PMC9944760_01
Computed tomography of the brain showing irregular high-density mass (arrow) below the occipital plate (A). Hypointense (arrow) on T2-weighted magnetic resonance imaging and edema (star) observed near the right cerebellar hemisphere (B). The enhanced scan shows significant enhancement and a dural tail sign (arrow) (C). Formation of granuloma and central stellate microabscess. The image was acquired at 100x magnification (D). The follow-up MRI shows the disappearance of the residual lesion in the surgical area (E, F).
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The CT scan showed an irregular high-density mass below the occipital plate, with patchy low-density areas in the right cerebellar hemisphere (Figure 1A), which the radiologist suspected to be a dural tumor and the neurosurgeon recommended performing MRI. T2 signals (Figure 1B). The enhanced scan showed a significant enhancement and a dural tail sign (Figure 1C). The patchy area of no enhancement in the right cerebellar hemisphere was considered edema. The patient was diagnosed with atypical meningioma by radiologists and neurosurgeons before the operation. While the lesion involving the venous sinus was not completely resected, the pathological examination showed granulation tissue and fibrosis with acute and chronic inflammation, granuloma, and central stellate micro-abscess (Figure 1D), which was suspected as the cat-scratch disease (CSD) by the pathologist. The follow-up MRI (Figures 1E, F) showed that the residual lesions in the surgical area disappeared at 4 weeks after the operation.