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Multiple meningiomas: neurofibromatosis type 2

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Altered conscious state, right upper limb weakness.

Patient Data

Age: 40 years
Gender: Male

In the left parietal region is a non-calcified enhancing extra-axial mass. There is surrounding vasogenic edema and significant rightward midline shift. 

There are other numerous extra-axial masses, most of which are calcified. Multiple prior craniotomies and craniectomies are noted along with left frontal encephalomalacia and sclerotic calvarium. Extracranial mass in the left masticator space (in the region of the pterygoid muscles) appearing to relate to the foramen ovale.

Case Discussion

Findings in keeping with known background of neurofibromatosis type 2. The left parietal mass had tripled in size from the prior scan 7 months ago, with the edema and midline shift being new. The patient proceeded to craniotomy and resection, which confirmed WHO grade I meningioma

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