En plaque meningioma

Case contributed by Tarek Moustafa Essam Daoud
Diagnosis almost certain

Presentation

Diplopia, proptosis and headache.

Patient Data

Age: 40 years
Gender: Female
mri

Left sphenoid wing extra-axial dural based mass lesion.

The lesion is seen averaging 2.7 x 2.5 x 5.7 cm in maximum AP, SS, and CC dimensions.

It is seen showing T1 & T2 iso-intense signal with avid post-contrast dural based enhancement. There is a subtle enhancement in the inferolateral orbital walls with lateral rectus muscle deformity. 

It is seen minimally infiltrating the left masticator space muscles.

This is associated with hyperostosis of the involved bone causing secondary mass effect on the orbit and left lateral rectus muscle leading to proptosis of the left eye.

Case Discussion

This case demonstrated typical MRI and contrast enhancement patterns of intra-osseous meningioma or en plaque meningioma.

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