Meningioma is the most common extra-axial, Dura-based tumor of the central nervous system. These tumors often present in middle to late adult life, especially in women, and account for 15% - 30% of all intracranial tumors(1). Incidence rate of 18.69 and 0.16 per 100,000 is recorded for patients above 40 years and 0-19 years age respectively(2). The World Health Organization (WHO) in its 2021 classification divides meningioma into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) variants. It further subclassifies grade I meningioma into 9 subtypes: meningothelial, fibrous, transitional, psammomatous, angiomatous, microcystic, secretory, lymphoplasmacyte rich, and metaplastic(3). Metaplastic meningioma is the rarest subtype, and defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations(4). We present a case of metaplastic meningioma with Myxoid, Xanthomatous and Osseous metaplasia presenting with anemia in a 17-year-old boy.

Keywords : Meningioma, Anemia, Immunohistochemistry