From the Radiologic Pathology Archives: Mass Lesions of the Dura: Beyond Meningioma—Radiologic-Pathologic Correlation

Abstract

Meningioma is the most common mass involving the dura, making it number one in the differential diagnosis for any dural-based mass; however, a variety of other neoplastic and nonneoplastic lesions also involve the dura. Knowledge of the dural anatomy can provide clues to the various processes that may involve this location. The neoplastic processes include both benign and malignant lesions such as hemangiopericytoma, lymphoma, solitary fibrous tumor, melanocytic lesions, Epstein-Barr virus-associated smooth muscle tumors, Rosai-Dorfman disease, and metastatic lesions. The nonneoplastic processes include infectious and inflammatory entities such as tuberculosis and sarcoid, which may mimic mass lesions. In some cases, neoplasms such as gliosarcoma may arise peripherally from the brain parenchyma, appearing dural-based and even inciting a dural tail. Many of these share similar computed tomographic, magnetic resonance imaging, and angiographic characteristics with meningiomas, such as a dural tail, increased vascularity, avid enhancement, and similar signal characteristics; however, knowledge of the patient's age, gender, and underlying conditions and certain imaging characteristics may provide valuable clues to recognizing these lesions. For example, in the population with human immunodeficiency virus infection, Epstein-Barr virus-associated smooth muscle tumors should be included in the differential diagnosis for dural-based lesions. The surgical course and prognosis for these lesions vary, and knowledge of the variety of lesions that involve the dura, their imaging appearances, and their clinical features assists in narrowing the radiologic differential diagnosis and optimizing patient treatment.

Magnetic resonance features of meningeal solitary fibrous tumors

“…Another previous study suggested that 60% were located outside of the pleura (16), as SFTs have occurred on the falxcerebri, the convexity of the brain, the saddle area, the posterior cranial fossa, the dura mater, the encephala and in the CNS. SFTs often originate in the dura mater (17) and have been reported to be ubiquitous neoplasms of mesenchymal origin (18). SFT originating from the meninges are rare overall; the world literature on solitary fibrous tumors of the central nervous system (CNS) between August 1996 and July 2011 were reviewed, only 220 cases were reported in CNS, and 170 cases of SFT were originated from the meninges (19) ISFT is rare, accounting for ~0.6% of all intracranial tumors (13,20,21).…”

Radiation Therapy of Meningeal Hemangiopericytomas (Literature Review and Clinical Observation)

“…Чаще эти опухоли об-наруживаются у 30-и 40-летних пациентов, но до 10 % случаев диагностируются у детей [9]. Несколько чаще с ними сталкиваются пациенты мужского пола: 1,4 : 1 [5,8].…”

“…Головные боли, судорожные приступы, очаговая неврологическая симптоматика -все это может быть симптомами болезни [9]. Вдобавок, до 20 % ге-мангиоперицитом способны метастазировать отда-ленно -обычно в печень, легкие, кости скелета [5,7,9], но также встречаются редкие варианты метастазиро-вания, в частности в почки [10,11].…”

Benign neck masses showing restricted diffusion: Is there a histological basis for discordant behavior?

“…Distinct immunohistochemical features characterize these tumours which include diffuse CD34 positivity and epithelial membrane antigen negativity [34] (Figure 5). Some tumours may show hypocellular areas with profuse extracellular collagen deposition alternating with hypercellular areas [35] . MRI reveals heterogeneous appearance of SFTs on T2 weighted images.…”