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Published online by Cambridge University Press: 10 July 2025
Background: Meningiomas are the most common intracranial extra-axial lesion. Reports of meningioma regression exist, often in the context of known hormonal or vascular fluctuations, though very few describe complete resolution. Though rare, extra-axial mimics such as lymphoma and chloroma may also spontaneously regress. Methods: Electronic medical records were used to access patient information in accordance with our local ethics review board. Results: A 29-year-old male presenting with new onset seizures was found to have a 22.7 x 26.6 mm left temporal extra-axial lesion, radiologically consistent with meningioma. Due to wait times and patient preference, repeat pre-operative imaging was not available prior to surgical resection 13 months later, though an interim CT had confirmed persistence of the tumour’s size 1 month after diagnosis. Decision was made to proceed with resection; however, intraoperatively, no lesion was identified. Post-operative imaging demonstrated complete disappearance of the lesion, and follow-up imaging has shown no recurrence. Conclusions: This case highlights the possibility of spontaneous resolution of extra-axial lesions and emphasizes the importance of serial imaging prior to resection.