A Distinctive Pathologic Meningioma Completely without Enhancement and Dural Tail Sign on Imaging Findings

It is known that meningiomas are common intracranial benign tumors that can be enhanced significantly on computed tomography or magnetic resonance imaging scans after the administration of contrast medium. The authors report here on an extremely rare case of meningioma with distinctive pathological features presenting completely without enhancement and dural tail sign on neuroimaging examination.

A 42-year-old man presented with occasional headache. Findings of the neurologic examination were negative. Computed tomography scans showed a mass lesion located in temporal region with homogeneous hyperdensity and foci calcification. The patient's magnetic resonance imaging studies demonstrated the lesion was hypointense on T1-weighted and T2-weighted images. After the administration of gadolinium-diethylenetriamine pentaacetic acid, the lesion revealed neither enhancement nor dural tail sign. After gross total excision of the lesion was accomplished, histopathologic examination confirmed the diagnosis of hyaline degeneration-rich fibrous meningioma, which represented a distinctive pathologic manifestation.

This report illustrates common meningiomas possess the rare occurrence of uncommon neuroimaging characteristics and pathologic features. According to radiologic and pathologic features, the causes of rare imaging characteristics are discussed.