CASE HISTORY / CLINIC:
Patient presenting with emergent progressive loss of visual acuity
and double images. The endoscopic examination of the head and neck region revealed no pathological findings.


FINDINGS:
The T1-weighted axial image reveals a hypodense mass around the left side of the sphenoid bone, left orbita and left temporal lobe. The mass is seen to enhance intensely in the T1-weighted axial image after contrast administration (upper left picture). Contrast enhancement is also demonstrated around the left carotid siphon. A definite demarcation from left the orbita is not posible.
The mass beside the ethmoid sinus
at the skull base appears hyperdense in the T1-weighted coronal images done after contrast administration. The image further demonstrates an enhancement of the dura on the temporal side, most probably due to a tumorous infiltration.


DIAGNOSIS:
Adenoid cystic carcinoma


DIFFERENTIAL DIAGNOSIS:
Meningeoma or other malignant tumor of the skull base


Web resources:

1) Amersham Health