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Infratentorial meningioma

Case contributed by Mohamed Mahmoud Elthokapy
Diagnosis almost certain

Presentation

Progressive headache, gait disturbance, and drowsiness.

Patient Data

Age: 60 years
Gender: Female
mri

Right posterior fossa tentorial-based extra-axial mass lesion measures 4.3 x 3.8 x 3.1 cm along its maximum AP, TR, and CC dimensions respectively. It elicits low to isointense T1 and high to iso-intense T2 with moderate non-homogenous enhancement in the post-contrast study showing small intralesional non-enhanced foci, moreover evidence of enhancing dural tail (tentorial leaflet) in the post-contrast series. It is surrounded by mild perifocal edema. Both exert a mass effect in the term of smoothly indenting the superomedial surface of the right cerebellar hemisphere and moderate compression of the fourth ventricle which appears kinked

Mild periventricular thin sheets of bright T2 and FLAIR signals are seen.  

Mild ventricular and sulcal dilatation.  

Case Discussion

Right posterior fossa extra-axial dural based SOL, with imaging features, the enhancement pattern and mass effect as described is impressive of an infratentorial meningioma.

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