Glioblastoma multiforme that unusually present with radiographic dural tails: Questioning the diagnostic paradigm with a rare case report

• Main Authors: Nara Miriam Michaelson, MD, MS, Michael A. Connerney, MD, MS
• Format: Article
• Language: English
• Published: Elsevier 2020-07-01
• Series: Radiology Case Reports
• Subjects: Glioblastoma multiforme; Magnetic resonance imaging; Dural tail; Astrocytoma; Meningioma; Diagnostics
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320301771

Glioblastoma multiforme (GBM) is both the most common as well as one of the most aggressive primary intracerebral tumors. It classically presents on magnetic resonance imaging as a heterogeneous ring-enhancing lesion in the brain parenchyma with central necrosis. This type of neoplasm can also rarely present, however, as a mass with meningeal attachment and radiographic evidence of a dural tail, which was until recently thought to be specific to meningiomas. Here we present a case of a central nervous system neoplasm that on imaging was initially suggestive of meningioma based on its presence of a dural tail. Final pathology, however, revealed desmoplastic GBM. It is, therefore, important to include GBM on the differential diagnosis of a patient presenting with a dural-based lesion on imaging, especially since the overall survival rate of GBM is much worse than that of a suspected meningioma.