Sphenoid wing en plaque meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Visual symptoms.

Patient Data

Age: Adult
CT

CT brain

Bone window / algorithm CT of the base of skull demonstrates expansion of the greater wing of sphenoid on the right, associated with expansion. 

MRI

MRI brain

The greater wing of sphenoid on the right is expanded, lacks normal fat marrow (see left side) and is enhancing. Thickened enhancing dura is seen at the anterior aspect of the middle cranial fossa extending to involve the cavernous sinus and anterior clinoid, as well as thickened enhancement of the lateral orbital wall. A moderate degree of proptosis is present. 

Case Discussion

This patient presented with proptosis on the right and has imaging features characteristic of a sphenoid wing en plaque meningioma.  There is little differential, however (depending on the age) fibrous dysplasia, Paget's disease of bone and a sclerotic metastasis should be considered. 

This case was subsequently histologically confirmed as being a meningioma. 

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Case information

rID: 14582
Case created: 7th Aug 2011
Last edited: 29th Mar 2017
Inclusion in quiz mode: Included

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