Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
May 2014
Next Case of the Month coming June 3 . . .
Synchronous Benign Brain and Multiple Lung Meningiomas
- Meningiomas are the most common extra-axial CNS tumors arising from meningo-epithelial arachnoid cells. Ectopic meningiomas result from differentiation of ectopic arachnoid cells. They occur outside the CNS in the neck, paraspinal soft tissues, lungs, mediastinum, foot, and skin.
- Clinical Presentation: Non-sepcific headache is the most common symptom
- Key Diagnostic Features: Hyperdense, homogenously enhancing extra-axial mass lesion. Enhancing dural tail is commonly seen and is not specific (only establishes extra-axial nature of the lesion). Presence of hyperostosis (and pneumosinus dilatans when adjacent to paranasal sinuses) is highly suggestive of meningioma. Pulmonary lesions are seen as well-defined soft tissue nodules. Psamoma bodies have been reported.
- DDx: Metastasis, lymphoma, granulomatous disorders
- Rx: Surgery and/or chemoradiotherapy of the brain lesion. The lung lesions have an indolent course.
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