En plaque meningioma with associated CPA / frontal convexity meningiomas
Diagnosis almost certain
Presentation
Decreased visual acuity of the left eye with right hearing loss
Patient Data
Age: 50 years
Gender: Female
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The MRI sequences demonstrate:
- an extra-axial dural-based mass at the right cerebellopontine angle extending into the ipsilateral internal auditory canal (IAC), enlarging the porus acousticus. It shows an isosignal to the cortical gray matter on T1WI, high signal on FLAIR/T2WI with an intense and homogeneous enhancement on postcontrast sequences with "dural tail sign". A mass effect is noted on the brainstem and cisternal portion of the ipsilateral trigeminal nerve.
- The left greater wing of the sphenoid bone is expanded with loss of the normal fatty signal. Dural thickening with enhancement is seen at the anterior aspect of the middle cranial fossa extending to involve the cavernous sinus and extraconal space of the lateral orbital wall with proptosis grade I. There is also an extension to the infratemporal soft tissues through the foramen ovale. Reduced diameter of the intracavernous internal carotid artery as compared to the right side.
- a small extra-axial enhancing mass with a dural tail sign is noted in the right frontal region.
Case Discussion
MRI features characteristic of en plaque meningioma with associated CPA and frontal convexity meningiomas.
Additional contributor: A. Ramdani, MD
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