Although the sign is seen in most meningiomas, it has also been described in other benign lesions, such as sarcoidosis, acoustic neurinoma, chloroma and malignant lesions, such as lymphoma, metastases and extra-axial malignant tumors. Meningiomas are typically hypervascular, fed by dural vessels with a typical sunburst of enlarged dural feeders and an intense tumor blush. The periphery of the lesion can be supplied by pial branches of the internal carotid artery. Differential diagnosis Differential diagnosis can be difficult from dural metastases and even peripheral parenchymal metastases. Peripherally located gliomas can mimic meningioma by the presence of a dural tail.
Differential diagnoses includes hemangiopericytoma, hemangioma and fibrous tumor.
In the cerebellopontine angle differentiation has to be made from schwannoma.