Meningioma - left parietal convexity
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Left parietal extra-axial mass exhibits mixed signal on the precontrast sequences, enhances nearly homogeneously on the postcontrast images, and shows restricted diffusion with low ADC value within nearly the whole mass. The extra-axial location of the mass is suggested based on the presence of CSF cleft sign and splaying of the cortex, as well as a pushed medially cortical vein. The mass measures 48 x 61 x 72 mm. Mass effect upon the left lateral ventricle that appears compressed with 7 mm contralateral shift of the midline. Multiple bilateral small lacunar infarcts.
The mass was pathologically proved to be meningioma.
Gross pathology: multiple irregular firm rubbery white tissue measures about 6 x 6 cm.
Microscopic: tumors tissue contains meningeal cells with plump nuclei, pale eosinophilic cytoplasm and indistinct cell borders arranged in whorls and lobules. Multiple foci of microcystic changes, focal necrosis and psammomatous calcifications. No mitotic activity.
Conclusion: Left parietal mass, excision, meningioma WHO grade I.