Mirror, mirror on the wall, who’s the fairest of them all? Atypical meningioma associated with multiple meningiomas

The incidence of multiple meningiomas (MMs) without stigmata of neurofibromatosis or family history of meningiomatosis is rare. MMs with atypical histology are even rarer, since most of them have benign histology. The authors report three cases of MMs, of which the symptomatic meningioma removed was an atypical meningioma (AM). We also review their possible pathogenesis and histopathology. Although there has not been established any MMs management and therapy strategy so far, our recommendation is to treat symptomatic and accessible lesions or growing tumours and also to prefer a conservative approach consisting of the imaging follow-up of asymptomatic lesions