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27b - Answer: 57-year-old female presents with previously noted meningioma

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 57-year-old female presents with followup of a previously noted meningioma.

(QUIZ ANSWER) PRIMARY FINDING: 

Tentorial meningioma.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

A 1.8 x 1.5 x 2.1cm oval extraaxial lesion in the left side of the posterior fossa laterally with homogeneous enhancement, no perilesional edema and no mass effect, consistent with a meningioma. This is likely a meningioma off the tentorium. Adjacent venous sinus is patent.  

No other enhancing lesions are seen. 

Craniocervical junction is without Chiari malformation. 

Venous sinuses are patent. 

Normal flow voids in the internal carotid artery and basilar artery. 

No obstructive hydrocephalus. 

No evidence of gliosis. Seventh and eighth nerve complex unremarkable.

Calvarium is intact. No scalp abnormality. 

Mucous retention cyst in the right maxillary antrum. Bilateral maxillary sinusitis with mucosal thickening. Ethmoid sinuses mucosal thickening. 

No evidence of otomastoid disease. 

Orbits including optic nerve and globe of the eye bilaterally symmetrical. 

No siderosis. 

CONCLUSION

1. A 1.8 x 1.5 x 2.1cm homogeneously enhancing extraaxial lesion just proximal to the left transverse sigmoid junction. No perilesional edema or mass effect, consistent with a meningioma likely from the tentorium. Lesion appears stable in comparison to prior MRI.

2. Mucous retention cyst in the right maxillary antrum. Ethmoid and sphenoid sinusitis. Findings were present on prior MRI.

LESSON 3, TOPIC 51

Case Challenge: Brain MRI Cases

Case Challenge

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Content reviewed: July 23, 2021

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