Question 2398
{"accessible":false,"alternatives":[{"id":11811,"text":"chordoma"},{"id":11812,"text":"lymphoma"},{"id":11813,"text":"meningioma"},{"id":11814,"text":"trigeminal schwannoma"}],"archived":false,"correctAlternativeId":11813,"explanation":"\u003cp\u003eMeningiomas are the most common tumor to involve the cavernous sinus. The presence of hyperostosis of adjacent bone and narrowing of the internal carotid artery flow void by the surrounding tumor can be helpful clues to the diagnosis when present.\u003c/p\u003e\u003cp\u003e\u003ca href=\"/articles/chordoma\"\u003eChordomas\u003c/a\u003e are usually T2 hyperintense rather than intermediate signal, tend to show more heterogeneous enhancement and cause bone destruction rather than hyperostosis.\u003c/p\u003e\u003cp\u003eAlthough \u003ca href=\"/articles/lymphoma\"\u003elymphoma\u003c/a\u003e is often T2 intermediate or low signal intensity and shows homogeneous enhancement, the bone change and ICA narrowing are not typical and lymphoma in the cavernous sinus is also much less common than meningioma.\u003c/p\u003e\u003cp\u003eWhilst they may extend into or from Meckel’s cave, \u003ca href=\"/articles/schwannoma\"\u003etrigeminal schwannomas\u003c/a\u003e of the cavernous sinus also do not often cause ICA narrowing or hyperostosis.\u003c/p\u003e","id":2398,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2398","nextQuestionPath":"/articles/cavernous-sinus-mass/questions/2397","relatedArticles":[{"id":5258,"title":"Cavernous sinus","link":"/articles/cavernous-sinus?lang=us"},{"id":67259,"title":"Cavernous sinus syndrome","link":"/articles/cavernous-sinus-syndrome?lang=us"},{"id":1065,"title":"Cavernous sinus thrombosis","link":"/articles/cavernous-sinus-thrombosis?lang=us"},{"id":9206,"title":"Tolosa-Hunt syndrome","link":"/articles/tolosa-hunt-syndrome-3?lang=us"},{"id":71525,"title":"Knosp classification of cavernous sinus invasion by pituitary macroadenomas","link":"/articles/knosp-classification-of-cavernous-sinus-invasion-by-pituitary-macroadenomas?lang=us"}],"alsoUsedIn":[{"id":1343,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1343","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1343"},{"id":1200,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1200","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1200"},{"id":248,"kind":"LiveSchedule","title":"248","link":"https://radiopaedia.org/admin/live_schedules/248"},{"id":153,"kind":"LiveSchedule","title":"153","link":"https://radiopaedia.org/admin/live_schedules/153"},{"id":1261,"kind":"Course","title":"Neuroradiology Lectures - page 1261","link":"https://radiopaedia.org/courses/neuroradiology-lectures/pages/1261"},{"id":1261,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1261","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1261"},{"id":1261,"kind":"Course","title":"New test course - page 1261","link":"https://radiopaedia.org/courses/new-test-course/pages/1261"},{"id":1449,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1449","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1449"}],"stem":"\u003cp\u003eAn MRI of a patient with left facial numbness and ophthalmoplegia shows a T2 intermediate signal intensity mass in the left cavernous sinus which exhibits homogeneous enhancement and extends into Meckel’s cave and the orbital apex. The flow void of the left internal carotid artery is mildly narrowed. CT shows mild thickening and sclerosis of the lateral wall of the left sphenoid sinus.\u003cbr\u003eWhat is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2398"}],"attemptsPercentages":[{"alternativeId":"11814","percentage":21},{"alternativeId":"11811","percentage":5},{"alternativeId":"11813","percentage":72},{"alternativeId":"11812","percentage":2}],"promptToLogin":false,"questionManager":false,"articleId":"cavernous-sinus-mass"}