56-year-old woman with history of breast cancer status post mastectomy, now with a aphasia. In the posterior portion of the left superior temporal sulcus (901/18) there is a round, dural-based extra-axial mass. This mass appears isointense on T1-weighted images, heterogeneously hyperintense on T2-weighted images, and enhances avidly. Additionally, there are punctate foci of susceptibility artifact within the posterior aspect of the mass suggestive of micro-calcification or hemorrhage not visible on the prior CT (702/15). There is slight diffusion restriction in this mass. There is increased T2/FLAIR signal in the adjacent left parietal lobe white matter with sulcal effacement consistent with vasogenic edema. There is slight mass effect on the trigone of the left lateral ventricle, but there is no significant midline shift or evidence of herniation. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. A focus of T2/FLAIR hyperintensity in the subcortical white matter of the left frontal lobe (401/18) is nonspecific and does not enhance. The brain parenchyma is otherwise unremarkable for age. The major flow-voids are preserved.The extracranial soft tissues and the overlying bone appears normal.
1.Prominent extra-axial mass along the posterior left superior temporal sulcus with local mass effect and extensive associated vasogenic edema with mild localized mass effect. No overlying osseous abnormality. Differential diagnosis would include a meningioma versus solitary dural metastasis.2.Nonspecific, nonenhancing focus of signal abnormality in the subcortical white matter of the left frontal lobe.