|Patient: 72 year old male|
|History: 72 yo male with right head pain and fall|
|Findings: 3 cm partially calcified extra-axial mass with mass effect on the adjacent righ frontal lobe. There is reactive hyperostosis of the adjacent calvarium. There is vasogenic edema with mass effect on the lateral ventricle and 3-4mm of midline shift.|
|Diagnosis: Calcified Meningioma. Brain MRI (not shown) showed classic findings including homogeneous enhancement and dural tail.|
Meningiomas represent 15% of all brain tumors. They are the most common extra-axial tumors in the brain and the most frequently occurring tumors of mesodermal or meningeal origin.
Survival rates from surgical series are 82%, 72%, and 60% at 2, 5, and 10 years, respectively.
-Invasion of surrounding dura frequently provokes an osteoblastic response, causing hyperostosis. Hyperostosis is seen in 15-20% of patients.
-CT is the imaging modality used best for demonstrating calcification of meningiomas.
-CT can show acute tumor hemorrhage and widened vascular grooves in the calvarium.
-Homogeneous masses with attenuation similar to the surrounding brain make up 25-33% of meningiomas.
-Contrast-enhanced CT displays moderate-to-strong homogeneous enhancement in most tumor.
-On nonenhanced T1-weighted images, most meningiomas have no signal intensity difference compared with cortical gray matter.
-On MRI and CT, meningiomas exhibit the same enhancement appearance after the injection of contrast medium. Intense enhancement is seen in 85% of tumors.
-Meningiomas have a collar of thickened, enhancing tissue that surrounds their dural attachment; this is also known as a dural tail. This sign represents thickened dura which may be either reactive or neoplastic. A dural tail occurs in approximately 65% of meningiomas and 15% of other peripheral tumors; therefore, it is a good predictor of lesion identity. While this radiographic feature is not specific for meningiomas, it is highly suggestive of the diagnosis.
|References: Castillo, G. Meningioma, Brain. http://www.emedicine.com/radio/topic439.htm|
Dahnert W. Radiology Review Manual, 5th edition. Lippincott Williams and Wilkins. Philadelphia 2003: 708.
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Case Number: 11041674Last Updated: 09-26-2007 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.