Introduction: Meningiomas, especially papillary meningiomas, are rare tumours in childhood and adolescence. They are histologically classified as atypical.
Case report: We present a 15-year-old girl with a cystic papillary meningioma extending from the infratentorial to the supratentorial region extracranially. After a two-stage gross total resection combined with fractionated radiotherapy of a small residual tumour in the infratemporal fossa, the clinical course was stable for at least 4 years. Then a new infratentorial cystic papillary meningioma with a histological change in tumour malignancy was recognised within only 1 year.
Discussion: Besides the rare histology of a cystic papillary meningioma in an adolescent, the case is remarkable due to the considerable extent of the tumour and the irregular course with rapid regrowth and change into malignancy after an initially stable and benign course. For a comparison, the current literature is reviewed and discussed with regard to sex and age distribution, histopathological features, clinical course and therapeutical options.