Isolated Sphenoid Sinus Lesions: Experience with a Few Rare Pathologies

AS. Clival and Paraclival Lesions: A Pictorial Review

The clivus is a midline anatomical structure in the central skull base. It is affected by a wide range of non-neoplastic, benign and malignant pathologies, some of which typically affect the clivus because of its strategic location and embryological origins. Clival lesions may often be asymptomatic with occasional complaints like headache or cranial neuropathy in few. Cross-sectional imaging techniques, namely, computed tomographic scan and magnetic resonance imaging, thus, play a key role in approximating to the final diagnosis and estimating the disease extent. In this article, we highlight the important imaging features of various clival and paraclival pathologies to facilitate effective diagnosis, therapeutic planning, and management.

Leiomyosarcoma of the Nasal Cavity and Paranasal Sinuses: A Case Report and Comprehensive Review of the Literature

Sinonasal leiomyosarcoma (LMS) is a rare and aggressive mesenchymal tumor with smooth muscle differentiation. The sinonasal tract is an unusual primary site for LMS, as scant smooth muscle exists in this location, with only 75 cases reported in the English literature including the case presented herein. Sinonasal LMS is considered an aggressive head and neck tumor with significant potential for recurrence and metastasis. Since recurrence is high and the potential for late metastasis exists, lifelong follow-up in these patients would be beneficial, especially among those with previous history of RB.

Sphenoid sinus aspergilloma clinically mimicking as malignancy—a case report

Background

Fungal sphenoid sinusitis mimicking as malignant tumor and invading the pituitary fossa is an uncommon entity. This report aims to highlight radiological salient features to help differentiate fungal lesion from malignant tumor in sphenoidal sinus mass lesions.

Case presentation

We intend to report a case of middle-aged female who presented with gradual progressive diminution of vision since 3 years complicated with acute attack of unilateral headache and numbness. Computed tomography (CT) showed hyperdense lesion involving the sphenoid sinus extending into pituitary fossa and bilateral cavernous sinuses with smooth bony remodeling. Lesion appeared hypointense on T2-weighted and hyperintense on T1-weighted images on magnetic resonance imaging (MRI). Surgical excision of the lesion was done and pathological examination showed fungal hyphae and aspergillus fumigatus species on culture after 2 weeks of incubation. Post-operative CT revealed empty sinuses with surrounding bone remodeling.

Conclusion

Combination of T1 hyperintensity, T2 hypointensity, and hyperdense sinus is a strong predictor of fungal mass lesion involving sphenoid sinus.