Meningiomas are common and mostly benign intracranial tumors, but may show a histological progression to malignancy. The mechanisms of malignant transformation remain unclear. Malignant meningiomas usually bear a high recurrence rate and unfavorable prognosis, and multiple surgical resections are required for the treatment. We report on a case of 51-year-old woman with a histologically benign intracranial meningioma. The patient had undergone multiple tumor resections and radiotherapy treatments. After multiple resections, the tumor demonstrated malignant transformation. A rapid tumor growth resulted in extensive tumor invasion of dura, brain and nasal sinus. Impaired brain function and subsequent intracranial hypertension caused serious headache, vomiting and coma. The patient survived 5 years following initial presentation. 3 subtotal resections of meningioma were performed. Radiotherapy was shown to be relatively ineffective during the course. The treatment strategies of recurrent meningiomas are briefly reviewed.