Weekly Image Challenge – May 14, 2023

This week’s scan is of a 65-year-old lady who presented with seizure and right arm weakness. What is the most likely diagnosis?

  1. Metastasis
  2. High-grade glioma
  3. Abscess
  4. Meningioma
  5. Arachnoid cyst

Answer

Congratulations to those who selected meningioma. Cystic meningiomas are uncommon, but the dural base and minimal edema favor meningioma over metastasis, high-grade glioma, and abscess.

An arachnoid cyst does not show rim enhancement and has the same signals as CSF on all sequences.