Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical Neuroradiology
Published in: Clinical Neuroradiology 2/2017

01-06-2017 | Review Article

Uncommon Cranial Meningioma: Key Imaging Features on Conventional and Advanced Imaging

Authors: Nader Zakhari, Carlos Torres, Mauricio Castillo, Thanh B. Nguyen

Published in: Clinical Neuroradiology | Issue 2/2017

Login to get access

Abstract

Given the high incidence of intracranial meningiomas encountered in clinical practice, it is not uncommon to find rare subtypes of meningioma, with unusual imaging findings. These commonly represent a diagnostic challenge. In this article, we review the imaging appearance of typical meningioma on conventional and advanced imaging as well as the key imaging features of multiple uncommon subtypes: cystic, microcystic, lipomatous, chordoid, angiomatous, intraosseous, extracranial, atypical/malignant, and tumor-to-tumor metastasis (also known as collision tumors). Some of these uncommon subtypes, however, demonstrate imaging features that may allow for a more specific diagnosis, or features, which can influence patient’s management.
Literature
1.
Nagar VA, Ye JR, Ng WH, Chan YH, Hui F, Lee CK, Lim CC. Diffusion-weighted MR imaging: diagnosing atypical or malignant meningiomas and detecting tumor dedifferentiation. AJNR Am J Neuroradiol. 2008;29(6):1147–52.CrossRefPubMed
2.
Watts J, Box G, Galvin A, Brotchie P, Trost N, Sutherland T. Magnetic resonance imaging of meningiomas: a pictorial review. Insights Imaging. 2014;5(1):113–22.CrossRefPubMedPubMedCentral
3.
Mawrin C, Perry A. Pathological classification and molecular genetics of meningiomas. J Neurooncol. 2010;99(3):379–91.CrossRefPubMed
4.
Osborn AG. Neoplasms, cysts, and tumor-like lesions. In: Osborn AG, editor. Osborn’s brain: imaging, pathology, and anatomy. Salt Lake City UT: Amirsys; 2013. pp. 443–808.
5.
Rokni-Yazdi H, Sotoudeh H. Prevalence of “dural tail sign” in patients with different intracranial pathologies. Eur J Radiol. 2006;60:42–5.CrossRefPubMed
6.
Toh CH, Castillo M, Wong AM, Wei KC, Wong HF, Ng SH, Wan YL. Differentiation between classic and atypical meningiomas with use of diffusion tensor imaging. AJNR Am J Neuroradiol. 2008;29(9):1630–5.CrossRefPubMed
7.
8.
Cha S, Knopp EA, Johnson G, Wetzel SG, Litt AW, Zagzag D. Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology. 2002;223(1):11–29.CrossRefPubMed
9.
Brandão LA, Castillo M. Adult brain tumors: clinical applications of magnetic resonance spectroscopy. Neuroimaging Clin N Am. 2013;23(3):527–55.CrossRefPubMed
10.
Yue Q, Isobe T, Shibata Y, Anno I, Kawamura H, Yamamoto Y, Takano S, Matsumura A. New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma. Eur Radiol. 2008;18(12):2901–11. doi:10.​1007/​s00330-008-1079-6.CrossRefPubMed
11.
Chen TY, Lai PH, Ho JT, Wang JS, Chen WL, Pan HB, Wu MT, Chen C, Liang HL, Yang CF. Magnetic resonance imaging and diffusion-weighted images of cystic meningioma: correlating with histopathology. Clin Imaging. 2004;28(1):10–9.CrossRefPubMed
12.
Hallinan JT, Hegde AN, Lim WE. Dilemmas and diagnostic difficulties in meningioma. Clin Radiol. 2013;68(8):837–44.CrossRefPubMed
13.
