A 62-year-old woman presented with drop metastasis of recurrent meningioma located in a vascularized free omental flap. She had undergone three resections of right sphenoid ridge meningioma in another hospital beginning in 1979. Invasive recurrent tumor in the infratemporal fossa was grossly totally removed and the defect was reconstructed with a vascularized free omental flap in our institute in 1999. Magnetic resonance imaging revealed a well-demarcated tumor in the omental flap in 2003. Histological examination showed meningothelial meningioma with Ki-67 labeling index of 2.5%. Surgeons should be aware of the possibility of drop metastasis if the tumor type has a tendency to local recurrence.
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