45-year-old woman with worsening daily left frontal headaches. Please evaluate for intracranial/anatomic etiology. A large, isodense, apparently extra-axial mass is seen in the right frontal region which measures 31 x 48 mm (image 17/36). The peripheral aspect of the mass appears low density which probably represents multiple superficial cysts. The overlying bony cortex is slightly irregular and appears to be partially absorbed. Findings are most consistent with a cystic meningioma however, the associated bony irregularity is atypical for a meningioma and further evaluation with MRI is recommended to exclude primary brain malignancy or metastases. There is significant associated vasogenic edema in the right frontal parenchyma with minimal, approximately 2 mm, midline shift at the level of the septum pellucidum. No additional mass lesions are seen. No intracranial hemorrhage is present. The ventricles and basal cisterns are normal in size and configuration. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Large, probable extra axial mass with significant associated vasogenic edema which may represent a cystic meningioma, however further evaluation with MRI is necessary to exclude primary brain malignancy or metastases. Findings were discussed with Dr. M. Glather at 10:30am on 3/25/2008.