====== Parasagittal Meningioma Differential Diagnosis ====== see also [[Meningioma Differential Diagnosis]]. ---- [[Intracerebral schwannoma]] ((Li M, Mei J, Li Y, Tao X, Hong T. Intracerebral schwannoma mimicking meningioma: case report. Can J Neurol Sci. 2013 Nov;40(6):881-4. PubMed PMID: 24257236.)) ((Ma L, Yang SX, Wang YR. Intracerebral schwannoma mimicking parasagittal meningioma. J Craniofac Surg. 2013 Nov;24(6):e541-3. doi: 10.1097/SCS.0b013e31828601bf. PubMed PMID: 24220461.)) ((Bristol RE, Coons SW, Rekate HL, Spetzler RF. Invasive intracerebral schwannoma mimicking meningioma in a child. Childs Nerv Syst. 2006 Nov;22(11):1483-6. Epub 2006 Sep 22. PubMed PMID: 17021734.)) ((Takei H, Schmiege L, Buckleair L, Goodman JC, Powell SZ. Intracerebral schwannoma clinically and radiologically mimicking meningioma. Pathol Int. 2005 Aug;55(8):514-9. PubMed PMID: 15998381.)). [[Extra-axial ependymoma]] ((Singh V, Turel MK, Chacko G, Joseph V, Rajshekhar V. Supratentorial extra-axial anaplastic ependymoma mimicking a meningioma. Neurol India. 2012 Jan-Feb;60(1):111-3. PubMed PMID: 22406799.)) ((Salunke P, Kovai P, Sura S, Gupta K. Extra-axial ependymoma mimicking a parasagittal meningioma. J Clin Neurosci. 2011 Mar;18(3):418-20. doi: 10.1016/j.jocn.2010.04.042. Epub 2011 Jan 13. PubMed PMID: 21236682.)). [[Fibrous histiocytoma]] ((Tsutsumi M, Kawano T, Kawaguchi T, Kaneko Y, Ooigawa H, Yoshida T. Intracranial meningeal malignant fibrous histiocytoma mimicking parasagittal meningioma--case report. Neurol Med Chir (Tokyo). 2001 Feb;41(2):90-3. PubMed PMID: 11255634.)). [[Rosai-Dorfman disease]] ((Kattner KA, Stroink AR, Roth TC, Lee JM. Rosai-Dorfman disease mimicking parasagittal meningioma: case presentation and review of literature. Surg Neurol. 2000 May;53(5):452-7; discussion 457. Review. PubMed PMID: 10874144.)). ---- A 14-year-old female mosaic for the de novo p.R108H pathogenic variant in the [[PIK3CA]] gene was found to have a large tumor involving the [[superior sagittal sinus]] with mass effect on the [[motor cortex]] most consistent with a [[parafalcine meningioma]]. She underwent surgical resection with pathology demonstrating a [[venous malformation]]. PIK3CA pathogenic variants have been identified in nonsyndromic extracranial venous and lymphatic malformations as well in [[brain tumor]]s, including [[glioma]] and [[meningioma]]. However, [[PIK3CA]] variants have not previously been identified in purely intracranial venous malformations. This distinction is relevant to treatment decisions, given that [[mTOR inhibitor]]s may provide an alternative option for noninvasive therapy in cases of suspected [[venous malformation]] ((Filippidis A, Lidov H, Al-Ibraheemi A, See AP, Srivastava S, Orbach DB, Fehnel KP. Intracranial venous malformation masquerading as a meningioma in PI3KCA-related overgrowth spectrum disorder. Am J Med Genet A. 2021 Dec 2. doi: 10.1002/ajmg.a.62570. Epub ahead of print. PMID: 34854542.)).