Giant atypical meningioma diagnosis and clinical treatment: a case report

Giant atypical meningioma (WHO grade 2), predominantly female-associated and rare in males. A 23-year-old male presented with episodic limb paralysis and progressive vision/olfaction decline. Magnetic resonance imaging (MRI) revealed a > 8 cm heterogeneously enhancing tumor invading the diploic space with multi-site compression. Preoperative embolization followed by subtotal resection and adjuvant gamma knife radiosurgery achieved 3-year recurrence-free survival. This case highlights: (i) exceptional rarity of young male onset, challenging epidemiological patterns and (ii) the combined strategy of embolization, subtotal resection, and radiotherapy may overcome traditional high recurrence rates in atypical meningiomas, offering insights for individualized management.