title: Rare Parenchyma Meningioma in an Adolescent Female With Cheek Tingling: A Case Report.
abstract: The following is a report on a rare parenchyma meningioma and the computed tomography (CT) and magnetic resonance imaging (MRI) findings. To our knowledge, this was the first characterization of magnetic resonance spectroscopy (MRS) in a parenchyma meningioma. Three days after initial presentation, a 14-year-old female student reported feeling tingling in her cheek, grading 3 to 4 points. Two hours later, the tingling had disappeared. The patient was admitted to hospital with stable vital signs and no abnormal presentations upon physical examination. A routine CT scan of the brain showed a quasicircular region of the left occipital lobe was homogenous hyperdense and an arcualia calcification was found on the lesion's margin and the boundary was ill-defined. Further MRI and contrast-enhanced scanning of the brain showed that a lobulated nidus with abnormal signaling was present in the left occipital lobe and was approximately 1.9 × 2.0 cm. Hypointensity on T1-weighted imaging and a slight hyperintensity on T2-weighted imaging was also observed. A short T2 signal appeared on the margin and a few longer T2 edema zones appeared around the nidus, whereas the lesion showed homogenous enhancement. MRS was characterized by a slight or moderate increase of a choline (Cho) peak and a small reduction of the N-acetyl aspartate (NAA) peak. After completing the preoperative preparation, the excision of the supratentorial deep lesions was performed on the patient. The pathology led to a diagnosis of a left occipital lobe meningioma, WHO I. The patient was followed-up for 14 months postoperation, and had no reoccurrences. Intraparenchymal meningioma rarely occurs in brain parenchyma, and is characterized by lesions with abundant blood supply and requires a glioma to be identified. MRS is a potential tool for preoperative diagnosis of intraparenchymal meningioma.
authors.affiliation: From the Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Liang
authors.forename: Meirong
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis*; D002610:Cheek; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008579:Meningioma / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed