Evaluation of a dural-based lesion

Introduction

There is significant overlap in the imaging appearance and presentation of dural-based mass lesions. The differential diagnosis includes both benign lesions (such as meningioma—WHO grade I) and more aggressive, malignant lesions (such as dural-based metastasis, atypical or malignant meningioma—WHO grade II and III, and lymphoma). Also included are inflammatory pathologies, such as IgG4-related disease (RD) and granulomatous disease (e.g., sarcoid). This chapter reviews several patient case studies of common and important dural-based mass lesions utilizing a structured framework that allows the reader to generate findings and a differential diagnosis. The case outcomes are then presented, and key teaching points are reviewed. An emphasis is placed on imaging and the interpretation of central findings. Treatment considerations are mentioned for continuity of thought, but most diagnoses have dedicated chapters later in this text that cover treatment in greater detail.