Frontal sinus giant osteoma with radiologically unusual component suggesting blood supply: A case report

Osteoma is a common, slow growing bone tumor, and often affects the paranasal sinus. Typically, it shows a very hyperdense osseous lesion on computed tomography (CT) scan and low-intensity change on T2-weighted image on magnetic resonance imaging (MRI). No report has mentioned osteomas in blood supply on MRI. A 57-year-old male patient presented with a prolonged declined activity and a gigantic osseous tumor that originated from the frontal sinus, which markedly compressed the bilateral frontal lobe. MRI revealed a slightly enhanced front basal part of the tumor by gadolinium, with blood supply from ethmoidal arteries. The patient underwent surgery, and the diagnosis of osteoma was made based on histological findings. We reported a case of giant osteoma originating from the frontal sinus with unusual blood supply on 4-dimensional MR angiography.     

"Spontaneous" pneumocephalus associated with aerobic bacteremia

Three cases of "spontaneous" pneumocephalus suspected to have resulted from aerobic bacteremia caused by Enterobacter cloacae, Escherichia coli, and Klebsiella aerogenes are reported. In two cases, the E. cloacae and K. aerogenes were isolated from the cerebrospinal fluid. These cases were characterized by a rapid accumulation of air, without niveau, in the subarachnoid space and ventricles.     

Spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization

We present a case of spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization. Collections of air such as these are normally due to injury or surgery, and more rarely, infection or tumor; exceptionally they may be spontaneous. The patient in question complained of a progressively enlarging retroauricular mass which increased in size on Valsalva maneuvers; he had no other symptoms. The etiology, skull X-rays, computed tomography and follow-up after surgery are shown here.     

Clavicular osteoma associated with bronchial osteomas

Osteoma is a rare benign tumor, composed of bony tissues. It predominantly involves the skull but rarely the long bones. In this report we present a case of clavicular osteoma associated with bronchial osteomas. This association has not previously been reported. There was no evidence of Gardners syndrome.     

Sphenoid sinus osteoma at the sella turcica associated with empty sella: CT and MR imaging findings

SUMMARY: A 50-year-old woman presented with intermittent headache for the past few years. A paranasal sinus CT scan showed a diffusely calcified lesion at the roof of the sphenoid sinus and sella turcica, with the sellar floor bony cortex involved. Empty sella was noted. MR imaging revealed a soft-tissue lesion with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and heterogeneous enhancement on postgadolinium images. Histologic examination revealed an osteoma composed of mature lamellar bone.     

Frontal sinus outflow tract evaluation by sagittal computed tomography in frontal sinus fracture

The status of the frontal sinus outflow tract is important in the management of frontal sinus fractures. Anatomic and mucosal obstruction of the FSOT leads to mucociliary stasis with consequent infectious complications. This has been evaluated by routine CT scan.     

Frontal sinus parameters in computed tomography and sex determination

The frontal sinus is a sturdy part of the skull that is likely to be retrieved for forensic investigations. We evaluated frontal sinus parameters in paranasal sinus computed tomography (CT) images for sex determination. The study was conducted on 200 normal paranasal sinus CT images of 100 men and 100 women of Persian origin. We categorized the studied population into three age groups of 20–34, 35–49 and ⩾50 years. The number of partial septa in the right frontal sinus and the maximum height and width were significantly different between the two sexes. The highest precision for sex determination was for the maximum height of the left frontal sinus (61.3%). In the 20–34 years age-group, height and width of the frontal sinus were significantly different between the two sexes and the height of the left sinus had the highest precision (60.8%). In the 35–49 years age-group, right anterior-posterior diameter had a sex determination precision of 52.3%. No frontal sinus parameter reached a statistically significant level for sex determination in the ⩾50 years age-group. The number of septa and scallopings were not useful in sex determination. Frontal sinus parameters did not have a high precision in sex determination among Persian adults.     

Mastoid effusion associated with dural sinus thrombosis

We present a series of three patients with mastoid air cell effusions associated with adjacent lateral sinus thrombosis. In all of these cases, the findings support the hypothesis that the mastoid effusion is secondary to sinus thrombosis rather then the other way around. Also shown is the chronology and natural evolution of mastoid air cell effusion secondary to sinus thrombosis as seen on planar imaging.     

Intracranial and subcutaneous lipoma associated with sagittal sinus fenestration and falcine sinus

Intracranial lipomas are rare lesions. Intracranial lipoma associated with a subcutaneous lipoma is extremely rare. Various vascular abnormalities have been described in association with intracranial lipoma, including distension, kinking, or narrowing of arteries and veins; arteriovenous malformation; and aneurysm. To our knowledge, association of sagittal sinus fenestration, falcine sinus, and absent straight sinus with intraextracranial lipoma has not been reported before. We report the imaging findings of an infant with interhemispheric and subcutaneous lipoma associated with falcine sinus and sagittal sinus fenestration.     

Pedicled osteoma of the maxillary sinus. A rare radiological finding?

Several cases of intrasinus bony densities above pathological dental areas are reported. Common radiological features are outlined (pediculate implantation on the sinusal floor, cortical limits, acute or chronic dental infection). In one case, an histological examination performed at the opportunity of a sinusal operation pointed out osteomatous tissues.     

Frontal sinus mucocele: A rare complication of craniofacial fibrous dysplasia

We present plain radiographic, computed tomographic and magnetic resonance imaging (MRI) findings in a 25-year-old female patient with craniofacial fibrous dysplasia (FD). Although FD has a tendency to involve craniofacial bones in a unilateral fashion, the involvement was bilateral and extensive in this case. An additional feature was the presence of a frontal sinus mucocele, presumably due to the involvement of the sinus recess by the dysplastic process. This complication of the craniofacial FD has been reported very infrequently in the literature.     

Frontal subcutaneous lipoma associated with large interhemispheric lipoma and corpus callosum agenesis

Intracranial lipomas are extremely rare fat-containing lesions that comprise 0.1%-0.5% of all primary brain tumors. They are congenital lesions that arise due to persistence and maldifferentiation of the meninx primitive (subarachnoid space precursor). We report a case of a 30-year-old woman who presented with seizures due to an intracranial lipoma and no neurological deficits. CT (computerized tomography) imaging findings demonstrated a large interhemispheric partially calcified lipoma that communicated with a large scalp lipoma and was associated with agenesis of the corpus callosum. Compared to the prior CT imaging, the lipoma increased in size from 3.4 cm to 4.1 cm transversely. A recent CT angiogram done due to suspicion of an aneurysm showed the lipoma now measuring 6 cm by 4.7 cm. Most cases of intracranial lipoma have been reported in the pediatric age group. Here, we report a rare case of interhemispheric intracranial lipoma in the adult age group. This case also demonstrates the importance of imaging modalities for detecting intracranial lipoma without performing invasive brain biopsy.