Recurrent craniopharyngioma invading the orbit,cavernous sinus and skull base: a case report

A case is described in which a recurrent craniopharyngioma extended into the sphenoid bone, posterior ethmoid cells, cavernous sinus and orbit.     

Radio-frequency coil selection for MR imaging of the brain and skull base

Radio-frequency coils play a crucial role in the quest for optimal magnetic resonance (MR) image resolution. Given the growing variety of specialized coils available for neuroradiologic imaging applications, it is critical that radiologists use a coherent strategy for successfully matching these coils to specific imaging situations. First, fundamental concepts of coil design are reviewed. Subsequently, a coil-selection algorithm for neuroimaging applications is described. The algorithm uses the patient's clinical history to derive a region of interest, a desired spatial resolution, and a desired contrast resolution. These factors are then used to impose anatomic coverage and imaging protocol constraints on the set of available coils. Finally, coil selection is further refined according to patient tolerance factors. The following coils are considered for use with a 1.5-T superconducting MR imager; namely, quadrature birdcage head, neurovascular phased-array, and dual single-circular-element coils, as well as investigational coils that have not yet been approved by the U.S. Food and Drug Administration: reduced-volume birdcage end-cap, temporal lobe phased-array, carotid artery phased-array, coils. Rationales are discussed regarding appropriate coil selection for screening whole brain and imaging brainstem, cranial nerves, orbits, cerebral cortex, mesial temporal lobes, and internal auditory canal, and for MR angiography.     

Tumor invasion of the anterior skull base: a comparison of MR and CT studies

Seven patients who had tumors arising in the anterior face or paranasal sinuses and invasion of the anterior skull base were evaluated with magnetic resonance (MR) and high resolution CT. Magnetic resonance was superior in evaluating tumor encasement of the carotid artery and invasion of the cavernous sinus; for assessing the relationship of the tumor to the anterior brain, optic nerves, and optic chiasm; in providing coronal images free from dental artifact; and in determining tumor extent within the infratemporal fossa. Bone destruction was more easily observed on CT than MR.     

眼眶-中颅窝沟通性脑膜瘤手术颅底重建

目的 探讨经眶上裂沟通眼眶-中颅窝的脑膜瘤手术的颅底重建的方法.方法 总结我院自2007-01至2012-05采用眶-翼点入路显微手术治疗72例通过眶上裂沟通眼眶-中颅窝底的脑膜瘤患者的临床资料,对该类肿瘤颅底重建的方法进行分析.结果 颅底硬脑膜及骨缺损修补效果满意,肿瘤全切率为90.3％.术后无脑脊液漏、局部脑膨出、脑膜炎等并发症的发生;皮下积液12例.结论 对于该类颅眶沟通性脑膜瘤行眶-翼点入路显微手术是较好的手术方式,颅底重建是手术成功的关键之一.     

Inflammatory myofibroblastic tumor of the orbit with associated enhancement of the meninges and multiple cranial nerves

Inflammatory myofibroblastic tumor (IMT), Tolosa-Hunt syndrome (THS), and idiopathic hypertrophic pachymeningitis (IHP) seem to be part of a spectrum of disorders that have diverse locations but similar histologic and imaging findings. We report a case of a 50-year-old man presenting with multiple progressive cranial nerves palsies with leptomeningeal cranial nerve enhancement on MRI (II, V1-V3, and X), orbital and infraorbital masses, prominence within the left cavernous sinus, and diffuse dural enhancement. Biopsies of the orbital lesion and infraorbital nerve revealed IMT. The patient's lesions, symptoms, and dural enhancement quickly improved with steroid administration and nearly resolved over multiple subsequent scans over the next few months. This case illustrates a rare case of pseudotumor mimicking a more aggressive appearance that would usually portend a case of malignancy. There is a potential association of IMT, THS, and IHP, which may have existed in a concomitant fashion in this patient. The case also describes the unique finding of enhancement of the cisternal segments of multiple cranial nerves (simulating leptomeningeal malignant involvement), which may be related to inflammatory perineural edema or ischemic neuropathy.     

鼻咽癌颅底侵犯的CT与MRI征象对比分析

目的:探讨CT及MRI在鼻咽癌颅底侵犯诊断中的应用价值.方法:回顾性分析经病理证实的52例鼻咽癌的CT及MRI图像,并以放疗后6个月的影像资料和临床资料为参考依据,比较CT与MRI在鼻咽癌颅底受侵诊断中的应用价值.结果:52例放疗6个月后定性诊断结果为颅底受侵41例,其中颅底骨质受侵39例,颅底肌肉受侵41例.52例中...     

Amyloidoma of the skull base

We report a case of a primary amyloidoma of the skull base. Plain radiography and CT showed a lytic, highly destructive lesion with multiple scattered calcifications within. MR imaging revealed that the tumor was isoto hypointense to muscle on T1-weighted images and extremely hypointense on T2-weighted images. In contrast to two previous reports, marked enhancement after the administration of contrast material was absent. Bone amyloidomas are very rare and are frequently misinterpreted as chondrosarcomas.     

Skull base tumours Part II. Central skull base tumours and intrinsic tumours of the bony skull base

With the advances of cross-sectional imaging radiologists gained an increasing responsibility in the management of patients with skull base pathology. As this anatomic area is hidden to clinical exam, surgeons and radiation oncologists have to rely on imaging studies to plan the most adequate treatment. To fulfil these endeavour radiologists need to be knowledgeable about skull base anatomy, about the main treatment options available, their indications and contra-indications and needs to be aware of the wide gamut of pathologies seen in this anatomic region. This article will provide a radiologists' friendly approach to the central skull base and will review the most common central skull base tumours and tumours intrinsic to the bony skull base.     

Primary lymphoma of the skull base

This case demonstrates the rare finding of a primary malignant lymphoma of the frontobasis and ethmoidal cells in a patient presenting with progressive loss of vision. Computed tomography and MRI demonstrated a homogenously enhancing tumour with extensive bony destructions of the skull base. After transsphenoidal biopsy, histology revealed a highly malignant primary B-cell lymphoma. The patient was further treated with immunochemotherapy. Tissue diagnosis is, therefore, crucial before a definitive therapy is instituted.     

Invasive aspergilloma of the skull base

Summary Aspergillus infection originating in the nasal cavity or paranasal sinuses is a rare cause of benign, locally invasive disease affecting the skull base. We describe a case in which extensive disease led to bilateral proptosis and invasion of the anterior cranial fossa.     

Giant-cell tumor of the skull base

Giant cell tumors are uncommon primary bone tumors. They primarily occur in the long bones. Giant cell tumors are extremely rare in the skull and head and neck. When it does occur, the maxilla and mandible are the common sites to be involved. We described two cases of giant cell tumor in the temporal bone. In the non-contrast enhanced CT, the lesion presents as a soft tissue density mass with expansion of the bone. The bony cortex is usually intact. The adjacent soft tissues and cerebral parenchyma show no infiltration or edema. The post contrast scan reveals homogenous enhancement of the mass. Received: 20 April 1998 Accepted: 11 August 1998