Meningioma of the olfactory groove, case 1

CLINICAL HISTORY:
This 42-year old woman suffered a partial complex seizure, with a warm sensation in the left leg and numbness of the left part of the face.

CT:
CONTRAST-ENHANCED SCAN IN THE TRANSAXIAL (IMAGE 1) AND CORONAL (IMAGE 2) PLANES: Presence in the midline in the anterior cranial fossa of a moderately enhancing lesion (arrow), with peripherally calcified wall. The mass is seen extending above the lamina cribrosa.

MRI:
a) TRANSAXIAL T2-WEIGHTED (2500/90/1) SPIN-ECHO SEQUENCE (IMAGE 3): Small rounded predominantly hypointense mass (arrowheads) in the anterior cranial fossa is seen with some surrounding edema.

b) TRANSAXIAL T1-WEIGHTED (680/20/1) SPIN-ECHO SEQUENCE (IMAGE 4): The mass (arrowheads) is almost invisible due to the isointensity with the grey matter. Some edema is again noted.

c) TRANSAXIAL (IMAGE 5), CORONAL (IMAGE 6) AND SAGITTAL (IMAGE 7) GADOLINIUM-ENHANCED SPIN-ECHO SEQUENCES: The mass (arrowheads) shows moderate to intense and rather inhomogeneous contrast enhancement. The mass is broadly implanted on the floor of the anterior cranial fossa (arrow). On the coronal slices the broad implantation on the lamina cribrosa is seen.

RADIOLOGICAL DIAGNOSIS is meningioma of the olfactory groove based on the extraaxial location, the calcifications, the broad implantation on the dura of the anterior cranial fossa and the intense enhancement.

SURGICAL FINDINGS: At surgery the tumor was inserted on the crista galli and the anterior part of the falx. The arterial supply arose from ethmoidal branches. Total resection of the tumor was performed with preservation of the olfactory bulbs and tracts.

ANATOMOPATHOLOGY (IMAGES 8 AND 9).

Search also:
Meningioma

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