Jung TY, Jung S, Shin SR, Moon KS, Kim IY, Park SJ, Kang SS, Kim SH. Clinical and histopathological analysis of cystic meningiomas. J Clin Neurosci. 2005;12(6):651–5.CrossRefPubMed
14.
Zhang D, Hu LB, Zhen JW, Zou LG, Feng XY, Wang WX, Wen L. MRI findings of intracranial cystic meningiomas. Clin Radiol. 2009;64(8):792–800.CrossRefPubMed
15.
Weber J, Gassel AM, Hoch A, Kilisek L, Spring A. Intraoperative management of cystic meningiomas. Neurosurg Rev. 2003;26(1):62–6.CrossRefPubMed
16.
17.
Buetow MP, Buetow PC, Smirniotopoulos JG. From the archives of the AFIP: typical, atypical and misleading features in meningioma. Radiographics. 1991;11:1087–106.CrossRefPubMed
18.
Zee CS, Chen T, Hinton DR, Tan M, Segall HD, Apuzzo ML. Magnetic resonance imaging of cystic meningiomas and its surgical implications. Neurosurgery. 1995;36:482–8.CrossRefPubMed
19.
Nauta HJ, Tucker WS, Horsey WJ, Bilbao JM, Gonsalves C. Xanthochromic cysts associated with meningioma. J Neurol Neurosurg Psychiatr. 1979;42:529–35.CrossRefPubMedPubMedCentral
20.
O’Leary S, Adams WM, Parrish RW, Mukonoweshuro W. Atypical imaging appearances of intracranial meningiomas. Clin Radiol. 2007;62(1):10–7.CrossRefPubMed
21.
Yi CK, Burgos RM, Biega TJ. Cyst with a mural nodule: unusual imaging characteristics of a cystic meningioma. BMJ Case Rep. 2014;2014.
22.
Docampo J, Gonzalez N, Vazquez C, Morales C, Gonzalez-Toledo E. Cystic meningioma simulating arachnoid cyst: report of an unusual case. Case Rep Radiol. 2014;2014:371969.PubMedPubMedCentral
23.
Chen CJ, Tseng YC, Hsu HL, Jung SM. Microcystic meningioma: importance of obvious hypointensity on T1-weighted magnetic resonance images. J Comput Assist Tomogr. 2008;32(1):130–4.CrossRefPubMed
24.
Paek SH, Kim SH, Chang KH, Park CK, Kim JE, Kim DG, Park SH, Jung HW. Microcystic meningiomas: radiological characteristics of 16 cases. Acta Neurochir (Wien). 2005;147(9):965–72.CrossRef
25.
Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathol. 1993;3(3):255–68.CrossRefPubMed
26.
Seung Hyun K, Dong Gyu K, Chae-Yong K, Gheeyoung C, Kee-Hyun C, Hee-Won J. Microcystic meningioma: the characteristic neuroradiological findings. J Korean Neurosurg Soc. 2003;35:401–6.
27.
Shimoji K, Yasuma Y, Mori K, Eguchi M, Maeda M. Unique radiological appearance of a microcystic meningioma. Acta Neurochir (Wien). 1999;141(10):1119–21.CrossRef
28.
Adam D, Hornea I, Moisescu C, Iftimie D, Papacocea T. Microcystic meningioma mimicking an arachnoid cyst. Rom Neurosurg. 2015;3:279–84.
29.
Liu Z, Wang C, Wang H, Wang Y, Li JY, Liu Y. Clinical characteristics and treatment of angiomatous meningiomas: a report of 27 cases. Int J Clin Exp Pathol. 2013;6(4):695–702.PubMedPubMedCentral
30.
Hasselblatt M, Nolte KW, Paulus W. Angiomatous meningioma: a clinicopathologic study of 38 cases. Am J Surg Pathol. 2004;28(3):390–3.CrossRefPubMed
31.
Sibtain NA, Butt S, Connor SE. Imaging features of central nervous system haemangiopericytomas. Eur Radiol. 2007;17(7):1685–93.CrossRefPubMed
32.
Meng Y, Chaohu W, Yi L, Jun P, Songtao Q. Preoperative radiologic characters to predict hemangiopericytoma from angiomatous meningioma. Clin Neurol Neurosurg. 2015;138:78–82.CrossRefPubMed
33.
