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Meningioma — SCE Neurology MCQ

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ModerateNeuro-oncologyMeningiomaSCE Neurology

A 22-year-old woman presented with gradual leg weakness and personality change in an older woman. On examination, there was spastic paraparesis greater on one side. Initial investigations showed: MRI showed extra-axial parasagittal enhancing mass with dural tail. What is the most likely diagnosis?

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Correct answer: D — Meningioma

Meningioma is the best answer because the vignette describes Meningioma: extra-axial dural-based enhancing mass suggests meningioma. Leptomeningeal carcinomatosis is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Glioblastoma and Limbic encephalitis from small-cell lung cancer are less appropriate because they would require different localisation, timing or test findings; Spinal cord compression from metastasis would fit a different syndrome. Clinical pearl: glioma is intra-axial and infiltrative.

Reference: NICE NG99; EANO guidance; ABN paraneoplastic guidance