A 42-year-old woman presents with progressive headache and visual deterioration. MRI brain shows a well-defined, homogeneously enhancing extra-axial mass attached to the dura at the sphenoid wing, with a CSF cleft between it and the brain, causing adjacent bone hyperostosis. What is the most likely diagnosis?

• A Glioblastoma multiforme
• B Metastatic deposit
• C Schwannoma
• D Meningioma ✓

Explanation

Meningioma is an extra-axial tumor arising from arachnoid cap cells, appearing as a well-defined dural-based mass with homogeneous contrast enhancement, a CSF cleft between the tumor and brain, and a dural tail sign on MRI. Reactive hyperostosis of adjacent calvarium is a characteristic associated finding. Glioblastoma is intra-axial with ring enhancement and central necrosis. Metastases are typically intra-axial and multiple. Schwannomas arise from cranial nerves, most commonly the eighth, and are centered on the internal auditory meatus.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.