Falcine meningioma

Case contributed by Bruno Di Muzio , 6 Nov 2015
Diagnosis certain
Changed by Bruno Di Muzio, 9 Nov 2015

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Falcine meningioma.
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This case illustrates a histologically proven falcine meningioma. Falcine and parasagittal meningiomas share the same concern about the superior sagittal sinus involvement, and both locations demand a venography study to make sure if there is or not sinus invasion.

  • +<p>This case illustrates a histologically proven falcine <a title="Meningioma" href="/articles/meningioma">meningioma</a>. Falcine and parasagittal meningiomas share the same concern about the superior sagittal sinus involvement, and both locations demand a venography study to make sure if there is or not sinus invasion. </p>

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Technique: Multiplanar, multisequence imaging has been obtained through the brain including post contrast fat saturated images and time-resolved MRA/MRV. Comparison has been made to previous external CT.

Findings:

Enhancing extra-axial mass centred on the mid falx and measuring 22 x 33 x 24 mm (AP x ML x SI) has not significantly in size and morphology compared with the prior study.

This abuts the superior sagittal sinus without evidence of invasion. The sinus enhances normally on time-resolved MRA/MRV.

Mild local mass-effect with FLAIR hyperintensity in the adjacent right parenchyma.

No other intra or extra-axial abnormality.

Conclusion: Falcine meningioma without superior sagittal sinus invasion.

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Updates to Study Attributes

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No report data foundTechnique: Pre and post-contrast axial images were obtained through the brain, with posterior sagittal and coronal reformations.

Findings: There is a solid, well-defined, and extra-axial tumour involving the mid falx cerebri, which shows to be spontaneously hyperdense, with some minor peripheral calcifications foci, abutting over the adjacent frontal lobes and partially involving the superior sagittal sinus. The lesion express homogeneous and vivid contrast enhancement and cause mild surrounding oedema in the adjacent right superior frontal gyrus. It is clear that the lesion goes through the falx.

Remainder brain is unremarkable.

Conclusion: Solid extra-axial tumour involving the mid falx cerebri, which most likely represents a meningioma; Haemangiopericytoma is among the differential diagnosis. Further evaluation with MRI venography is advised to assess possible sinus invasion.

Updates to Quizquestion Attributes

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Which features make haemangiopericytoma plausible to be considered?
Answer was added:
Although impossible to be certainly separated from a meningioma on imaging, some features make haemangiopericytomas a differential to be included. In this case, in particular, the fact that the tumour goes through the falx instead of involving it on both faces.

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