Imaging Lesions of the Cavernous Sinus

Abstract

SUMMARY:Our aim was to review the imaging findings of relatively common lesions involving the cavernous sinus (CS), such as neoplastic, inflammatory, and vascular ones. The most common are neurogenic tumors and cavernoma. Tumors of the nasopharynx, skull base, and sphenoid sinus may extend to the CS as can perineural and hematogenous metastases. Inflammatory, infective, and granulomatous lesions show linear or nodular enhancement of the meninges of the CS but often have nonspecific MR imaging features. In many of these cases, involvement elsewhere suggests the diagnosis. MR imaging is sensitive for detecting vascular lesions such as carotid cavernous fistulas, aneurysms, and thromboses.

Unusual primary sphenoid adenoid cystic carcinoma: the importance of combined CT and MR evaluation

“…The intermediate T2 signal demonstrated in our case did not correlate with magnetic resonance findings for most chordomas which exhibit very high T2 signal intensity. 8 The typical 'thumb sign' appearance (posterior projection of the mass indenting the pons) of clival chordomas was absent in our case which showed preservation of the brainstem. In addition, the sparing of the pituitary gland with sellar floor destruction indicated a nonpituitary origin of the tumour.…”

“…Single modality has shown poor outcomes while multimodality treatments with surgery and postoperative radiation has better results. 8,9 Some recommend tumor debulking followed by adjuvant therapy while others encourage more aggressive surgery in selected cases to achieve maximum local control and improve prognosis. 3,8,9 The benefit with the use of chemotherapy is not yet defined.…”

“…8,9 Some recommend tumor debulking followed by adjuvant therapy while others encourage more aggressive surgery in selected cases to achieve maximum local control and improve prognosis. 3,8,9 The benefit with the use of chemotherapy is not yet defined. Some important prognostic factors for the adenoid cystic carcinoma are; anatomic location, size, involvement of adjacent structures, cellular atypia grade, surgical margin and the presence of metastasized ganglions.…”

Histiocytosis: a review focusing on neuroimaging findings

“…Meningeal lesions and meningioma-like mass lesions: either a single/multiple dural mass, or diffuse pachymeningeal thickening, or even both of those 32,35 . Parasellar lesions have also been reported, which may infiltrate the cavernous sinus 22 . Although Erdheim-Chester disease rarely affects spine, it should still be considered in the differential diagnosis of subdural or epidural masses 37 .…”

“…Suprasellar region involvement is extremely rare 16 . There have also been reports of cavernous sinus invasion 22 . Most lesions in intracranial Rosai-Dorfman disease mimic meningioma in both clinical and radiologic aspects (Figure 7), making the diagnosis more difficult.…”