Metastatic prostate carcinoma mimicking meningioma

We report the case of a large dural-based adenocarcinoma of the prostate clinically and radiographically mimicking a meningioma. A 57-year-old male presented to our institution for the first time with a progressive history of gradual hemiparesis, seizures and headache. Imaging revealed a very large extraparenchymal lesion with significant mass effect initially felt to be consistent with a meningioma. The patient underwent successful surgical resection. The pathology revealed metastatic adenocarcinoma of the prostate. The patient received postoperative radiotherapy and subsequent imaging demonstrated no evidence of disease progression. We discuss the implications of intracranial mass lesions in patients with prostate cancer and review of the literature.