PMC6691317_01
(A-D) CECT brain and paranasal sinuses showing infiltrative solid-cystic mixed density lesion epicentred in the base of skull predominantly involving the sphenoid sinus causing its expansion and ballooning. The lesion has caused erosion of the left lateral wall of the sphenoid sinus, left anterior and posterior clinoid process, floor of sella and sphenoid sinus and lateral wall of the left orbit with extension into the left antero-medial temporal lobe and left cavernous sinus
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The lesion had caused erosion of the left lateral wall of the sphenoid sinus, left anterior and posterior clinoid process, floor of sella and sphenoid sinus and lateral wall of the left orbit with extension into the left antero-medial temporal lobe and left cavernous sinus (Figure 1).
(A-D) CEMRI brain and paranasal sinuses showing a multiseptated cystic lesion appearing iso to hyperintense on T1 and T2W images causing cortical buckling and displacement of the left temporal lobe. Peripheral enhancement of the lesion is evident on contrast
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The findings were suggestive of infected mucocele. (Figure 2).
H&E x 40 showing a spindle cell neoplasm, with hypercellular areas representing Antoni (A) and edematous hypocellular areas of Antoni (B) type and palisading nuclei consistent with Verocay bodies (C). On immunohistochemistry (D), tumor cells and membrane lining the cyst is positive for S-100 protein (magnification x 40)
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Histopathological examination of the resected specimen revealed a spindle cell neoplasm, with hypercellular areas corresponding to Antoni A (Figure 3, A) and edematous hypocellular areas of Antoni B type (Figure 3, B). Palisading nuclei consistent with Verocay bodies were noted (Figure 3, C). S-100 protein and vimentin and negative for epithelial membrane antigen (EMA) and cytokeratin (Figure 3, D). S-100 protein was also found to be strongly positive at the membrane lining the cyst.