What is the main abnormality?
A large sellar and suprasellar mass is identified with invasion of the right cavernous sinus, the sphenoid body and sinuses.
What is the differential?
Pituitary macroadenoma, meningioma, metastasis, lymphoma, and possibly a sphenoid sinus mucosal tumour (e.g. SCC) should be considered.
How would you describe the bony changes?
Many areas appear destroyed with irregular bony margins. Some areas appear remodelled.
What bony feature is often seen in meningiomas, which is not present in this case?
Hyperostosis is a frequent finding in invasive meningioma, although it can also be seen merely as a reaction to adjacent meningiomatous tissue.
A large sellar and suprasellar mass is identified with invasion of the right cavernous sinus, the sphenoid body and sinuses, in particular the right. Lysis of the right petrous apex, suggestive of invasion. Posterior and anteromedial dehiscence of the right carotid canal is noted.The ventricular size is within normal limits.