CT features of primary pleural gritty meningioma: A case report and review of the literature

Primary ectopic meningiomas, although widely reported in multiple sites of the body, are particularly rare in the pleura. Here, we report a 35-year-old asymptomatic woman who was found to have a large mass in the right pleural area on physical examination chest radiography. Chest CT scan showed a large irregular mass from the right second anterior costal pleura to the right supradiaphragm, in which calcified plaques of varying sizes were widely and heterogeneously distributed. The mass was connected to the pleura (anterior rib pleura, mediastinal pleura, diaphragmatic pleura) in a wide base, with oblique “Z” changes in the coronal view. After the contrast agent injection, the mass exhibited mild enhancement on both arterial and venous phase scans. Furthermore, a linear enhancement that was indicative of “pleural tail sign” changes in the pleura adjacent to the mass was observed. The disease was preoperatively misdiagnosed as malignant pleural mesothelioma, and the postoperative pathological diagnosis was right pleural meningioma (gritty type). Therefore, we carefully analyzed its imaging features and differential diagnosis by consulting relevant literature.