Intracranial meningioma with extracranial propagation
Slowly growing lump on the patient's forehead for 5 years. Follow up examination once per year was advised by the neurosurgeon. An extra-axial expansile lesion measuring about 3 cm in diameter with bone destruction and extracranial propagation was described in the report for last year's CT (not shown).
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There is an expansile extra-axial frontal midsaggital lesion with lobular borders, measuring approximately 30 x 36 x 38 mm (AP x LL x CC), straddling the falx cerebri above the frontal sinus, with bone destruction and extracranial propagation. The lesion is isointense to gray matter in almost all sequences, with avid, homogenous postcontrast enhancement.
There are also multiple chronic ischemic lesions with leukoaraiosis.
This patient noticed a lump on the forehead 5 years ago, which prompted the first CT study, where the lesion was described as a meningioma. The neurosurgeon advised imaging follow up, intending to avoid surgery, taking into consideration the patient's age and the fact that the lesion is slow-growing.