Transformation of Grade II to Grade III Rhabdoid-Papillary Meningioma: Is Stereotactic Radiosurgery the Culprit? A Case Report and Literature Review.

Background: In the management of meningiomas, single-fraction stereotactic radiosurgery (SRS) is an established alternative treatment to surgical resection. However, its effects on tumorigenesis and malignant transformation are still uncertain.
Case Description: We have described a grade II parafalcine meningioma that was initially surgically resected (Simpson 2 clearance) and then managed with a single dose of SRS on recurrence. The tumor recurred again 7 years later, with histological features of a grade III rhabdoid-papillary lesion, with local brain invasion.
Conclusion: To the best of our knowledge, this is the first report to describe malignant transformation of a grade II to grade III meningioma after SRS to date.
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