How many masses do you see? Where are they?
Two masses are present. One is extrmedullary intradural in the cervical canal the other is in the posterior fossa, abutting the inferior surface of the tentorium.
What is the diagnosis of the posterior fossa lesion?
It almost certainly represents a meningioma.
What about the cervical lesion?
The main differential is between a neurogenic tumour (most likely a schwannoma) or a second meningioma.
A vividly-enhancing 2.7 cm (L) x 1.2 cm x 1.4 cm (D) heterogeneous T2 hyperintense intradural / extramedullary mass, with broad dorsal dural base (but no dural tail) is centred in the right side of the mildly expanded spinal canal at C2 and C3. This severely compresses and displaces the mildly hyperintense spinal cord to the left, with increased epidural enhancement noted to extend along the right C3-C5 nerve roots.
The resultant severe spinal canal stenosis extending from C2 to C3/4 is further compounded by a contained 5 mm diameter C3/4 superiorly-projecting central posterior to right paracentral disc extrusion.
A vividly-enhancing 2-3 cm isointense extra-axial mass, compatible with a globular meningioma, is partially imaged posteriorly in the left posterior fossa. This extends superiorly across the tentorium cerebelli, indenting the posterior left cerebellar hemisphere and inferior occipital lobe, with mild adjacent vasogenic oedema.