The dural tail sign revisited.

The “dural tail sign” was described by Wilms and colleagues as a thin, tapering rim of dural enhancement, in continuity with a convexity meningioma on gadopentetate dimeglumine– enhanced magnetic resonance (MR) (1). Goldsher and associates subsequently, in 1990, demonstrated the dural tail sign in 60% of their series of meningiomas and concluded that its presence, associated with an extraaxial mass, was very specific for meningioma (2). The dural tail sign more recently has been described in patients having chloroma, lymphoma, sarcoidosis (3), acoustic neuroma (4), and metastatic tumors (5). We report three cases demonstrating the dural tail sign. The first is a case of primary central nervous system lymphoma of the dura mater in an immunocompetent young woman. The second case is a syphilitic gumma involving the dura mater. The third case is that of an aggressive papillary middle-ear tumor extending intracranially.