Cavernous Angioma of the Dural Convexity Mimicking a Meningioma

Case Report

Austin Neurosurg Open Access. 2014;1(4): 1019.

Cavernous Angioma of the Dural Convexity Mimicking a Meningioma

Kashlan ON1, Sack JA2 and Ramnath S1*

1Department of Neurosurgery, University of Michigan, USA

2Department of Neurosurgery, University of California-San Diego, USA

*Corresponding author: Ramnath S, Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Dr., Room 3552 TC, Ann Arbor, MI 48109-5338, USA

Received: May 29, 2014; Accepted: August 08, 2014; Published: August 12, 2014


Background: Dural-based cavernous angiomas represent a small proportion of all intracranial cavernous angiomas. Moreover even though these lesions have a similar histological appearance as their intra-axial counterparts, they have different imaging characteristics. This fact leads to frequent misdiagnosis via imaging. We present a case of a dural-based occipital convexity cavernous angioma thought to be a meningioma preoperatively followed by a review of the recent literature.

Case Presentation: A 56-year-old man with a known left occipital mass presented with a recent history of visual scintillations. Imaging showed an enhancing mass felt to represent a meningioma. At the time of his operation, a red to purple appearing extra cerebral mass was removed, and its histology was consistent with cavernous angioma.

Conclusions: It is difficult to distinguish an isolated dural based convexity cavernous angioma from a meningioma based on radiology. This case report highlights the importance of keeping both etiologies in the differential diagnosis of a dural-based lesion.

Keywords: Cavernous angioma; Cavernoma; Cavernous malformation; Meningioma mimicker


CT: Computed Tomography; MRI: Magnetic Resonance Imaging

Case Presentation

A 56-year-old man presented with a 6-month history of episodic visual scintillations of bright lights in the right visual field. His neurologic findings were normal, with no visual field deficits. A left occipital mass had been found incidentally seven years earlier on a CT scan performed at an outside hospital following a closed head injury. Repeat CT and MRI scans showed an enhancing mass in the left occipital convexity measuring 2.5 cm X 3.2 cm X 3cm as shown in Figures 1 & 2. His non-contrast CT scan report from seven years earlier described a 1.8cm X 2cm mass. Preoperatively, this mass was thought to be an enlarging meningioma. At craniotomy, it was noted that there was no erosion or hyperostosis of the overlying skull. After incising the dura, a dense, red mass was easily dissected off the cortical surface with no invasion of the brain. The mass histologically showed numerous vascular channels divided by various thicknesses of connective tissue septae typical of cavernous angiomas as shown in Figure 3. The patient's postoperative course was uneventful and his imaging demonstrated a gross total resection. At his 1 year postoperative visit, the patient had no evidence of recurrence or development of other lesions.