Presentation
Headaches.
Patient Data
Large well-circumscribed extra-axial mass of the anterior aspect of the left middle cranial fossa with broad-based dural attachment to the sphenoid wing. It elicits an isosignal to the cortical grey matter on T1 and T2 and an iso-to-high signal on FLAIR with intense homogeneous enhancement with a dural tail sign. It extends medially to the ipsilateral cavernous sinus. No evidence of intraorbital extension. A mass effect is noted on the ipsilateral frontal and temporal lobes as well as the adjacent frontal horn.
Cerebral volume loss with small vessel ischemic change is noted.
Case Discussion
MRI features are most consistent with a sphenoid wing meningioma.