impact of residual tumor on long-term outcomes in olfactory groove meningioma’s. Although initial resection was a GTR that achieved substantial cytoreduction, the presence of postoperative residue led to delayed but progressive recurrence, including bone invasion, despite benign histology.

Conclusion: These findings highlight that recurrence risk is shaped not only by WHO grade but also by residual tumor burden and local anatomical behavior. Long-term and careful radiological follow- up is therefore essential when GTR cannot be achieved.