En plaque meningioma

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Progressive painless swelling of the right scalp and headache.

Patient Data

Age: 60 years
Gender: Female
mri

Right fronto-temporo-parietal intensely enhancing extra-axial dural based lobulated mass lesion is seen, demonstrating isointense T1 and T2 signal intensity relative to the cerebral cortex with restricted diffusion.

The lesion is associated with evident hyperostosis of the right temporo-fronto-parietal as well as the greater wing of sphenoid bones with transgression across that sclerotic bone into the subgalial and temporalis regions. Associated enhancing dural tail is seen.

 The lesion measures about 9 X 9 X 3 cm in its maximal CC, AP and TS diameters respectively. The lesion is associated with moderate (grade II) vasogenic brain edema with slight compression of the right lateral ventricle.  No midline shift.

Case Discussion

This case demonstrates a typical pathologically proved en-plaque meningioma with associated bone sclerosis as well as transgression through the calvarial bones and an extracranial component.

 

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