A cavernous sinus mass has a wide differential, including:
- meningioma
- orbital apical inflammation with cavernous sinus involvement (Tolosa-Hunt syndrome)
- infection
-
schwannoma
- any of the cranial nerves traversing the cavernous sinus: III, IV, V (V1 and V2) and VI
- trigeminal schwannoma is the most common
- cavernous hemangioma
- lymphoma/ neurolymphomatosis
- metastatic disease (i.e. perineural spread of tumor through neural foramina)
- aneurysm
- hemangiopericytoma
- neurosarcoidosis: rarely involves the cavernous sinus
- pituitary macroadenoma
-
base of skull tumor
- chondrosarcoma
- osteosarcoma
- chordoma (usually midline)
- juvenile angiofibroma
- nasopharyngeal carcinoma with intracranial extension (especially in Southeast Asia)
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