Meningioma with Myxoid Features

56-year-old female who underwent brain MRI examination for chronic headaches following an automobile accident in which an incidental extra-axial mass was identified over the left frontal region for which a preoperative MRI examination was ordered. The images demonstrate an extra-axial dural based T2/FLAIR hyperintense predominately solid lesion with a small hemorrhagic component along its posterolateral margin with more peripheral hemosiderin deposition and lobular T2/FLAIR hyperintense regions which restrict diffusion. There is prominent signal loss on the fat saturated T2 weighted images at that site. A large dural tail is identified on the postcontrast images. The imaging findings are most consistent with a meningioma. Following resection, a myxoid meningioma histopathologic diagnosis was given. Myxoid meningiomas do not display the usual histologic features of more typical meningiomas, and contain abundant mucoid stroma similar to other myxoid tumors. The differential includes other lesions such as schwannomas, fibromyxoma, or fibroxanthoma. Treatment is with primary surgical resection with recurrence rates similar to non-myxoid meningioma subtypes.