DX: Olfactory groove meningioma

This case shows some of the peculiar imaging characteristics of a Meningioma. It was hyperdense on CT post contrast, T1 and T2 iso-hyperintense, and hyperintense on FLAIR images with avid enhancement on post Gad. It had a dural based tail and showed a falx calcification. It was located in the orbitofrontal region just above the cribiform plate and near the midline. It had vasogenic edema.

Here are the images:

Although the tumor is small in size it provoked considerable presence of edema that probably caused symptoms. These symptoms were vague with components of a frontal lobe disorder that could explain changes in personality. There was no Anosmia that could lead us to the specific location of symptoms. But current literature says that symptoms may vary in this condition. This tumor is benign but has great growing potential so diagnosis is crucial.

Olfactory groove meningiomas arise over the cribriform plate and can be differentiated from tuberculum sellae meningiomas because olfactory groove meningiomas arise more anterior in the skull base and displace the optic nerve and chiasm inferiorly rather than superiorly. Although these tumors arise in the midline, they may extend predominantly to one side like this case. It can also be very atypical in presentation with restricted DWI.


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http://www.medscape.com/viewarticle/457741
http://radiopaedia.org/cases/olfactory-groove-meningioma
http://www.neuroradiologycases.com/2011/10/olfactory-groove-meningioma.html