Case contributed by Dr Varun Babu


Patient came for a follow up study after not opting for surgery, reluctant to take any intravenous contrast

Patient Data

Age: 50 years
Gender: Male

A 3.1 x 6.5 x 6.0 cm (TR x AP x CC) extra-axial solid dural-based lesion is seen along left temporofrontal convexity causing moderate vasogenic edema in perisylvian cortex. No cortical infiltration. Lesion is isointense to grey matter in all pulse sequences with diffusion restriction. Areas of blooming on gradient imaging, likely calcification. Hyperostosis of underlying calvaria. 5 mm midline shift to right. Ipsilateral lateral ventricle mild compression. Normal rest of supratentorial neuroparenchyma. No transtentorial herniation. MRS reveals significant rise in choline with an elevated lactate peak. Reduced NAA. 

Case Discussion

This case defines some of the classic signs of an extra-axial mass lesion, in this case a meningioma, including: cleft of CSF seen all around the lesion, obvious dural base from which the mass arises, acute angles against the brain parenchyma. 

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Case information

rID: 61798
Published: 19th Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Vivid Diagnostic Centre

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