Learning Radiology xray montage

Planum Sphenoidale Meningioma


General Considerations

  • As many as 10% of meningiomas
  • Typically occur in women in 5th and 6th decades of life
  • Occur at the anterior cranial base overlying the cribiform plate of the ethmoid bone, frontosphenoid suture and planum sphenoidale
  • Meningiomas are extra-axial lesions that arise from arachnoid cells
  • Patients with neurofibromatosis type 2 (NF-2) have a 50% chance of developing one or more meningiomas

Clinical Findings

  • Often attain significant size before producing symptoms
  • Changes in cognition and personality
  • Headaches
  • Visual disturbances, often more severe ion one eye but both are commonly involved
  • Seizures

Imaging Findings

  • CT
    • CT is important for showing bony involvement which may be helpful in surgical planning
    • On unenhanced studies. They are isodense to slightly hyperdense
    • With contrast, they enhance intensely and homogeneously
    • There may be extensive surrounding edema
    • Adjacent brain is compressed but not invaded

  • MRI
    • They have variable signal intensity on T1 and T2-weighted images
    • After gadolinium, they again enhance homogeneously and intensely
    • More perilesional edema may be seen than on CT
    • At their periphery, an enhancing tail to the dura may be seen
    • Cystic meningiomas may exhibit intratumoral or peritumoral cysts

Differential Diagnosis

  • Multiple meningiomas may resemble metastases


  • Surgical resection
  • Radiation therapy


 Planum Sphenoidale Meningioma. Unenhanced axial CT of the base of the skull shows a hyperdense midline mass (white arrows) arising from the planum sphenoidale region. 



Meningiomas of the Tuberculum Sellae and Planum Sphenoidale: A Review of 83 Cases. JE Finn, LA Moun. Arch Ophthalmol. 1974;92(1):23-27