Pneumosinus dilatans associated with meningioma

Maria Inês de Sá, Filipa Proença

PAMJ-CM. 2023; 11:22. Published 17 Jan 2023 | doi:10.11604/pamj-cm.2023.11.22.38660

A 54-year-old man presented to the emergency department after having fallen from a height. The physical examination was unremarkable. The computed tomographic (CT) brain scan (A, B) showed no signs of trauma, instead, revealed a right frontal solid space-occupying lesion with cystic and calcified areas. Magnetic resonance imaging (MRI) was performed (C) and showed a voluminous dural-based mass (arrow), with well-defined borders, a strong and homogeneous contrast-enhancing on T1-WI. The calcified and cystic areas were osteosclerotic reaction and extensive hyperpneumatization of the adjacent ethmoid sinus (asterisk). Meningioma with associated complex pneumosinus dilatans (PSD), with new sinus cells formation, was the suggested diagnosis. Although it is rare, PSD can occur associated to meningiomas and the theory behind it is of obstruction of the sinus ostium causing expansion through a “ball-valve” effect. Effective treatment can avoid pneumocephalus formation. The patient underwent surgical resection, and the histologic and intraoperative observation confirmed the diagnosis.
Corresponding author
Maria Inês de Sá, Neuroradiology, Department of Neuroradiology, Santa Maria Hospital, North Lisboa University Hospital Center, Lisboa, Portugal (

This image

Articles published in PAMJ-CM are Open Access and distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0).

eISSN: 2707-2797

The PAMJ - Clinical Medicine (ISSN: 2707-2797) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, ESCI

Physical address: Kenya: 3rd Floor, Park Suite Building, Parkland Road, Nairobi. PoBox 38583-00100, tel: +254 (0)20-520-4356 | Cameroon: Immeuble TechnoPark Essos, Yaounde, PoBox: 10020 Yaounde, tel: +237 (0)24-309-5880