42 Year-Old With Headache

This is unpublished
CT Noncontrast Soft Tissue Window.
CT Noncontrast Soft Tissue Window
CT Noncontrast Bone Window.
CT Noncontrast Bone Window
T1 Axial Noncontrast.
T1 Axial Noncontrast
T1 Axial Post Gad.
T1 Axial Post Gad

Findings:

Hyperdense mass with hyperostosis on NECT
Homogeneously enhancing extra-axial dural based mass
Cortical buckling and trapped cortical vessels

DDX:

Dural metastasis
Granuloma (Sarcoid, TB)
Hemangiopericytoma
Solitary fibrous tumor

Diagnosis:

Meningioma

Discussion:

Arise from arachnoid meningothelial “cap” cells
Most common primary adult intracranial tumor
F>M; may be related to female sex hormones
XRT pre-disposes
Associated with NF-2
Dural based mass with cortical buckling and/or trapped CSF clefts/cortical vessels
Hyperostosis of bone; Calcifications
MRS: elevated levels of alanine at short TE

Submitted by Sung Logerfo, MD, UW Neuroradiology