Post-traumatic meningioma or coincidental occurrence? A case report and critical review of the literature.

Background: The possible causal relationship between traumatic brain injury and subsequent meningioma development remains controversial. Although historical and anecdotal reports have suggested a post-traumatic origin of meningiomas, robust epidemiological evidence is lacking, and the distinction between causality and coincidence remains challenging. Case Description: We report the case of a 78-year-old man who sustained a severe frontal cranial trauma with a comminuted fracture and retained foreign body 40 years earlier, treated surgically by craniectomy. Decades later, the patient presented with a headache and cognitive disturbance. Neuroimaging revealed a frontal meningioma arising beneath and within the previous craniectomy site. The tumor was successfully removed en bloc through navigated craniectomy, followed by dural reconstruction and cranioplasty. Histopathological examination confirmed a benign meningioma. The postoperative course was uneventful, and follow-up imaging showed no recurrence. Conclusion: Rather than supporting a traumatic origin of meningioma, this case underscores the limitations in attributing causality between head trauma and tumor development. It emphasizes the need for cautious interpretation of post-traumatic tumor cases and provides clinically relevant insights into the evaluation of meningioma etiology.