title: Rapid Recurrence of a Benign Meningial Perineurioma.
abstract: BACKGROUND
  We describe a rare case of a rapidly recurring benign meningial-based perineurioma. Clinical, radiologic, and pathologic features of a rapidly recurring falxial perineurioma are described; the perineurioma was discovered incidentally in an 86-year-old woman.
  
  
  METHODS
  Due to progressive gait disturbances and radiologically proven progression after a 3-year symptom-free interval, subtotal resection of a large falxial-based meningeal tumor was performed.
  
  
  CONCLUSIONS
  The pathologic examination confirmed the diagnosis of a perineurioma (World Health Organization grade I). Follow-up magnetic resonance tomography 5 months later due to neurologic deterioration revealed an abnormally rapidly growing and extensive local tumor recurrence. Due to the mass effect, reoperation was performed and adjuvant radiation of 20 Gy to the tumor bed was implemented thereafter. Meningeal-based perineuriomas of the central nervous system are extremely rare, and literature on proper management is scarce. Although histologic classification reveals a benign lesion, follow-up may be considered for this type of tumor.
authors.affiliation: Department of Neurosurgery, University of Bern, Bern, Switzerland; Department of Neurosurgery and F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Lukas
authors.initials: L
authors.lastname: Andereggen
authors.affiliation: Division of Neuropathology, Department of Pathology, University of Bern, Bern, Switzerland.
authors.forename: Istvan
authors.initials: I
authors.lastname: Vajtai
authors.affiliation: Department of Neurosurgery, University of Bern, Bern, Switzerland.
authors.forename: Hans R
authors.initials: HR
authors.lastname: Widmer
authors.affiliation: Department of Neurosurgery, University of Bern, Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Raabe
authors.affiliation: Department of Neurosurgery, University of Bern, Bern, Switzerland. Electronic address: robert.andres@hin.ch.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Andres
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018317:Nerve Sheath Neoplasms / Q000473:pathology* / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods; D018714:Radiotherapy, Adjuvant; D012086:Reoperation
keywords: Meningeal-based tumor; Perineurioma; Recurrence