Enhanced CT Enhanced CT Enhanced CT

Diagnosis: Recurrent meningioma.

Meningiomas are usually dural based enhancing extraaxial masses often presenting in woman between the ages of 40 and 60. They are the most common non-glial primary CNS tumor. Typical locations are over the convexities, parasagittal regions, and the sphenoid wing. Multiple meningiomas are associated with neurofibromatosis type II. Meningiomas may be intraventricular in 2% of cases. They are usually hyperdense on precontrast CT and have intense homogeneous enhancement. Hemorrhage is unusual however some cystic areas may be present. One quarter of meningiomas have calcification. T1 signal is usually isointense while T2 signal is variable. Bony hyperostosis is characteristic of meningioma. Due to the aggressive appearance of this tumor, malignancy is a consideration. Lymphoma and invasive squamous cell carcinoma are possibilities. Rhabdomyosarcoma is usually seen in a much younger patient population. Plexiform neurofibroma may also have a very aggressive appearance. The presence of bony hyperostosis suggests meningioma. This patient had a meningioma resected from the greater wing of the sphenoid on the left in 1979. Related Cases

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