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Cavernous sinus meningioma

Case contributed by Eid Kakish
Diagnosis almost certain

Presentation

Chronic headaches and dizziness.

Patient Data

Age: 50 years
Gender: Female
mri

There is a large lobulated avidly enhancing extra-axial lesion originating from the right cavernous sinus extending to involve the pituitary gland, sphenoid sinuses, the right aspect of the right temporal lobe, with infratentorial extension to the right CP angle, causing marked right-sided brainstem compression.

This lesion causes encasement and narrowing of the cavernous portion of the right carotid artery, proximal right MCA as well as displacement of the basilar artery to the left. 

A smaller extra-axial lesion of similar imaging features is seen in the right frontal lobe, posteriorly.

Both lesions are strongly suggestive of multiple meningiomas.

Retained fluid is seen in the right mastoid air cells. 

A CSF cleft is clearly demarcated between the cavernous sinus meningioma and the brainstem in the magnified T2W image.

Case Discussion

Characteristic dural tail and CSF cleft of extra-axial lesions, and imaging features of meningiomas are clearly seen in this case. Please refer to the full radiopaedia articles.

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