“…A previous study reported that a meningioma with telomerase reverse transcriptase promoter mutations harbors a higher risk of malignant transformation and a more aggressive clinical course compared to meningioma without (TERT) promoter mutations ( 17 ). Furthermore, another study demonstrated that a neurofibromatosis type 2 mutation activated the Hippo, Notch, PI3K/AKT, mTOR and RAS/MAPK signaling pathways, with an ensuing increase in cell proliferation ( 18 ). In addition, some studies have found that stereotactic radiosurgery ( 19 ), surgical stress ( 16 ) and viral infection ( 4 ) can induce the malignant transformation of intracranial meningioma.…”