Presentation
Chronic progressive headache with a normal neurological exam.
Patient Data
Well-defined extra-axial infratentorial space-occupying lesion, measuring about 3.5 x 3.6 x 3.8 cm, isointense on T1 and hyperintense on T2 and FLAIR, with intense homogeneous enhancement and dural tail sign on post-contrast T1 sequences. A mass effect is noted on the left cerebellar hemisphere and the 4th ventricle with tonsillar herniation. No significant hydrocephalus.
Axial and coronal T2 show CSF cleft sign indicating extra-axial lesion.
Hyperdense space-occupying lesion in the posterior fossa.
Sections show neoplastic meningothelial cells proliferation within fibrocollagenous background. Tumor cells are arranged in syncytial pattern, in short bundles and in whorling pattern. Several psammoma bodies are noted. There is no evidence of increased mitotic activity or signlffcant atypical changes.
Case Discussion
All imaging findings correlate with meningioma.
The diagnosis was confirmed by pathology (meningioma grade 1).
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