Case #62

Initial MRI

• Dural-based, avidly enhancing mass along the anterior right frontal convexity and floor of the right anterior cranial fossa measuring 3.1 x 2.7 x 2.3 cm
• Prominent associated dural tail
• Spoke-wheel internal vascularity (best seen on T2)
• Internal foci of susceptibility artifact likely representing calcification
• Mass effect on the right frontal lobe without adjacent parenchymal edema

9-month follow-up MRI

• Marked enlargement of the extra-axial right frontal mass measuring 4.4 x 4.7 x 4 cm with internal areas of hemorrhage (T1 signal hyperintensity and susceptibility artifact)
• The mass now has a much more heterogeneous appearance, has irregular, lobulated contours, and bulges across midline
• A cystic component along the posterior margin of the tumor abuts the genu of the corpus callosum
• Surrounding vasogenic edema in the right greater than left frontal lobes extending into the right external capsule and subinsular white matter
• Increased intracranial mass effect with right-to-left midline measuring 7 mm anteriorly
• No hydrocephalus