The highlighted patient had an atypical primary meningioma per WHO grading (at the most recent relapse), as well as homozygous CDKN2A deletion, NF2 high variant allele frequency, and TERT promoter mutation that similarly corroborate the described risk factors in the literature.8,38–41 Although few, if any, studies have directly analyzed metastatic meningiomas, key implications can be inferred from the risk factors associated with tumor progression. Here, TERT is linked to meningioma.