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Findings

Intraventricular, non-hemorrhagic, solid mass within the atria of the right lateral ventricle

Iso to slightly hypointense on T1 with heterogenous enhancement with gadolinium

Increased FLAIR and T2 signal within the adjacent temporal and occipital lobe parenchyma compatible with edema

Differential diagnosis

Intraventricular Meningioma

Ependymoma

Choroid plexus papilloma/carcinoma

Central Neurocytoma

Metastatic disease

Meningioma

Most common primary adult intracranial tumor

2% of meningiomas are intraventricular

Arise from arachnoid meningiothelial cells

Loss of one copy of chromosome 22 is the most prevalent chromosomal change in meningiomas

10% of patients with multiple meningiomas have NF 2

Peak age in the middle decade of life

More common in females (1.5-3:1) and African-Americans

Slow growth with compression of adjacent structures

Asymptomatic lesions are followed with serial imaging

Surgical goal is the resection of tumor, involved dura, and the involved bone.

Recurrence rate is 9% for common meningiomas (WHO Grade I), 29% for atypical meningiomas (WHO Grade II), and 50% for malignant meningiomas (WHO Grade III).

Osborn AG: Diagnostic Imaging-Brain. Salt Lake City, 2004, Amirsys Inc.