Medulloblastoma presenting with tentorial "dural-tail" sign: Is the "dural-tail" sign specific for meningioma?

To the best of our knowledge, the association of a medulloblastoma with a " dural-tail" sign has not been previously reported. A 24-year-old male developed severe headaches and right-sided dysmetria tha t worsened over 1 month, Magnetic resonance (MR) imaging of the brain demon strated a heterogeneously enhancing lesion in the posterior fossa, The lesi on appeared to be tentorially based and exhibited a characteristic "dural-t ail" sign, which is considered pathognomonic for meningioma. Cerebellar ton sil ectopia and hydrocephalus were also present. The presumptive diagnosis of tentorial meningioma was made. The lesion was resected by a posterior fossa approach. At surgery, the appe arance of the tumor was inconsistent with the diagnosis of meningioma, and histopathologic evaluation yielded the diagnosis of medulloblastoma. This case and the literature demonstrate that malignant tumors can present with the characteristic MR imaging appearance of a meningioma. This possibi lity must be considered when treatment is planned, especially if a nonopera tive course is favored.