A 30 yo male with right side hearing loss and ophthalmoplegia, Rt side 3rd, 4th and 6th CN Palsy.
Description of findings:
A neoplastic soft tissue with expansile osseous destruction of underlying right petrous apex, well demarcated, lobulated with moderate enhancement on post contrast T1, no cystic component. Clustures of blood vessel seen as multiple punctate T2 flow voids with low signals on T2*GRE in the substance of mass implies to vascular nature of mass. The soft tissue partially protruding in sphenoid sinus. Right side ICA petrous portion completely encased by the mass but show normal T2 flow voids. The soft tissue is extending anteriorly in right parasellar region, obliterating right side cavernous sinus with possible involvement of right side cranial nerves traversing the cavernous sinus which explains right side ophthalmoplegia. T2 high signals of fluid in right mastoid air cells implies involvement of right side Eusthecian tube and impaired drainage which explains right side hearing loss. Right side inner ear and semicircular canals encased by mass but not destroyed completely. Protruding partially in right CP angle and at the floor of right middle cranial fossa with mild compression over right cerebellar hemisphere and right temporal lobe, no obvious parenchymal invasion or infiltration on post contrast.
Imaging wise possible DDs given were malignant mesenchymal tumors and malignant meningioma.
Histopathology Report : Chondrosarcoma , a type of malignant mesenchymal tumor.
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| Axial T2 |
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| Axial Diffusion and T2*GRE |
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| Axial FLAIR and T1 |
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| Post contrast T1 |
A neoplastic soft tissue with expansile osseous destruction of underlying right petrous apex, well demarcated, lobulated with moderate enhancement on post contrast T1, no cystic component. Clustures of blood vessel seen as multiple punctate T2 flow voids with low signals on T2*GRE in the substance of mass implies to vascular nature of mass. The soft tissue partially protruding in sphenoid sinus. Right side ICA petrous portion completely encased by the mass but show normal T2 flow voids. The soft tissue is extending anteriorly in right parasellar region, obliterating right side cavernous sinus with possible involvement of right side cranial nerves traversing the cavernous sinus which explains right side ophthalmoplegia. T2 high signals of fluid in right mastoid air cells implies involvement of right side Eusthecian tube and impaired drainage which explains right side hearing loss. Right side inner ear and semicircular canals encased by mass but not destroyed completely. Protruding partially in right CP angle and at the floor of right middle cranial fossa with mild compression over right cerebellar hemisphere and right temporal lobe, no obvious parenchymal invasion or infiltration on post contrast.
Imaging wise possible DDs given were malignant mesenchymal tumors and malignant meningioma.
Histopathology Report : Chondrosarcoma , a type of malignant mesenchymal tumor.
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