Presentation
Headache.
Patient Data
A well-defined large extra-axial soft tissue mass lesion is seen at the left cerebellopontine angle (CPA). It exhibits initial iso to slight hyperdensity with moderate homogeneous enhancement after contrast injection showing central calcification. Mild mass effect in term of effacement of the left CPA cistern and 4th ventricle with subsequent supra tentorial hydrocephalic changes.
A well-defined posterior fossa mass lesion is seen occupying the left cerebellopontine region.
The mass shows a wide dural base with junction to the inferior aspect of the tentorium.
The lesion exhibits iso intense to grey matter in all pulse sequences.
It shows intense homogenous enhancement after contrast administration.
This large mass is compressing the brainstem and the fourth ventricle with subsequent dilation of the third and both lateral ventricles.
Case Discussion
Meningiomas are extra-axial tumors and represent the most common tumor of the meninges.
Three is no intracanalicular extension so can be differentiated from vestibular schwannoma.
Also, the hypointense signal in T2 WI is supportive for meningioma.
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