Presentation
Follow-up in breast cancer. First exam after surgery
Patient Data
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The CT examination shows the presence of a roundish formation in the right frontal lobe, with contrast impregnation. Even though the characteristics are not typical of metastases, the clinical history of breast cancer needs to be further investigated.
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Axial and sagittal T1-weighted sequence demonstrates in the right frontal lobe, anteriorly the middle cerebral artery, the mass to be isointense to grey matter; axial T2-weighted sequence demonstrates the mass to be mildly, homogeneously hyperintense to grey matter and to extend anteriorly along the posterior aspect of the anterior cranial fossa floor.
Post-contrast coronal T1-weighted sequence demonstrates a well-circumscribed, homogeneously enhancing mass with a broad dural tail that inferomedially.
Case Discussion
Meningiomas are the most common non-glial tumor of the central nervous system (CNS).
Even though meningioma has a reasonably typical behavior, it is necessary to consider atypical forms; at the same time, some pathologies can mimic meningioma.
In this case, the CT aspect, while suggesting a meningioma, required an in-depth investigation to exclude the presence of metastases in the patient's clinical history, operated for breast cancer.
The MR appearance, as well as the presence of a dura tail, confirmed the diagnostic hypothesis of meningioma making the diagnosis essentially certain.
Editorial note: a dural tail is not pathognomonic of a meningioma.
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