PMC7332468_01
A 17-year-old woman with meningioangiomatosis presented with seizures and persistent headache and dizziness. Non-contrast head CT image demonstrated a densely calcified mass (arrow) in the left temporal lobe.
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F1
At time of initial presentation, a non-contrast CT of the head found a densely calcified mass in the left temporal lobe [Figure 1].
A 17-year-old woman with meningioangiomatosis presented with seizures and persistent headache and dizziness. (a) Brain MRI T2/FLAIR image revealed a hypointense lesion (arrow) in the left temporal lobe. (b) Brain MRI T1-weighted image showed corresponding heterogeneous hypointense signal (arrow). (c) Brain MRI post-contrast T1-weighted image further demonstrated irregular enhancement (arrow) in close association with the left middle cerebral artery.
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F2
T2-weighted imaging with some associated heterogeneous contrast enhancement [Figure 2]. The mass appeared to encase the left middle cerebral artery. The patient opted for non-surgical treatment and was closely followed with medical management of her seizures.
A 17-year-old woman with meningioangiomatosis presented with seizures and persistent headache and dizziness. Hematoxylin and eosin stained tissue sample demonstrated (a) innumerable and confluent psammoma bodies (blue arrows) intimately associated with (b) extensive fibrotic bundles (red asterisks) as well as (c) perivascular proliferation of spindle cells (green arrows), which are characteristic findings of meningioangiomatosis.
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F3
Pathology demonstrated innumerable and confluent psammoma bodies intimately associated with extensive fibrotic bundles [Figure 3].
A 17-year-old woman with meningioangiomatosis presented with seizures and persistent headache and dizziness. (a) Brain MRI T2 image revealed a CSF-filled hyperintense resection cavity (arrow) in the anterior left temporal lobe. (b) Brain MRI post-contrast T1-weighted image demonstrated irregular residual enhancement (arrow) intercalated with the middle cerebral artery consistent with residual disease.
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F4
MRI demonstrated the expected post-operative changes including evidence of partial resection with the residual around the surgical cavity [Figure 4].