Presentation
Chronic headache.
Patient Data
Vividly enhancing T2 isointense mass centered at the left petrous apex/cerebellopontine angle shows bony erosion at the base of the posterior clinoid processes and subtle erosive change also extending to the petrous apex. Mild cortical hyperostosis of the left petrous temporal bone.The porous acousticus is not widened.The left mastoid air cells and tympanic cavity are clear.Partial opacification of the left sphenoid sinus.
Case Discussion
MICROSCOPIC DESCRIPTION: Sections show diathermied fragments of a moderately cellular fibroblastic and meningothelial meningioma composed of spindle cells with focal whorling set within a densely fibrous stroma containing hyalinised blood vessels. Dural attachment is noted. No brain tissue is seen. No necrosis or mitoses are seen. No atypical or malignant features are identified.
DIAGNOSIS: Brain tumor: Meningioma, WHO grade I.
This case illustrates typical features of a petroclival meningioma, in which a solid soft tissue mass is seen involving both sides of the left petrous apex, showing vivid and intense contrast enhancement, hyperostosis and spoke wheel appearance of the intratumoral vessels.
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