An osteolytic solid, high T2 signal intensity, mildly heterogeneous, enhancing mass lesion is present involving the clivus as described on the recent CT. The lesion is adjacent to the medial and posterior aspects of right internal carotid artery in the posterior cavernous sinus region, extends into the posterior aspect of the right sphenoid sinus and protrudes slightly posteriorly into the pre-pontine cistern adjacent to the anterior aspect of basilar artery. The lesion involves the posterior wall of sella but it does not involve the pituitary.
IMPRESSION: An osteolytic lesion involving the clivus is present with differential diagnosis including chordoma, chondrosarcoma or metastasis. A lymphoma or plasmacytoma could also have this appearance in the appropriate clinical setting.