Petrous ridge meningioma

Case contributed by Dr Ian Bickle

Presentation

Right side trigeminal neuralgia. Space occupying lesion ?

Patient Data

Age: 44
Gender: Female
Modality: CT

3.4cm enhancing convex mass with underlying bony irregularity adjacent to the right petrous ridge.  

The mass covers the right internal auditory meatus.

The 4th ventricle is effaced as it the brainstem, due to mass effect.

The supratentorial brain is the normal.

Modality: MRI

3.4cm avidly and homogenously enhancing convex mass with a broad meningeal attachment to the inferior aspect of the tentorium cerebelli and the adjacent petrous ridge. The mass covers the right internal auditory meatus and extends 1.4cm into the auditory canal, but without overt expansion.

Thin dural tail. No internal cystic change within the mass.

Moderate amount of mass effect of the brainstem, cerebellum and inferior aspect of the midbrain. The mass also contacts and displaces the right trigeminal nerve.

Mild displacement and effacement of the fourth ventricle.  Mild hydrocephalus.

Case Discussion

Large mass at the right IAM, with a dural tail and MRI characteristics of a meningioma.

Meningiomas are common occurring at a multitude of sites - this being one of the less common sites.

A chief differential at this site would be a vestibular schwannoma.

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Case Information

rID: 50777
Case created: 21st Jan 2017
Last edited: 5th Apr 2017
Inclusion in quiz mode: Included

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