MedPix® Patient Chart - Case No: 12700 :: Imaging - Review Images

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History

Age: 37 :: Gender: man

Patient History

37 year old man with a Hx of surgery and radiation therapy prior to the age of 10 for a medulloblastoma. History of multiple shunt malfunction episodes in the intervening 25 years. Recent CT scan for worsening headache revealed multiple dural based masses

Exam


Physical Exam and Laboratory

Non-contributory


Imaging

Imaging - Review Images for PT: 12700

Findings


Summary of Findings

Multiple dural-based masses associated with vasogenic edema.
Postoperative changes posterior fossa from remote medulloblastoma surgery.
Cerebral atrophy and white matter changes from childhood radiation therapy.


Imaging

Imaging - Review Images for PT: 12700

Diffferential


Differential Diagnosis

Metastatic disease
Hemangiopericytoma


Imaging

Imaging - Review Images for PT: 12700

Diagnosis


Case Diagnosis

Dx: Multiple Meningiomas likely radiation induced.


Dx Confirmed by: surgery and pathology

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Followup


Followup and Treatment

Largest convexity lesion removed.
Minimal change in smaller lesions over past 5 years

Topic


Meningioma

Read

Dural based (intradural, transdural)
Round, hemispherical
Homogeneous
Enhancing (homogeneous)
Hyperostosis
Hyperdense (CT)
Hormones (F>>M)

Variants:
en plaque (carpet-like mass)
intraventricular

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History:
37 year old man with a Hx of surgery and radiation therapy prior to the age of 10 for a medulloblastoma. History of multiple shunt malfunction episodes in the intervening 25 years. Recent CT scan for worsening headache revealed multiple dural based masses

Exam:
Non-contributory

Findings:
Multiple dural-based masses associated with vasogenic edema.
Postoperative changes posterior fossa from remote medulloblastoma surgery.
Cerebral atrophy and white matter changes from childhood radiation therapy.



Differential:
Metastatic disease
Hemangiopericytoma

Diagnosis:
Multiple Meningiomas likely radiation induced.
Confirmed by:surgery and pathology

Treatment and Followup:
Largest convexity lesion removed.
Minimal change in smaller lesions over past 5 years

Discussion:

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Case Contributor and Editor
Topic Author: James G. Smirniotopoulos, M.D.
Submitted by: Steven J Goldstein - Author Info
Case/Image Editor: James G. Smirniotopoulos, M.D. - Editor Info
Case Accepted: 2009-01-18 11:41:01-05 :: Revised: :: Submitted:
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