Meningioma differential diagnosis

Meningioma differential diagnosis

The differential for dural lesions is extensive and includes 1):

Dural metastases (e.g. breast cancer)

Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma exhibit similar radiographic features, however, they differ in their prognoses. Preoperative differentiation between them is important for determining the treatment and follow-up plan.

Age and myo-inositol level calculated from MRS are useful factors for distinguishing SFT/HPC from meningioma preoperatively 2).


Gliosarcomas

Leiomyosarcomas

Melanocytomas

Hodgkin lymphoma

Plasmacytomas

Inflammatory pseudotumors

Neurosarcoidosis

Plasma cell granulomas

Rosai Dorfman disease

Castleman disease

Xanthomas

Rheumatoid nodules

Tuberculomas


In the setting of hyperostosis consider:

Paget’s disease

Fibrous dysplasia

Sclerotic metastases (e.g. prostate and breast carcinoma)


Specific location differentials include:

Cerebellopontine angle

Vestibular schwannoma

Pituitary region:

Base of the skull:

References

1)

Johnson MD, Powell SZ, Boyer PJ, Weil RJ, Moots PL: Dural lesions mimicking meningiomas. Hum Pathol 33:1211–1226, 2002
2)

Ohba S, Murayama K, Nishiyama Y, Adachi K, Yamada S, Abe M, Hasegawa M, Hirose Y. Clinical and radiographic features for differentiating solitary fibrous tumor/hemangiopericytoma from meningioma. World Neurosurg. 2019 Jun 21. pii: S1878-8750(19)31646-8. doi: 10.1016/j.wneu.2019.06.094. [Epub ahead of print] PubMed PMID: 31233926.

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