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Meningothelial meningioma

Case contributed by Dr Ammar Ashraf

Presentation

Dizziness and fall down with brief loss of consciousness & dropping of saliva from the mouth an hour ago. Left frontal headache more than 6 months. No sensory or motor deficit.

Patient Data

Age: 40 years
Gender: Female
CT

Well-defined extra-axial hyperdense lesion measuring about 4.5 x 4.5 cm in the left anterior cranial fossa. A few small calcifications are seen in it. Mild hyperostosis of the underlying left orbital bone is noted. Moderate vasogenic edema in the left frontal lobe, pressure effects on the frontal horn of the left lateral ventricle and contralateral midline shift measuring 4.0 mm are also noted. No recent major territorial infarction or intracranial hemorrhage. 

MRI

Well-defined extra-axial soft tissue lesion measuring 4.8 x 4.3 x 2.9 cm, in the left anterior cranial fossa with broad base to the left orbital roof. Focal bony hyperostosis seen in the left orbital roof adjacent to the mass. Some tiny calcifications are seen within the mass. Vasogenic edema within the left frontal lobe and mild right sided midline shift of about 6 mm. No hydrocephalus is seen. The lesion is isointense to the grey matter on T1 & T2-weighted images and shows no significant diffusion restriction. The lesion shows homogeneous enhancement and dural tails at its boundary to the cranial fossa on post-contrast study. The lesion is displacing the anterior cerebral arteries; otherwise, brain MRA is normal.

MRI

Postoperative day 1

Status post left frontal craniotomy with complete excision of the left frontal extra-axial space occupying lesion. Postoperative changes seen in the scalp tissues. Significant residual vasogenic edema in left cerebral hemisphere and minimal right sided midline shift still appreciable.

Case Discussion

Procedure: Left frontal craniotomy with excision of the left anterior cranial fossa extra-axial tumor.

Diagnosis: Meningothelial meningioma (grade I according to the WHO grading). Negative for brain invasion.

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Case information

rID: 86269
Published: 26th Jan 2021
Last edited: 27th Jan 2021
Inclusion in quiz mode: Included
Institution: Ministry of national guard health affairs

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