Olfactory groove meningioma

Case contributed by Dr Ian Bickle


Middle aged female. Unspecified previous neurosurgery. Admitted out of hours with first fit.

Patient Data

Age: 45 years
Gender: Female

Left frontal craniectomy with cranioplasty.  Minor underlying post operative gliosis.

3cm round anterior midline isodense mass centered on the planum sphenoidale at the site of the olfactory groove, with avid symmetrical edema.

Smaller similar lesion in the right temporal region close to the sphenoid wing.

Hyperostosis of the floor of the anterior cranial fossa, without bony destruction.

Left frontal craniotomy.

Minor gliosis in the left frontal lobe at the site of previous surgery.

3.7 cm well-defined anterior midline mass with homogeneous enhancement, in the olfactory groove/planum sphenoidale, the posterior aspect of which abuts the anterior aspect of the sella turcica. Mild underlying hyperostosis of the planum sphenoidale. No bony destruction.

Moderate bilateral perilesional edema in the frontal lobes, with minor effacement of the frontal horns of the lateral ventricles.  The white matter buckling sign is evident.

Identical 2.7 cm right dural based temporal lobe mass, centered on the sphenoid wing, with an enhancing dural tail.

Normal posterior fossa.

Case Discussion

Meningiomas are common.   They may be multiple and a wide range of potential imaging appearances are possible.  However, the vast majority have a typical appearance, as in this case with avid homogenous enhancement and a dural tail.

A small proportion occur along the olfactory groove/planum sphenoidale with a very central, symmetrical appearance.

Surgery was performed which confirmed two meningiomas.

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