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Meningioma - cavernous sinus

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Decrease in vision from the right eye.

Patient Data

Age: 75 years
Gender: Female
mri

A large right paraselllar mass is noted measuring up to 18 mm thick, filling the cavernous sinus and moderately narrowing in the transverse portion of the cavernous carotid artery. Anteriorly, the tumor extends for 1 centimeter into the apex of the right orbit, medially into the upper right sphenoid sinus. The tumor grows over the suprasellar region, displacing the posterior pituitary bright spot up and to the left. It contacts the optic chiasm and posteriorly mildly thickens the prepontine dura and anterior right tentorium. Inferiorly, the tumor extends into Meckels cave almost completely filling it. 

Annotated images

mri
  • blue arrow: the posterior pituitary bright spot has been pushed up and to the left by the meningioma
  • red arrow: narrowed right internal carotid artery is significantly narrowed by the surrounding meningioma
  • yellow arrows: craniotomy defect
  • green arrow: susceptibility induced distortion and signal loss due to craniotomy fixation device

Case Discussion

This case illustrates a large meningioma centered on the right cavernous sinus (histologically confirmed). 

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