Central tumor necrosis of a large meningioma following acute anemia caused by hysterectomy.

A 55-year-old woman, with a one-year history of headache, gait disturbance, and slight aphasia, was transferred to our hospital after head injury. Magnetic resonance (MR) imaging and computed tomography revealed a large meningioma with peripheral edema. However, priority was given to previously planned gynecological surgery for uterine cancer. She developed severe anemia after the surgery, followed by consciousness disturbance. MR imaging revealed spontaneous tumor necrosis. The meningioma was totally removed. Her consciousness improved, and she was discharged with no neurological deficit. Patients with large meningioma may suffer deterioration of symptoms due to central tumor necrosis triggered by acute anemia.