Cerebral gumma showing linear dural enhancement on magnetic resonance imaging--Case report

A 51-year-old male presented with a rare cerebral gumma accompanied by abducens nerve paresis and cerebellar infarction. Magnetic resonance (MR) imaging demonstrated a homogeneous enhance mass lesion and adjacent linearly enhanced dura mater. Histological examination of the mass revealed a caseating granuloma. Serological studies were positive for active syphilis. Although linear dural enhancement adjacent to the mass lesion on MR imaging is characteristic of meningioma, this finding is also demonstrated in cerebral gumma. Therefore, cerebral gummas should also be included in the differential diagnosis. Immunological tests for syphilis (serum, cerebrospinal fluid) can confirm the diagnosis.