Intraventricular cavernous malformation radiologically mimicking meningioma

Area of Science:

• Neurosurgery
• Neuroradiology
• Neuropathology

Background:

• Cavernous malformations (CMs) are vascular malformations that can occur in the brain.
• Atrial CMs are rare and can present diagnostic challenges.
• Distinguishing CMs from other intracranial lesions is crucial for appropriate management.

Observation:

• A partially calcified lesion with slight contrast enhancement was identified in the left lateral ventricle atrium.
• Radiological imaging, including CT angiography and MRI, suggested a meningioma.
• The lesion lacked the characteristic hemosiderin ring often seen in other cavernous malformations.

Findings:

• Surgical resection via a parieto-occipital transcortical approach successfully removed the lesion.
• Histopathological examination confirmed the diagnosis of cavernous malformation.
• The trigonal location and imaging features mimicked a meningioma.

Implications:

• Cavernous malformations should be included in the differential diagnosis of atrial mass lesions.
• The absence of a hemosiderin ring does not exclude cavernous malformation in specific locations.
• Accurate preoperative diagnosis can guide surgical planning and improve patient outcomes.