Gasparinho MG, Ferreira M, Lavrador JP, Livraghi S. Revisiting lipomatous meningioma: a case report and review of an unusual entity. Int J Surg Pathol. 2015;23(5):399–403.CrossRefPubMed
34.
Roncaroli F, Scheithauer BW, Laeng RH, Cenacchi G, Abell-Aleff P, Moschopulos M. Lipomatous meningioma: a clinicopathologic study of 18 cases with special reference to the issue of metaplasia. Am J Surg Pathol. 2001;25(6):769–75.CrossRefPubMed
35.
Ohba S, Yoshida K, Akiyama T, Ikeda E, Kawase T. Lipomatous meningioma. J Clin Neurosci. 2007;14(10):1003–6.CrossRefPubMed
36.
Colnat-Coulbois S, Kremer S, Weinbreck N, Pinelli C, Auque J. Lipomatous meningioma: report of 2 cases and review of the literature. Surg Neurol. 2008;69(4):398–402.CrossRefPubMed
37.
Lin JW, Ho JT, Lin YJ, Wu YT. Chordoid meningioma: a clinicopathologic study of 11 cases at a single institution. J Neurooncol. 2010;100(3):465–73.CrossRefPubMed
38.
Tena-Suck ML, Collado-Ortìz MA, Salinas-Lara C, García-López R, Gelista N, Rembao-Bojorquez D. Chordoid meningioma: a report of ten cases. J Neurooncol. 2010;99(1):41–8.CrossRefPubMed
39.
Epari S, Sharma MC, Sarkar C, Garg A, Gupta A, Mehta VS. Chordoid meningioma, an uncommon variant of meningioma: a clinicopathologic study of 12 cases. J Neurooncol. 2006;78(3):263–9.CrossRefPubMed
40.
Kobata H, Kondo A, Iwasaki K, Kusaka H, Ito H, Sawada S. Chordoid meningioma in a child. Case report. J Neurosurg. 1998;88(2):319–23.CrossRefPubMed
41.
Pond JB, Morgan TG, Hatanpaa KJ, Yetkin ZF, Mickey BE, Mendelsohn DB. Chordoid meningioma: differentiating a rare world health organization grade II tumor from other meningioma histologic subtypes using MRI. AJNR Am J Neuroradiol. 2015;36(7):1253–8.CrossRefPubMed
42.
Rushing EJ, Bouffard JP, McCall S, Olsen C, Mena H, Sandberg GD, Thompson LD. Primary extracranial meningiomas: an analysis of 146 cases. Head Neck Pathol. 2009;3(2):116–30.CrossRefPubMedPubMedCentral
43.
Possanzini P, Pipolo C, Romagnoli S, Falleni M, Moneghini L, Braidotti P, Salvatori P, Paradisi S, Felisati G. Primary extra-cranial meningioma of head and neck: clinical, histopathological and immunohistochemical study of three cases. Acta Otorhinolaryngol Ital. 2012;32(5):336–8.PubMedPubMedCentral
44.
Thompson LD, Gyure KA. Extracranial sinonasal tract meningiomas: a clinicopathologic study of 30 cases with a review of the literature. Am J Surg Pathol. 2000;24(5):640–50.CrossRefPubMed
45.
Albsoul N, Rawashdeh B, Albsoul A, Abdullah M, Golestani S, Rawshdeh A, Mohammad M, Alzoubi M. A rare case of extracranial meningioma in parapharyngeal space presented as a neck mass. Int J Surg Case Rep. 2015;11:40–3.CrossRefPubMedPubMedCentral
46.
Changhong L, Naiyin C, Yuehuan G, Lianzhong Z. Primary intraosseous meningiomas of the skull. Clin Radiol. 1997;52(7):546–9.CrossRefPubMed
47.
Lloret I, Server A, Taksdal I. Calvarial lesions: a radiological approach to diagnosis. Acta Radiol. 2009;50(5):531–42.CrossRefPubMed
48.
Tokgoz N, Oner YA, Kaymaz M, Ucar M, Yilmaz G, Tali TE. Primary intraosseous meningioma: CT and MRI appearance. AJNR Am J Neuroradiol. 2005;26(8):2053–6.PubMed
49.
Agrawal V, Ludwig N, Agrawal A, Bulsara KR. Intraosseous intracranial meningioma. AJNR Am J Neuroradiol. 2007;28(2):314–5.PubMed
