PMC7451153_01
Diagnostic computed tomography maxillofacial images figure description: images a and b demonstrate axial and coronal views of a 5.2 x 6.6 x 4.3 cm intra-axial mass with compression and displacement of the brainstem. Image C demonstrates an axial view of the mandible, showing asymmetry of the left mandibular ramus and muscular hypotrophy on the left side.
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F1
A computed tomography (CT) scan maxillofacial without contrast was performed, demonstrating a 5.2 x 6.6 x 4.3 cm intra-axial mass with compression and displacement of the brainstem [Figure 1]. There was slight dilatation of the third and lateral ventricles representing mild obstructive hydrocephalus and erosion of the base of the skull involving the carotid canal, foramen rotundum, pterygoid canal, foramen ovale, middle cranial fossa floor, and the internal auditory canal [Figure 1]. An underbite occlusion was noted with associated atrophy of the left masticator, mylohyoid, and anterior belly of digastric muscles and underdeveloped left mandible body and ramus [Figure 1].
Diagnostic computed tomography angiogram figure description: bony erosion and remodeling of the left sphenoid and petrous temporal bones are seen, related to the mass (a and b). On contrasted imaging (c), angiography demonstrates external compression (approximately 50% narrowing) of the cavernous and petrous segment of the left internal carotid artery.
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F2
CTA demonstrated bony remodeling of the left sphenoid and petrous portion of the temporal bones related to the mass with external compression (approximately 50% narrowing) of the cavernous and petrous segment of the left internal carotid artery (ICA) [Figure 2].
Preoperative magnetic resonance imaging figure description: contrasted T1-weighted magnetic resonance imaging with axial, sagittal, and coronal views of the 5.2 x 7.8 x 5.1 cm heterogeneously extra-axial enhancing mass centered in the left mesial temporal region with involvement of the skull base and left foramen ovale, rotundum and spinosum, encasement and moderate narrowing of the left internal carotid artery, mild obstructive hydrocephalus, and marked compression of the brainstem.
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F3
ICA, mild obstructive hydrocephalus, and marked compression of the brainstem [Figure 3]. In addition, there was associated atrophy of the left masticator muscles with underdevelopment of the left mandible body and ramus [Figure 4].
Mandibular and muscular atrophy figure description: contrasted T1-weighted magnetic resonance imaging demonstrates asymmetric of the mandibular rami, with left smaller than right, as well as atrophy of the muscles of mastication.
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F4
ICA, mild obstructive hydrocephalus, and marked compression of the brainstem [Figure 3]. In addition, there was associated atrophy of the left masticator muscles with underdevelopment of the left mandible body and ramus [Figure 4].
Postoperative magnetic resonance imaging figure description: contrasted T1-weighted magnetic resonance imaging with axial, sagittal, and coronal views demonstrates near complete resection with a thin rim of residual tumor along the lateral dural margin of the left cavernous sinus/lesser sphenoid wing and at the floor of the left middle cranial fossa extending posteriorly to the roof of the remodeled left petrous temporal bone.
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F5
Postoperative imaging demonstrated near-complete resection with a thin rim of the residual tumor along the lateral dural margin of the left cavernous sinus/lesser sphenoid wing and at the floor of the left middle cranial fossa extending posteriorly to the roof of the remodeled left petrous temporal bone [Figure 5].