Multifocal intracranial meningioma coexiting with a transphenoidal meningocele of the Sella as seen on magnetic resonance imaging: A case report from a specialist hospital in Port Harcourt Rivers State, Nigeria

Abstract

Meningiomas are frequently extra axial tumors and represent the most common tumor of the meninges. They are benign non- glial neoplasms which arise from meningothelial cells of the arachnoid membranes. However, they could be locally invasive and aggressive. They are classified into three grades according to the WHO, criteria, namely grade I (benign), grade II (atypical) and grade III (anaplastic). Atypical locations of meningioma (subcortical intra axial) have been reported. Our case study shows both the extra axial and intra axial locations. The latter represents a challenge in Radiological diagnosis because it could be taken as a metastatic tumor or a vascular malformation. Our case study, is a 57year old woman who presented to the Radiology department for a brain magnetic resonance imaging (MRI) investigation on account of a 3year history of seizure disorder, headache and occasional irrational behavior as explained by her relative. The seizures are inconsistent in pattern, it could be generalized tonic clonic or focal (facial or limb twitches or abnormal movement of the head). Magnetic Resonance Imaging of the brain revealed a dura based homogenously enhancing, isointense subcortical mass at the right occipital lobe with marked vasogenic perilesional oedema. A similar but smaller lesion is seen at the parasagittal area of the frontal lobe.