Meningioma versus dural breast cancer metastasis. There is a 6 mm wide dural-based, homogeneously enhancing mass along the left middle frontal gyrus convexity. There is no evidence of intracranial hemorrhage or acute infarct. There are minimal scattered punctate foci of high T2 signal in the cerebral white matter. There is a nonspecific punctate focus of susceptibility effect in the left parietal lobe deep white matter without associated enhancement. There is a small left cerebellar hemisphere developmental venous anomaly. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. A 6 mm wide dural-based, homogeneously enhancing mass along the left middle frontal gyrus convexity likely represents a meningioma and less likely a metastasis given the lack of aggressive feature, but there can be overlap in the imaging findings of the conditions. 2. A nonspecific punctate focus of susceptibility effect in the left parietal lobe deep white matter without associated enhancement may represent a chronic microhemorrhage rather than an atypical metastasis. Otherwise, no evidence of brain metastases.