Cystic Meningioma with Interesting Imaging Characteristics in Frontal Region: A Case Report

Cystic meningioma is an unusual shape of meningioma, and the imaging manifestations and site of the solid/cystic components of the mass increase our difficulties in making a diagnosis.

We report a case of a 78-year-old right-handed woman who presented with right-sided hemiparesis, urinary incontinency, and Broca aphasia. A large left-sided frontal region cystic extra-axial mass with a suspicious small solid nodule and adjacent bony erosion was detected on non-contrast CT of the brain. Brain Magnetic resonance imaging (MRI) with gadolinium depicted the cystic and solid components exactly. A probable diagnosis of cystic meningioma was made and subsequently confirmed by histological study after surgical resection of the tumor. To confirm the category and subtypes of the tumor, a histopathological examination of the tumor cells should be done.

Cystic or solid cystic intracranial lesions have several differential diagnoses making the final diagnosis difficult in some cases. There are four types of cystic meningiomas according to the Nauta classification that was revised by Jung et al. Determination of the type of cystic meningioma is crucial for surgical planning. To confirm the category and subtypes of the tumor, a histopathological examination of the tumor cells should be done. Our case was a type IV cystic meningioma with a small mural enhancing solid nodule but an associated adjacent bony invasion.