Male, 56 years old, with a hamartoma with meningothelial elements in the right frontoparietal scalp. Evaluate for underlying meningioma with extracranial extension. An area of subcutaneous thickening is seen in the high right parietal scalp which appears to be composed of both fatty and scarlike tissue. The lesion enhances on postcontrast images and demonstrates restricted diffusion. The bone immediately deep to the scalp lesion is mildly thickened with irregular margins and is somewhat heterogeneously low in signal intensity. There may be very mild marrow enhancement, best appreciated on sagittal T1 postcontrast images (image 9 series 12). The extracranial periosteum is slightly thickened and enhancing as well.No evidence of any intracranial mass or pathologic enhancement is seen including in the high right parietal area. No edema or mass effect is detected. A few scattered small foci of T2 hyperintensity in the cerebral hemispheres are nonspecific. No findings are seen to indicate intracranial hemorrhage or any abnormal extra-axial fluid. Ventricular size and morphology are within normal limits.
An area of subcutaneous scalp thickening is seen in the high right parietal region likely indicating the site of the biopsied/excised lesion. The bone immediately deep to the lesion is thickened with irregular margins and perhaps minimal marrow enhancement. While these findings are by no means specific, they can be seen in the context of intraosseous meningioma, which could potentially account for the meningothelial elements on histology. If further evaluation is warranted, a CT examination can be considered to better evaluate the bony features. No evidence of any intracranial meningioma is seen.