PMC4921176_01
Noncontrast axial CT image demonstrates a large extra-axial mass in the right middle cranial fossa, expanding into the right cavernous sinus.
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There was expansion of the cavernous sinus with encasement of the right cavernous carotid, and scalloping of the bony margins of the middle cranial fossa with enlargement of the right foramen ovale (Fig. 1).
Post-contrast axial CT image demonstrates homogeneous enhancement.
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Postcontrast head CT demonstrated homogeneous enhancement (Fig. 2).
Sagittal T1 noncontrast image shows buckling of the cortex, supporting extra-axial location.
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T1 and high signal intensity on T2 and FLAIR (Fig. 3, Fig. 4, Fig. 5, Fig. 6). The mass resulted in hydrocephalus due to obstruction of the left lateral ventricle, likely at the level of the foramen of monro.
Post-contrast coronal T1.
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T1 and high signal intensity on T2 and FLAIR (Fig. 3, Fig. 4, Fig. 5, Fig. 6). The mass resulted in hydrocephalus due to obstruction of the left lateral ventricle, likely at the level of the foramen of monro.
Frontal angiogram digital subtraction image demonstrates elevation of the right middle cerebral artery and medial deviation of the right internal carotid artery with a mass receiving significantly supply from an internal maxillary branch of the right external carotid artery, which was then embolized (A: caroticotympanic, B: lateral cavernous, C: hypophyseal, D: internal maxillary branch of the right external carotid).
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Subselective catheterization of an internal maxillary branch of a right external carotid artery demonstrated an irregular blushing pattern throughout the intracranial mass (Fig. 7).
Frontal angiogram digital subtraction image, post embolization, of a right external carotid artery branch.
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Embolization of this branch was performed (Fig. 8).
Hematoxylin and eosin-stained image at 100x magnification showing aggregate of variably-sized, thin-walled venous structures.
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Adjacent tissue comprised dense fibrous tissue and large nerve trunks with frequent ganglion cells, without evidence of cerebral parenchyma (Fig. 9, Fig. 10).