A case of intraosseous and subcutaneous meningioma transforming head like a rugby ball

A case of huge intraosseous and subcutaneous meningioma presenting transformation of head like a rugby ball is described. He was admitted to our hospital with an elastic hard, painless growing mass in parietal and occipital region. Neurological examination and laboratory data was revealed no abnormalities. Bone target CT showed a wide range of osteoblastic lesion in parieto-occipital skull. Gd-enhanced magnetic resonance images (MRI) showed large homogeneous enhanced tumor at subcutaneous and intradiploic portions, and small enhanced tumor at subdural parasagital portion. At biopsy, subcutaneous and intradiploic tumor proved benign meningothelial meningioma. After biopsy, subcutaneous, intradiploic and parasagittal meningiomas were resected as far as possible with no complications and cranioplasty was performed with a titanium sheet. Microscopically there was not a relation between extradural tumor and intradural parasagittal tumor. Follow-up MR images was present no tumor regrowth one and a half year after surgery. Intraosseous meningioma was extremely rare. Especially unusual appearance was presented by this rare case, so we present clinical course of this case and reviewed clinical charactaristics on medical literatures.