• Hongyi Cao, Biying Jiang, Yang Zhao, and Chuifeng Fan.
• Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University Department of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China.
• Medicine (Baltimore). 2018 Jun 1; 97 (23): e11019e11019.

RationaleAnaplastic meningioma, a rare subtype of meningioma, has malignant morphological characteristics and a World Health Organization (WHO) grade of III.Patient ConcernsIn this report, we present findings from 6 cases of anaplastic meningioma.DiagnosesPathological examination of the tumors, including hematoxylin and eosin staining and immunohistochemical staining, was performed. Of the six cases of anaplastic meningioma, two were recurrent tumors from original seminoma with a WHO grade of I. Histologically, three cases had carcinoma-like morphology, one case had sarcoma-like morphology, and two had two kinds of tissue structures: carcinoma-like tumor cell nests and areas with spindle tumor cells. Necrosis was detected in most cases (5/6). Ki67 index was high and varied from 20% to 70%.InterventionsAll the patients received surgery. 3 patients received adjuvant radiotherapy. 1 patient received chemotherapy.Outcomes4 patients had no recurrence at follow-up of 19, 30, 46 and 54 months after the last surgery. 1 patient had recurrence 3 months after the last surgery. 1 patient died 12 days after the last surgery.LessonsThis malignant subtype can be secondary to a WHO grade I meningioma after a long quiescent period. Necrosis was common in the tumor tissues, and Ki67 index was usually high. For patients with a history of meningioma, including benign cases, regular physical examination is important for early detection of tumor recurrence and malignant transformation.

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