Meningioma or Mimic: Look Twice and Save a Life

Meningiomas are the most common brain tumors in adults and are often incidentally detected on imaging studies. Most often diagnostic confidence is high on the basis of imaging findings. Meningiomas may demonstrate atypical features such as cysts, hemorrhage, or metaplastic changes that can be misleading. Several other neoplastic and granulomatous inflammatory conditions may mimic meningiomas. Differentiating these lesions from meningiomas is important because treatment strategies and prognoses differ. We will review and discuss the typical and atypical imaging features of meningiomas and how to differentiate meningioma from its mimics.Learning Objectives: After reading the review and completing the accompanying CME questions, the reader will be able to do the following: describe the typical and less common imaging findings of meningiomas, diagnose meningiomas presenting in uncommon locations, and differentiate meningiomas from mimics.