Enplaque meningioma
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Findings
- Lobulated left sphenoid wing extra axial dural based mass lesion which shows intense homogeneous enhancement after post contrast study with dural tail sign. No non enhancing areas/ necrotic changes are seen within.
- Lesion is encroaching superior and inferior orbital fissure and causing mild proptosis of left orbit. Lesion is encircling intra-canalicular segment of left optic nerve. Lesion is elevating optic chiasma in mid line and left side with indistinct margins. Prominent CSF fluid intensity is seen in retro-orbital segment of left orbit nerve without abnormal enhancement.
- Lesion is extending in left cavernous sinus, completely encircling cavernous segment of left internal carotid artery with mild narrowing. Lesion is extending in sella, closely abutting pituitary gland, infundibulum and shows similar enhancing component measuring 15x9 mm in sella. Pituitary gland is not visualized separately.
- There is significant hyperostosis of left sphenoid wing and posterior wall of sphenoid sinus. Sphenoid sinus shows moderately enhancing similar soft tissue component - suggestive of sphenoid sinus invasion.
- It indents the medial aspect of the left temporal lobe and causing mild white matter edema in adjacent temporal lobe. It is extending into posterior fossa through the meckel’s cave and indenting left lateral aspect of the pons.
- Lesion is extending through the foramina rotandum in pterygo-palatine fossa and abutting postero lateral wall of left maxillary sinus. Lesion is extending through the foramen lacerum into left parapharyngeal space.
- Lesion is encroaching superior and inferior orbital fissure and causing mild proptosis of left orbit. Lesion is encircling intra-canalicular segment of left optic nerve. Lesion is elevating optic chiasma in mid line and left side with indistinct margins. Prominent CSF fluid intensity is seen in retro-orbital segment of left orbit nerve without abnormal enhancement.
- Lesion is extending in left cavernous sinus, completely encircling cavernous segment of left internal carotid artery with mild narrowing. Lesion is extending in sella, closely abutting pituitary gland, infundibulum and shows similar enhancing component measuring 15x9 mm in sella. Pituitary gland is not visualized separately.
- There is significant hyperostosis of left sphenoid wing and posterior wall of sphenoid sinus. Sphenoid sinus shows moderately enhancing similar soft tissue component - suggestive of sphenoid sinus invasion.
- It indents the medial aspect of the left temporal lobe and causing mild white matter edema in adjacent temporal lobe. It is extending into posterior fossa through the meckel’s cave and indenting left lateral aspect of the pons.
- Lesion is extending through the foramina rotandum in pterygo-palatine fossa and abutting postero lateral wall of left maxillary sinus. Lesion is extending through the foramen lacerum into left parapharyngeal space.
Diagnosis
1. Meningioma (en plaque type).
Differntial Diagnosis : Hemangiopericytoma.
Differntial Diagnosis : Hemangiopericytoma.
Dr Sheenu Agrawal DNB is a Consultant Radiologist from with experience of 5-8 years post-graduated from Sagar Apollo Hospital, Bangalore. Specialized in Reporting of CT-SCAN , MRI , MAMMOGRAM cases with expertise in Neuro-imaging , Spine-imaging , Musculoskeletal , Joints , Stroke-imaging , Breast-imaging
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