A 50-year-old woman presents with a 5-year history of headaches, generalized tonic-clonic seizures, and bilateral leg weakness. Skull films reveal hyperostosis of the calvarium. Biopsy of the responsible lesion shows a whorling pattern of the cells. Which of the following is the most likely diagnosis?

## **Core Concept**
The patient's symptoms and radiographic findings suggest a condition affecting the skull, leading to neurological manifestations. The whorling pattern of cells in the biopsy is characteristic of a specific type of tumor.

## **Why the Correct Answer is Right**
The presence of hyperostosis of the calvarium, along with symptoms such as headaches, generalized tonic-clonic seizures, and bilateral leg weakness, points towards a space-occupying lesion. The whorling pattern of cells in the biopsy is highly suggestive of a **Meningioma**. Meningiomas are typically benign tumors arising from the meninges, which are the protective membranes covering the brain and spinal cord. They are known to cause hyperostosis (increased bone thickness) of the adjacent skull. The described symptoms can result from the mass effect of the tumor.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is not provided, but typically, incorrect options for such a question might include other types of tumors or conditions that do not match the biopsy findings or clinical presentation.
- **Option B:** Similarly, without the specific text, we can infer that any incorrect option would not align with the characteristic whorling pattern of cells or the clinical and radiographic findings presented.
- **Option C:** Again, this would not be the correct diagnosis based on the information given.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **Meningiomas** are often benign (WHO Grade I) and are characterized by a whorling pattern of cells and the presence of psammoma bodies. They are more common in women and can present with a variety of symptoms depending on their location. The association with hyperostosis of the skull is a classic radiographic finding.

## **Correct Answer:** . Meningioma

✓ Correct Answer: C. Meningioma