Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1998; 8(4): 233–236.
PMCID: PMC1656697

Medulloblastoma Presenting with Tentorial “Dural-Tail” Sign

Is the “Dural-Tail” Sign Specific for Meningioma?


To the best of our knowledge, the association of a medulloblastoma with a “dural-tail” sign has not been previously reported. A 24-year-old male developed severe headaches and right-sided dysmetria that worsened over 1 month. Magnetic resonance (MR) imaging of the brain demonstrated a heterogeneously enhancing lesion in the posterior fossa. The lesion appeared to be tentortally-based and exhibited a characteristic “dural-tail” sign, which is considered pathognothonic for meningioma. Cerebellar tonsil ectopia and hydrocephalus were also present. The presumptive diagnosis of tentorial meningioma was made. The lesion was resected by a posterior fossa approach. At surgery, the appearance of the tumor was inconsistent with the diagnosis of meningioma, and histopathologic evaluation yielded the diagnosis of medulloblastonia. This case and the literature demonstrate that malignant tumors can present with the characteristic MR imaging appearance of a meningioma. This possibility must be considered when treatment is planned, especially if a nonoperative course is favored.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Goldsher D, Litt AW, Pinto RS, Bannon KR, Kricheff II. Dural "tail" associated with meningiomas on Gd-DTPA-enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiology. 1990 Aug;176(2):447–450. [PubMed]
  • Wilms G, Lammens M, Marchal G, Demaerel P, Verplancke J, Van Calenbergh F, Goffin J, Plets C, Baert AL. Prominent dural enhancement adjacent to nonmeningiomatous malignant lesions on contrast-enhanced MR images. AJNR Am J Neuroradiol. 1991 Jul-Aug;12(4):761–764. [PubMed]
  • Tien RD, Yang PJ, Chu PK. "Dural tail sign": a specific MR sign for meningioma? J Comput Assist Tomogr. 1991 Jan-Feb;15(1):64–66. [PubMed]
  • Tien RD, Brasch RC, Jackson DE, Dillon WP. Cerebral Erdheim-Chester disease: persistent enhancement with Gd-DTPA on MR images. Radiology. 1989 Sep;172(3):791–792. [PubMed]
  • Sze G. Diseases of the intracranial meninges: MR imaging features. AJR Am J Roentgenol. 1993 Apr;160(4):727–733. [PubMed]
  • Senegor M. Prominent meningeal "tail sign" in a patient with a metastatic tumor. Neurosurgery. 1991 Aug;29(2):294–296. [PubMed]
  • Paz-Fumagalli R, Daniels DL, Millen SJ, Meyer GA, Thieu TM. Dural "tail" associated with an acoustic schwannoma in MR imaging with gadopentetate dimeglumine. AJNR Am J Neuroradiol. 1991 Nov-Dec;12(6):1206–1206. [PubMed]
  • Morioka T, Matsushima T, Ikezaki K, Nagata S, Ohta M, Hasuo K, Fukui M. Intracranial adenoid cystic carcinoma mimicking meningioma: report of two cases. Neuroradiology. 1993;35(6):462–465. [PubMed]
  • Kutcher TJ, Brown DC, Maurer PK, Ghaed VN. Dural tail adjacent to acoustic neuroma: MR features. J Comput Assist Tomogr. 1991 Jul-Aug;15(4):669–670. [PubMed]
  • Koenigsberg RA, Patil K. Pituitary apoplexy associated with dural (tail) enhancement. AJR Am J Roentgenol. 1994 Jul;163(1):227–228. [PubMed]
  • Bourekas EC, Wildenhain P, Lewin JS, Tarr RW, Dastur KJ, Raji MR, Lanzieri CF. The dural tail sign revisited. AJNR Am J Neuroradiol. 1995 Aug;16(7):1514–1516. [PubMed]
  • Wilms G, Lammens M, Marchal G, Van Calenbergh F, Plets C, Van Fraeyenhoven L, Baert AL. Thickening of dura surrounding meningiomas: MR features. J Comput Assist Tomogr. 1989 Sep-Oct;13(5):763–768. [PubMed]
  • Tokumaru A, O'uchi T, Eguchi T, Kawamoto S, Kokubo T, Suzuki M, Kameda T. Prominent meningeal enhancement adjacent to meningioma on Gd-DTPA-enhanced MR images: histopathologic correlation. Radiology. 1990 May;175(2):431–433. [PubMed]
  • Nägele T, Petersen D, Klose U, Grodd W, Opitz H, Voigt K. The "dural tail" adjacent to meningiomas studied by dynamic contrast-enhanced MRI: a comparison with histopathology. Neuroradiology. 1994 May;36(4):303–307. [PubMed]
  • Schörner W, Schubeus P, Henkes H, Lanksch W, Felix R. "Meningeal sign": a characteristic finding of meningiomas on contrast-enhanced MR images. Neuroradiology. 1990;32(2):90–93. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers