Glioblastoma multiforme that unusually present with radiographic dural tails: Questioning the diagnostic paradigm...

Glioblastoma multiforme (GBM) is both the most common as well as one of the most aggressive primary intracerebral tumors. It classically presents on magnetic resonance imaging as a heterogeneous ring-enhancing lesion in the brain parenchyma with central necrosis. This type of neoplasm can also rarely present, however, as a mass with meningeal attachment and radiographic evidence of a dural tail, which was until recently thought to be specific to meningiomas. Here we present a case of a central nervous system neoplasm that on imaging was initially suggestive of meningioma based on its presence of a dural tail. Final pathology, however, revealed desmoplastic GBM. It is, therefore, important to include GBM on the differential diagnosis of a patient presenting with a dural-based lesion on imaging, especially since the overall survival rate of GBM is much worse than that of a suspected meningioma.