Intracranial Dural Metastases and Diagnostic Misunderstandings


  • Maria Caffo Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
  • Antonello Curcio Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
  • Roberta Laera Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
  • Valeria Barresi Department of Diagnostics and Public Health, University of Verona, Italy
  • Gerardo Caruso Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy



Brain metastasis, Dural metastasis, Differential diagnosis, Meningioma, Metastasis


Dural metastases are rare intracranial tumors. They are not sufficiently studied and there are still no specific methods are not to detect them. Differential diagnosis is difficult and only the histologic examination allows a sure diagnosis. We reviewed data records from 2016 to 2020 of patients treated for dural metastases. We included only patients with complete anamnestic history, with both known and unknown primitive cancer. Collected data were compared with recent literature. We operated on 16 single dural metastases, also from very unusual cancers. The most common primitive type of cancer, in our series, was lung tumor, in contrast to prostate cancer, recently reported in literature as the most frequent. A retrospective multicenter study is mandatory to assess new epidemiologic evidences.


Achrol AS, Rennert RC, Anders C, et al. Brain metastases. Nat Rev Dis Primers 2019; 5: 5. DOI:

Barnholtz-Sloan J.S, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 2004; 22: 2865-72. DOI:

Laigle-Donadey F, Taillibert S, Mokhtari K, Hildebrand J, Del-attre JY. Dural metastases. J Neurooncol 2005; 75: 57-61. DOI:

Alafaci C, Caffo M, Caruso G, et al. Brain metastases as first clinical manifestation of ovarian carcinoma. Clin Neuropathol 2011; 30: 203-5. DOI:

Barresi V, Caffo M, Branca G, Caltabiano R, Tuccari G. Meningeal tumors histologically mimicking meningioma. Pathol Res Pract 2012; 208: 567-77. DOI:

Yue Q, Isobe T, Shibata Y, et al. New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma. Eur Radiol 2008; 18: 2901-11. DOI:

Bulakbasi N, Kocaoglu M, Ors F, Tayfun C, Uçöz T. Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors. AJNR Am J Neuroradiol 2003; 24: 225-33.

Weon YC, Kim EY, Kim HJ, Byun HS, Park K, Kim JH. Intracranial solitary fibrous tumors: Imaging findings in 6 consecutive patients. AJNR Am J Neuroradiol 2007; 28: 1466-9. DOI:

Lyndon D, Lansley JA, Evanson J, Krishnan AS. Dural masses: meningiomas and their mimics. Insights Imaging 2019; 6: 11. DOI:

Clarençon F, Bonneville F, Rousseau A, et al. Intracranial solitary fibrous tumor: imaging findings. Eur J Radiol 2011; 80: 387-94. DOI:

Singh G, Das KK, Sharma P, et al. Cerebral gliosarcoma: Analysis of 16 patients and review of literature. Asian J Neurosurg 2015; 7: 19. DOI:

Yamada SM, Ikawa N, Toyonaga S, Nakabayashi H, Park KC, Shimizu K. Primary malignant B-cell-type dural lymphoma: Case report. Surg Neurol 2006; 66: 539-43. DOI:

Montoto S, Lister TA. Secondary central nervous system lymphoma: risk factors and prophylaxis. Hematol Oncol Clin North Am 2005; 19: 751-63. DOI:

Pareek M, Greenaway C, Noori T, Munoz J, Zenner D. The impact of migration on tuberculosis epidemiology and control in high-income countries: a review. BMC Med 2016; 14: 48. DOI:

Aggarwal A, Patra DP, Gupta K, Sodhi HB. Dural tuberculoma mimicking meningioma: a clinicoradiologic review of dural en-plaque lesions. World Neurosurg 2016; 88: 686.e1-686.e7. DOI:

Donald PR, Schaaf HS, Schoeman JF. Tuberculous meningitis and miliary tuberculosis: the rich focus revisited. J Infect 2005; 50: 193-5. DOI:

Khanna PC, Godinho S, Patkar DP, Pungavkar SA, Lawande MA. MR spectroscopy-aided differentiation: “Giant” extra-axial tuberculoma masquerading as meningioma. AJNR Am J Neuroradiol 2006; 27: 1438-40.

Chatterjee S, Saini J, Kesavadas C, Arvinda HR, Jolappara M, Gupta AK. Differentiation of tubercular infection and metastasis presenting as ring enhancing lesion by diffusion and perfusion magnetic resonance imaging. J Neuroradiol 2010; 37: 167-71. DOI:

Stern B. Neurological complications of sarcoidosis. Curr Opin Neurol 2004; 17: 311-6. DOI:

Tsukada Y, Fouad A, Pickren JW, Lane WW. Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer 1983; 52: 2349-54.<2349::AID-CNCR2820521231>3.0.CO;2-B DOI:<2349::AID-CNCR2820521231>3.0.CO;2-B

Sgouros S, Walsh AR. Synchronous dural and cutaneous metastases along the distribution of the external carotid artery. British J Neurosurg 1994; 8: 617-9. DOI:

Caffo M, Barresi V, Caruso G, et al. Innovative therapeutic strategies in the treatment of brain metastases. Int J Mol Sci 2013; 14: 2135-74. DOI:

Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997; 37: 745-51. DOI:

Fink KR, Fink JR. Imaging of brain metastases. Surg Neurol Int 2013; 4: 209-19. DOI:

Kremer S, Grand S, Rémy C, et al. Contribution of dynamic contrast MR imaging to the differentiation between dural metastasis and meningioma. Neuroradiology 2004; 46: 642-8. DOI:

Bendszus M, Warmuth-Metz M, Burger R, Klein R, Tonn JC, Solymosi L. Diagnosing dural metastases: the value of 1H magnetic resonance spectroscopy. Neuroradiology 2001; 43: 285-9. DOI:




How to Cite

Caffo, M., Curcio, A., Laera, R., Barresi, V., & Caruso, G. (2022). Intracranial Dural Metastases and Diagnostic Misunderstandings. Journal of Analytical Oncology, 11, 54–62.