A 46-year-old woman with right sphenoidal ridge meningioma (alar type), which recurred in the orbit and the pterygomaxillary fossa three years after total removal, is presented. Histologically the first examination showed transitional type meningioma. She noticed right exophthalmos, ophthalmoplegia, visual disturbance and swelling of the right side of the face three years later. Microscopically, the tumor showed malignant meningioma. Electron microscopic examination of the specimen disclosed the nucleoli lying on the nuclear membrane, interdigitation with desmosomes, polymorphous mitochondria, free ribosomes, glycogen granules and an enlarged Golgi apparatus. In conclusion, this patient had a transitional type of meningioma when it first presented, but developed malignant histological features invasion at extracranial sites three years later.
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