Presentation
Moderate headaches.
Patient Data
The large extra mass in the right frontotemporal region with predominantly T2 hypointense signal with multiple foci of T2 hyperintensity within the tumor represents a ying-yang sign; the underlying bone is intact, T2 blackout effect on DWI and ADC.
Midline shift to the left up to 6mm.
Case Discussion
There is a rare example of the dural involvement by the solitary fibrous tumor.
The extra-axial mass differential diagnosis was: meningioma (too low T2 signal but no gross calcification, ying-yang appearance), intracranial epidermoid/dermoid (non-specific signal characteristics, no diffusion restriction, T1 signal does not fit for such low T2 signal), dural metastasis (large single lesion without vasogenic brain edema), melanocytic tumor (no T1 hyperintensity).
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