50.
Bassiouni H, Asgari S, Hübschen U, König HJ, Stolke D. Dural involvement in primary extradural meningiomas of the cranial vault. J Neurosurg. 2006;105(1):51–9.CrossRefPubMed
51.
Lee HY, Prager J, Hahn Y, Ramsey RG. Intraosseous meningioma: CT and MR appearance. J Comput Assist Tomogr. 1992;16(6):1000–1.CrossRefPubMed
52.
Garfinkle J, Melançon D, Cortes M, Tampieri D. Imaging pattern of calvarial lesions in adults. Skeletal Radiol. 2011;40(10):1261–73.CrossRefPubMed
53.
Takei H, Powell SZ. Tumor-to-tumor metastasis to the central nervous system. Neuropathology. 2009;29(3):303–8.CrossRefPubMed
54.
Moody P, Murtagh K, Piduru S, Brem S, Murtagh R, Rojiani AM. Tumor-to-tumor metastasis: pathology and neuroimaging considerations. Int J Clin Exp Pathol. 2012;5(4):367–73.PubMedPubMedCentral
55.
Widdel L, Kleinschmidt-DeMasters BK, Kindt G. Tumor-to-tumor metastasis from hematopoietic neoplasms to meningiomas: report of two patients with significant cerebral edema. World Neurosurg. 2010;74(1):165–71.CrossRefPubMed
56.
Jun P, Garcia J, Tihan T, McDermott MW, Cha S. Perfusion MR imaging of an intracranial collision tumor confirmed by image-guided biopsy. AJNR Am J Neuroradiol. 2006;27(1):94–7.PubMed
57.
Lee A, Wallace C, Rewcastle B, Sutherland G. Metastases to meningioma. AJNR Am J Neuroradiol. 1998;19(6):1120–2.PubMed
58.
Hsu CC, Pai CY, Kao HW, Hsueh CJ, Hsu WL, Lo CP. Do aggressive imaging features correlate with advanced histopathological grade in meningiomas? J Clin Neurosci. 2010;17(5):584–7.CrossRefPubMed
59.
Kane AJ, Sughrue ME, Rutkowski MJ, Shangari G, Fang S, McDermott MW, Berger MS, Parsa AT. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer. 2011;117(6):1272–8.CrossRefPubMed
60.
Yin B, Liu L, Zhang BY, Li YX, Li Y, Geng DY. Correlating apparent diffusion coefficients with histopathologic findings on meningiomas. Eur J Radiol. 2012;81(12):4050–6.CrossRefPubMed
61.
Yang S, Law M, Zagzag D, Wu HH, Cha S, Golfinos JG, Knopp EA, Johnson G. Dynamic contrast-enhanced perfusion MR imaging measurements of endothelial permeability: differentiation between atypical and typical meningiomas. AJNR Am J Neuroradiol. 2003;24(8):1554–9.PubMed
62.
Demir MK, Iplikcioglu AC, Dincer A, Arslan M, Sav A. Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol. 2006;60(1):48–55.CrossRefPubMed
Metadata
Title
Uncommon Cranial Meningioma: Key Imaging Features on Conventional and Advanced Imaging
Authors
Nader Zakhari
Carlos Torres
Mauricio Castillo
Thanh B. Nguyen
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 2/2017
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0583-y

Other articles of this Issue 2/2017

Clinical Neuroradiology 2/2017 Go to the issue

Editorial

Emerging Challenges for Neuroradiologists

Original Article

Limbic-Auditory Interactions of Tinnitus: An Evaluation Using Diffusion Tensor Imaging

Original Article

Considerations about Occlusion of the Intracranial Distal Internal Carotid Artery

Clinical Case

Freiburg Neuropathology Case Conference

Information

Societies‘ Communications

Correspondence

Revascularization of acute basilar artery occlusion using the Tigertriever adjustable clot retriever