Presentation
Right proptosis.
Patient Data
Well-circumscribed extra-axial mass of the anterior aspect of the right middle cranial fossa with broad-based dural attachment to the greater wing of sphenoid which is expanded with loss of the normal fatty signal (hyperostosis). It elicits an isosignal to the cortical grey matter on T1, T2 and high signal on FLAIR with vivid homogeneous enhancement and dural tail sign. It extends superiorly to the lateral and superior extraconal space displacing the lateral and superior rectus muscles with non-axial proptosis grade 3. There is also anterolateral extension to the temporal fossa invading the temporalis muscle as well as to the infratemporal fossa.
Case Discussion
MRI features most consistent with sphenoid wing meningioma extending to the temporal and infratemporal fossae.
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