Temporal lobe meningioma masked by polymyalgia rheumatica

An elderly woman who had a typical polymyalgia rheumatica (PMR) syndrome, associated with severe headache, was considered to have giant cell arteritis despite negative temporal artery biopsies and was treated with corticosteroids. At autopsy, no arteritis, but a large temporal lobe meningioma, was found as the cause of her headache. Both PMR and meningiomas are frequent in elderly patients, and overlapping symptoms may occur. Patients with PMR and headache should be fully investigated to exclude an occult meningioma or other disease, especially when no positive histologic evidence of temporal arteritis can be obtained.