En-plaque-meningioma (EPM) is characterized by its flat growth along the bony contour. It accounts for 2–9% of all meningiomas. Very few grade II or III EPM cases were reported. Surgical resection of sphenoid wing EPM is especially challenging as the tumour tends to invade the cavernous sinus, and/or the orbit, and their neurovascular structures. Consequently, tumours in such locations have a higher rate of recurrence. We report the clinical course and management of a patient suffering a second recurrence of grade II EPM. The clinical course of grade II EPM, and the management of multiple recurrences of EPM are scarcely reported in the literature. A 53-year-old male with a history of three previous surgeries for EPM presented with decreased vision in the right eye. Brain magnetic resonance imaging (MRI) showed progression of a sphenoid wing meningioma invading the left optic nerve, indicating a second recurrence of the tumour. We reviewed the literature discussing the clinical course of grade II EPM, and cases suffering multiple recurrences. Only a few cases were found with varying clinical course and management. In our case, surgical intervention was necessary to save the patient's vision. A modified orbitozygomatic craniotomy was performed. A small residual tumour invading the cavernous sinus was left for treatment with stereotactic radiosurgery. Sphenoid wing EPM is challenging pathology to manage, especially grade II tumours which are rarely encountered. Multimodality treatment with surgery and radiotherapy offers EPM patients the best chance of treatment.

Introduction and importance Glioblastoma multiforme (GBM) is the most common primary central nervous system tumor. The frontotemporal location is the most common location for the occurrence of GBM, however, the occurrence of this lesion in the intraventricular system is very rare and only a few cases have been reported about it in the literature. Case presentation: We present another case of primary intraventricular GBM of a 61-year-old patient with a detailed description of the clinical presentation, neuro-radiological and pathological findings, and the surgical approach to the tumor. Clinical discussion We reviewed cases of primary intraventricular glioblastomas in the literature and concluded that it is very rare and has poor prognosis. Surgical gross debulking and the extent resection are very important factors that affect the prognosis of GBM patients. Conclusion: Intraventricular GBM is an aggressive tumor with a challenging location that is usually associated with a poor prognosis. However, our patient showed a long-term survival of 78 months.