Pineal-region meningioma

Case contributed by Ryan Thibodeau
Diagnosis certain

Presentation

Headache.

Patient Data

Age: 75 years
Gender: Female
mri

There is a large avidly enhancing mass centered upon the right side of the pineal gland measuring 4.4 x 4.0 x 2.5 cm with peripheral deviation of calcifications. The mass effaces the cerebral aqueduct results in mass effect upon the cerebellar vermis, third ventricle, and to a minor extent the right thalamus. There is associated mild dilatation of the lateral and third ventricles with transependymal flow of cerebral spinal fluid consistent with obstructive hydrocephalus. There is deviation of the internal cerebral veins.

There is evidence of previous bilateral cataract surgery. There is T2/FLAIR hyperintensity along the posterior aspect of the right transverse sinus, suspicious for chronic venous thrombus.

Case Discussion

This is a case of a pineal-region meningioma. The patient underwent a stereotactic suboccipital craniotomy with suprasellar infratentorial approach for tumor resection. Histopathologic analysis was consistent with a meningioma. Upon discharge, the patient continued to experience symptoms of head pressure, headache, and dizziness. These symptoms were severe enough to be limit the patient’s ability to participate in rehab. The patient was scheduled for radiation therapy for further management.

Co-author:
Alannah McCann

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