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Intraparenchymal Meningioma
Raul Ramirez-Grueso1, Sergio I Patino-Ladino1, Jorge A Amortegui-Beltran1
1Department of Neurosurgery, Universidad Nacional de Colombia, USS Tunal, Bogota, Colombia.
Abstract:
Meningiomas have been described as the most frequent extra-axial tumor in the brain. Most are benign and correspond to World Health Organization (WHO) grade I; however, there are some reports of cases that shows atypical locations, like subcortical intra-axial meningiomas. This represents a challenge in radiological diagnosis because it could be taken as a metastasis tumor or vascular malformations. The authors bring a case report of a previously healthy patient who presents a traumatic brain injury with no traumatic lesions. A computed tomography (CT) evidenced a left frontal rounded subcortical lesion surrounded by large vasogenic edema. The first diagnostic impression was a metastasis tumor. During surgery, a total resection was completed, and the appearance of the tumor was meningioma. This was later confirmed by histological analysis. The literature was reviewed in order to determine the importance of including intraparenchymal meningiomas in the differential diagnosis of intracranial lesions.
Insights
Intraparenchymal meningiomas, rare brain tumors, can mimic metastasis on CT scans. Early inclusion in differential diagnosis is crucial for accurate radiological assessment and patient management.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Meningiomas are typically extra-axial tumors, with most being benign World Health Organization (WHO) grade I.
- Atypical locations, such as subcortical intra-axial meningiomas, pose diagnostic challenges.
- These lesions can be misdiagnosed as metastasis or vascular malformations.
Observation:
- A case report details a healthy patient with traumatic brain injury but no traumatic lesions.
- Computed tomography (CT) revealed a left frontal subcortical lesion with significant vasogenic edema.
- Initial diagnosis suggested a metastasis tumor due to the lesion's appearance.
Findings:
- Surgical exploration revealed a tumor consistent with meningioma.
- Histological analysis confirmed the diagnosis of meningioma.
- Literature review highlights the importance of considering intraparenchymal meningiomas in differential diagnoses.
Implications:
- Radiologists and clinicians should consider intraparenchymal meningiomas in the differential diagnosis of subcortical brain lesions.
- Accurate radiological interpretation is vital for appropriate patient management and surgical planning.
- This case underscores the need for a broad differential diagnosis in neuroimaging, especially for atypical tumor presentations.
