IMAGING OF MENINGIOMA

Oktavia Putri M.
21704101079

Pembimbing
dr. P. Tigor Yeheskiel, Sp.Rad
Background

• Harvey Cushing, 1922.

• Meningiomas are extraaxial tumors that arise from
arachnoid cap or meningothelial cells, Predilection at the
brain or the medulla spinalis
• Most meningiomas are benign
• One of every 10 intracranial tumors originates in the
cerebellopontine angle (CPA), most of which are
schwannomas and meningiomas
Epidemiology

• 26% of primary intracranial neoplasm

• Among intracranial meningiomas, 5%–10% are located in
the cerebellopontine angle (CPA)
• Incidency rate 6/100.000 (mostly > 50 years).
• Rarely found in children
• Female and Male ratio ➡ 2:1
Etiopathology

• Radiation exposure
• Head Trauma
• Genetic
• Hormonal
Meningioma Types
In general, a meningioma is classified into 3 grades:
• grade I tumor grows slowly.
• grade II tumor grows more quickly and is often called
atypical meningioma.
• grade III tumor grows and spreads very quickly and is
often called anaplastic or malignant meningioma.
Clinical Features

• Based on size and location of tumor

– Headache
– Seizures
– Vision loss
– Nausea and vomitting
– Motor or Sensory Disorder
– Personality changes, confusion and altered level of
consciousnes
Diagnosis
• Anamnesis
– Sign and symptom
• Definitive diagnosis
– CT Scan
• Extra-axial mass
• Broad dural base
• Well defined mass
• Hyperostosis
• Hyperdense with contrast administration
– MRI
• Dural tail
• CSF cleft
Radiographic Features
Differential Diagnosis

• Dural Metastasis
• Hemangiopericytoma
• Schwannoma
Prognosis

• Quality of Resection
• Histological grade
• Patient’s age
• Location and size tumor
Case Description

• A 45 years old woman with a paresis N.VII and N.VIII

sinistra

• CT scan examination with enhancement administration

• CT scan examination with enhancement administration
revealed a Well defined mass, solid, regular edge, strong
contrast enhancement on right CPA, with perifocal edema
around the mass, so it press the fourth ventricle that cause
a dilated of right and left ventrikel and third ventrikel, it's
also expands to the right anterior cerebellum.
Conclusion
• Meningiomas are extra-axial tumors and represent the
most common tumor of the meninges.
• They are a non-glial neoplasm that originates from the
meningocytes or arachnoid cap cells of the meninges and
are located anywhere that meninges are found,
• Diagnose of meningioma base on clinical manifestation
also CT scan examination
• CT Imaging of Meningioma such as extra-axial mass,
broad dural base, well defined mass, hyperostosis iso to
slightly hyperdense compared with normal brain, and
dural tail
Reference
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Meningioma. ONCOLOGY LETTERS 13: 2965-2970, 2017.
3. Kesari, S. dkk. Meningioma. American Brain Tumor Association. 2017.
4. Gurcay, A. G., Bozkurt, I., Senturk, S., Kazanci, A., Gurcan, O., Turkoglu, O. F., and Beskonakli,
E. Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. Asian
Journal of Neurosurgery | Published by Wolters Kluwer – Medknow. 2018
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Overview of Meningiomas. 2018
Thank You