Figure 1d. Meningioma after medulloblastoma. (a) CT scan of a 4-year-old child shows a posterior mass. Follow-up CT over the next several years was unremarkable. (b) CT scan obtained 7 years later shows a high-attenuation, asymptomatic extraaxial mass. (c, d) T2-weighted (c) and contrast-enhanced T1-weighted (d) MR images show a well-defined, extraparenchymal left occipital mass that is isointense relative to gray matter (c) and anterior hyperintense white matter edema and homogeneous enhancement (d), findings that are consistent with meningioma. Surgery and posterior histologic analysis revealed anaplastic tumor foci with a typical whorl of bland meningothelial cells. (e) Follow-up MR image demonstrates tumor recurrence with dural venous sinus invasion and transcalvarial extension. Two other resections were performed, but the tumor progressed and the patient died.