Abdurrahim TEKİN, Engin CAN, Ozan BAŞKURT
Comprehensive Medicine - 2026;18(1):34-39
Objective: This study aimed to evaluate the prevalence of meningioma-like dural-based lesions that were histopathologically diagnosed as non-meningioma tumors, characterize their underlying pathologies, and assess clinical-radiological correlations to improve diagnostic accuracy and patient management. Materials and Methods: A retrospective dual-center study was conducted, including 210 patients with dural-based lesions resembling meningiomas on MRI between January 2020 and December 2025. Imaging features, histopathological diagnoses, and clinical data were analyzed. Statistical comparisons were performed using univariate and multivariate analyses. Results: Among the 210 patients, 12.8% (n=27) of lesions initially suspected as meningiomas were histopathologically confirmed as non-meningioma tumors. Metastatic lesions were the most common mimics (63%), followed by high-grade glial tumors (14%), lymphomas (11%), schwannomas (7%), low-grade glial tumors (7%), and primitive neuroectodermal tumors (4%). Homogeneous contrast enhancement and dural tail signs were observed in both meningiomas and their mimics, complicating preoperative diagnosis. Advanced imaging techniques and histopathological examination were critical for accurate differentiation. Conclusion: A significant proportion of dural-based lesions resembling meningiomas are non-meningioma tumors, with metastatic and high-grade glial neoplasms being the most prevalent. Careful evaluation of imaging features and a multidisciplinary approach, including advanced imaging and histopathological confirmation, are essential for accurate diagnosis and optimal patient management.
