Multiple sections show cellular meningeal tumor formed of plump spindle meningeal cells with indistinct cellular borders and focally arranged in whorly patterns with many small onion-bulb structures and some psammoma bodies. No evidence of malignancy. This is a WHO grade I meningioma.
History of headache and left eye pain has a large avidly enhancing suprasellar and left parasellar extra-axial mass—highly suggestive of a meningioma—that encases the left internal carotid artery, compresses the optic chiasm and left optic nerve, and causes an 8 mm rightward midline shift with subsequent active asymmetric obstructive hydrocephalus.
Soft tissue fragments collectively measured 1.3x1 cm, totally embedded.
Suprasellar and left parasellar extra-axial mass, excision biopsy: