Case 5: A: Sagittal sections of MRI scans showing a huge meningioma which was contrast enhanced in the pineal region. It grows below and above the tentorium. B-C: CTA images show moderate tumor (T) staining. The meningioma is supplied by the posterior branch of the cerebral artery (ellipse). VC shows downward shifting (arrow). D: An image of the opening of the cerebral falx (black arrow) and tentorium (green arrow) that exposed the tumor (T), in order to carry out the piecemeal excision. E: Postoperative contrast-enhanced sagittal MRI sections showing the surgical removal of the pineal region meningioma; the artefact of the early postoperative period can be seen. F: Histopathological section of the tumor showing an endothelial WHO grade I meningioma (HE ×200).