SMO and meningioma: Sporadic gene mutations in AKT1, SMO, and KLF4 have been found with higher-grade meningiomas correlated with homozygous cyclin-dependent kinase inhibitor 2A (CDKN2A) gene deletions and telomerase reverse transcriptase (TERT)-promoter mutations [10]. Moreover, meningiomas can further present histopathological and immunological obscurities that can create a diagnostic challenge.