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Meningioma

Probably should've gone with a frontal lobectomy from the start, because that's how it ended. A very challenging case for all involved, particularly anaesthetics.

Teaching point

Clear cell meningioma is an uncommon histologic subtype of meningioma and is classified as CNS WHO grade 2. In children and young adults, it more frequently involves the posterior fossa and spinal canal than typical meningiomas. Imaging findings, including homogeneous enhancement and occasional internal cystic spaces, are not specific and do not reliably distinguish this entity from other meningioma subtypes or posterior fossa tumors. The diagnosis is defined histologically by sheets of glycogen-rich clear cells, and the grade 2 designation reflects a higher risk of local recurrence based on clinical behavior rather than imaging appearance.