Benign neoplasm of cerebral meninges [D32.0], Reason for Study: ^Reason: yearly f/u for meningioma History: surveillance Again seen is an avidly enhancing dural-based enhancing extra-axial mass along the dorsal aspect of the clivus extending through the ventral foramen magnum to the upper C2 level. Inclusive of the dural tail, the lesion measures 3.9 x 1.8 cm in maximal transverse dimension in the sagittal plane and 2.7 x 2.4 cm in the axial plane, which represents no significant change from the prior study. This lesion impinges upon and significantly flattens the medulla, similar to the prior exam. There is susceptibility effect in the right aspect of the lesion which may represent calcification or chronic blood products.No additional intracranial masses or enhancing abnormalities are detected. Brain parenchyma is otherwise significant only for mild scattered T2 hyperintensities within the white matter which are unchanged and likely reflect chronic small vessel ischemic disease. Diffusion-weighted images are negative for evidence of acute ischemia. No intracranial hemorrhage or abnormal extra-axial fluid collections are detected. A left parietal approach ventricular shunt catheter is in stable position with distal tip along the septum pellucidum. The ventricles are stable in size with left lateral ventricle smaller than right. No hydrocephalus.There is redemonstration of a 7 mm enhancing T2 hyperintense lesion in the posterior right pituitary. Lesion demonstrates a more solid pattern of enhancement relative to prior. The lesion has not clearly grown, however, and the pituitary gland itself appears slightly decreased in size.Bone marrow signal characteristics are unremarkable. A mucous retention cyst is redemonstrated in the right maxillary sinus.
1. There is a stable meningioma extending along the dorsal clivus through the foramen magnum with unchanged mass effect on the medulla.2. A subcentimeter posterior right pituitary lesion appears more solidly enhancing but no larger than on prior examination.