Extra-axial Cavernoma Mimicking Meningioma: A Case Report

Background— Extra-axial cavernous malformations (ECMs) are rare benign vascular malformations that may
mimic meningioma. ECMs may have different radiologic features but some specific radiologic characteristics may
help to differentiate them from meningioma. Herein, we describe a rare case of ECM with radiologic features similar
to meningioma.
Case Description— The patient is a 62-year-old woman who presented with 3 months of headache. Initial head
computed tomography (CT) showed an extra-axial hyper-dense lesion in the middle cranial fossa. A brain MRI con
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firmed the presence of an extra-axial lesion in her left middle cranial fossa which was hypo-intense on T1-weighted
image and iso-intense on T2-weighted image with fine heterogenous contrast enhancement on contrast-enhanced
T1-weighted image. Based on her imaging findings, pre-operative diagnosis of cavernoma was made, and when the
lesion was resected, biopsy confirmed the diagnosis.
Conclusions— ECMs are rare lesions which should be considered in the differential diagnosis of the extra-axial
masses, particularly if neuroradiological features suggest a meningioma. Given histopathological confirmation is
always essential, total resection of the lesion should be the treatment of choice.