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. 1998;8(4):233–236. doi: 10.1055/s-2008-1058190

Medulloblastoma Presenting with Tentorial “Dural-Tail” Sign

Is the “Dural-Tail” Sign Specific for Meningioma?

Paul W Detwiler, Jeffrey S Henn, Randall W Porter, Michael T Lawton, William L White, Robert F Spetzler
PMCID: PMC1656697  PMID: 17171073

Abstract

To the best of our knowledge, the association of a medulloblastoma with a “dural-tail” sign has not been previously reported. A 24-year-old male developed severe headaches and right-sided dysmetria that worsened over 1 month. Magnetic resonance (MR) imaging of the brain demonstrated a heterogeneously enhancing lesion in the posterior fossa. The lesion appeared to be tentortally-based and exhibited a characteristic “dural-tail” sign, which is considered pathognothonic for meningioma. Cerebellar tonsil ectopia and hydrocephalus were also present. The presumptive diagnosis of tentorial meningioma was made. The lesion was resected by a posterior fossa approach. At surgery, the appearance of the tumor was inconsistent with the diagnosis of meningioma, and histopathologic evaluation yielded the diagnosis of medulloblastonia. This case and the literature demonstrate that malignant tumors can present with the characteristic MR imaging appearance of a meningioma. This possibility must be considered when treatment is planned, especially if a nonoperative course is favored.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bourekas E. C., Wildenhain P., Lewin J. S., Tarr R. W., Dastur K. J., Raji M. R., Lanzieri C. F. The dural tail sign revisited. AJNR Am J Neuroradiol. 1995 Aug;16(7):1514–1516. [PMC free article] [PubMed] [Google Scholar]
  2. Goldsher D., Litt A. W., Pinto R. S., Bannon K. R., Kricheff I. I. Dural "tail" associated with meningiomas on Gd-DTPA-enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiology. 1990 Aug;176(2):447–450. doi: 10.1148/radiology.176.2.2367659. [DOI] [PubMed] [Google Scholar]
  3. Koenigsberg R. A., Patil K. Pituitary apoplexy associated with dural (tail) enhancement. AJR Am J Roentgenol. 1994 Jul;163(1):227–228. doi: 10.2214/ajr.163.1.8010236. [DOI] [PubMed] [Google Scholar]
  4. Kutcher T. J., Brown D. C., Maurer P. K., Ghaed V. N. Dural tail adjacent to acoustic neuroma: MR features. J Comput Assist Tomogr. 1991 Jul-Aug;15(4):669–670. doi: 10.1097/00004728-199107000-00024. [DOI] [PubMed] [Google Scholar]
  5. Morioka T., Matsushima T., Ikezaki K., Nagata S., Ohta M., Hasuo K., Fukui M. Intracranial adenoid cystic carcinoma mimicking meningioma: report of two cases. Neuroradiology. 1993;35(6):462–465. doi: 10.1007/BF00602833. [DOI] [PubMed] [Google Scholar]
  6. Nägele T., Petersen D., Klose U., Grodd W., Opitz H., Voigt K. The "dural tail" adjacent to meningiomas studied by dynamic contrast-enhanced MRI: a comparison with histopathology. Neuroradiology. 1994 May;36(4):303–307. doi: 10.1007/BF00593266. [DOI] [PubMed] [Google Scholar]
  7. Paz-Fumagalli R., Daniels D. L., Millen S. J., Meyer G. A., Thieu T. M. Dural "tail" associated with an acoustic schwannoma in MR imaging with gadopentetate dimeglumine. AJNR Am J Neuroradiol. 1991 Nov-Dec;12(6):1206–1206. [PMC free article] [PubMed] [Google Scholar]
  8. Schörner W., Schubeus P., Henkes H., Lanksch W., Felix R. "Meningeal sign": a characteristic finding of meningiomas on contrast-enhanced MR images. Neuroradiology. 1990;32(2):90–93. doi: 10.1007/BF00588555. [DOI] [PubMed] [Google Scholar]
  9. Senegor M. Prominent meningeal "tail sign" in a patient with a metastatic tumor. Neurosurgery. 1991 Aug;29(2):294–296. doi: 10.1097/00006123-199108000-00025. [DOI] [PubMed] [Google Scholar]
  10. Sze G. Diseases of the intracranial meninges: MR imaging features. AJR Am J Roentgenol. 1993 Apr;160(4):727–733. doi: 10.2214/ajr.160.4.8456653. [DOI] [PubMed] [Google Scholar]
  11. Tien R. D., Brasch R. C., Jackson D. E., Dillon W. P. Cerebral Erdheim-Chester disease: persistent enhancement with Gd-DTPA on MR images. Radiology. 1989 Sep;172(3):791–792. doi: 10.1148/radiology.172.3.2772189. [DOI] [PubMed] [Google Scholar]
  12. Tien R. D., Yang P. J., Chu P. K. "Dural tail sign": a specific MR sign for meningioma? J Comput Assist Tomogr. 1991 Jan-Feb;15(1):64–66. [PubMed] [Google Scholar]
  13. Tokumaru A., O'uchi T., Eguchi T., Kawamoto S., Kokubo T., Suzuki M., Kameda T. Prominent meningeal enhancement adjacent to meningioma on Gd-DTPA-enhanced MR images: histopathologic correlation. Radiology. 1990 May;175(2):431–433. doi: 10.1148/radiology.175.2.2326470. [DOI] [PubMed] [Google Scholar]
  14. Wilms G., Lammens M., Marchal G., Demaerel P., Verplancke J., Van Calenbergh F., Goffin J., Plets C., Baert A. L. Prominent dural enhancement adjacent to nonmeningiomatous malignant lesions on contrast-enhanced MR images. AJNR Am J Neuroradiol. 1991 Jul-Aug;12(4):761–764. [PMC free article] [PubMed] [Google Scholar]
  15. Wilms G., Lammens M., Marchal G., Van Calenbergh F., Plets C., Van Fraeyenhoven L., Baert A. L. Thickening of dura surrounding meningiomas: MR features. J Comput Assist Tomogr. 1989 Sep-Oct;13(5):763–768. doi: 10.1097/00004728-198909000-00003. [DOI] [PubMed] [Google Scholar]

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