Background: Dural lesions in the anterior skull base may occur secondary to benign or malignant pathology that may be difficult to differentiate on imaging.
Detailed clinical evaluation in many cases will narrow the differential diagnosis. In spite of using all the available information, in certain cases the underlying etiology of a lesion remains unclear.
Participant: We report a rare case of metastatic prostate adenocarcinoma to a meningioma in a 67-year-old-man who presented with progressive confusion and mental status alterations with no prior history of malignancy. Neuroimaging revealed a large anterior skull base lesion.
Results: The lesion was surgically resected, and histopathology revealed a collision tumor, in which prostate adenocarcinoma was found admixed with a World Health Organization grade I meningioma.
Conclusion: Anterior dural skull base lesions can be either benign or malignant. Although infrequently reported, a benign-appearing dural-based lesion may be a manifestation of an underlying malignancy, and a thorough clinical, radiologic, and pathologic examination may be necessary, especially in the elderly.
Rahmathulla G, Prayson RA, Weil RJ. Are you the author?
Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, the Neurological Institute, Cleveland Clinic, Cleveland, Ohio, United States; Department of Pathology, Cleveland Clinic, Cleveland, Ohio, United States.
Reference: J Neurol Surg Rep. 2014 Aug;75(1):e81-3.