Meningioma

Case contributed by Dr Mariela Sosa

Presentation

Pain in the left eye for three months accompanied by inflammatory changes, which have increased in recent days. Her treating physician refers her for CT.

Patient Data

Age: 75 years
Gender: Female
CT

Bone remodeling and hyperostosis of the temporal region left frontal and lateral wall of the orbit on the same side with associated proptosis
The brain region's evaluability shows an extra-axial mass in the left frontal region, hyperdense measuring 2.2 x 6 cm, which causes perilesional edema causing displacement of structures to the right. Homogeneous enhancement is evidenced upon administration of the contrast medium, a cleft sign of the dural tail is produced.
Opacification of the frontal paranasal sinus and the right maxilla and mastoid cells is observed.

 

Case Discussion

An extra-axial mass in the left frontal region with perilesional edema compatible with a meningioma.

Meningioma is the most common extra-axial tumors, representing 38% in women and 20% in men; however, other masses can mimic their characteristics, including primary neoplasms, infections, metastases, findings that increase the probability that an If the lesion is meningioma, mention is made of skull hyperostosis, dural tail sign, and homogeneous enhancement to the administration of contrast medium. Among the central differential is the hemangiopericytoma, considered malignant, a large, lobular mass that often causes hydrocephalus, edema, and mass effect; in tomography without contrast, a hyperdense lesion is shown that enhances when contrast, hyperostosis is not frequent, these extra-axial tumors affect men more than women.

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