PMC4898226_01
62-year-old woman with chondrdomyxoid fibroma involving the sphenoid sinus. Lateral view of the skull. A mass arising from the skull base partly fills the sphenoid sinus and contains calcifications, many with rounded, "rings-and-arcs" configuration (arrows).
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A bone survey ordered as part of the evaluation of possible plasma cell dyscrasia revealed a lytic lesion at the base of the skull with heterogeneous calcifications, some having ring-and-arc configuration (Fig. 1).
62-year-old woman with chondrdomyxoid fibroma involving the sphenoid sinus. 62-year-old woman with chondrdomyxoid fibroma involving the sphenoid sinus. Axial and sagittal CT images demonstrate a mass with coarse calcifications just caudal to the sella turcica. Axially, images show an expansile midline mass with smoothly expanded, benign bony margins. On the sagittal image, the mass extends into the posterior aspect of the nasal cavity and superior aspect of the nasopharynx. Bony margins are more difficult to evaluate on this view, but the clivus does not appear to be eroded..
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A CT scan for further evaluation of the skull lesion (Fig. 2, A and B) confirmed a 33 x 33 x 33-mm mass arising in the central base of the skull with coarse calcification.
62-year-old woman with chondrdomyxoid fibroma involving the sphenoid sinus. Axial T2, T1, and postcontrast T1-weighted MR images through the mass at the base of the skull confirm that the majority of the tumor remains intact after biopsy. Areas of signal dropout correspond to the coarse calcifications seen on conventional radiography and on CT scan. The mass is hyperintense on T2 and appears noninfiltrative. It enhances after contrast administration.
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An MRI scan was performed after biopsy to evaluate the residual mass and to serve as a baseline for follow-up (Fig. 3).