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).




Hodgkin lymphoma


Inflammatory pseudotumors


Plasma cell granulomas

Rosai Dorfman disease

Castleman disease


Rheumatoid nodules


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:



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

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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