Secondary Reconstruction of Recurrent Primary Intraosseous Meningioma of the Calvarium Using a Fasciocutaneous Anterolateral Thigh Free Flap

Abstract

We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re- presented with progressive swell ing in the same area. Imaging confirmed aggressive tumour recurrence with both intra- and extra - cranial disease s and also extension to the ipsilateral orbit. The original anterolateral free flap was raised on anterior pedicle and further de bulking of the tumour was performed. Histology confirmed widely infiltrative atypical meningioma (WHO grade II). This case highlights the benefit of using a fasciocutaneous free flap for reconstruction given the potential for tumour recurrence .