• Anhui Yao, Liyun Jia, Benhan Wang, Jiashu Zhang, Jun Zhang, and Bainan Xu.
• Department of Neurosurgery, General Hospital of PLA, Beijing, China; Department of Neurosurgery, The 988 Hospital of PLA, Zhengzhou, China.
• World Neurosurg. 2019 Jul 1; 127: 534-537.

BackgroundIdiopathic hypertrophic pachymeningitis is a rare inflammatory condition with diffuse thickening of the dura mater, which may cause a compressive effect or vascular compromise.Case DescriptionA 40-year-old Chinese man presented with persistent headache for 6 months and a sudden epileptic seizure 2 days ago. Magnetic resonance imaging demonstrated a large (71 × 34 × 27 mm) extra-axial mass at the right frontal convexity with severe edema mimicking meningioma. The lesion and peripheral dura mater showed contrast enhancement. Additionally, the skull near the lesion was eroded. Meningioma was diagnosed, and the patient underwent surgery. During the operation, we found the lesion texture was very tough, and the superior sagittal sinus was occluded. Histopathologic findings revealed a large number of infiltrated lymphocytes with fibrosis and microabscess formation; intracranial idiopathic hypertrophic pachymeningitis was diagnosed. Follow-up magnetic resonance imaging performed 3 months after surgery demonstrated the enhancement was notably alleviated.ConclusionsIdiopathic hypertrophic pachymeningitis should be part of the differential diagnosis of some cases of meningioma.Copyright © 2019 Elsevier Inc. All rights reserved.

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