Presentation
Headache and visual disturbances.
Patient Data
Right parasellar mass centered on the cavernous sinus encasing the internal carotid artery. It appears isointense to the cortical grey matter on both T1 and T2, hyperintense on FLAIR with no calcification or hemorrhagic component seen on GE sequence. The postcontrast sequences show a vivid homogeneous enhancement with associated hyperostosis of the adjacent anterior clinoid process.
There is medial extension to the right aspect of the sellar region with a mass effect on the pituitary stalk, pituitary gland and optic chiasma. Posterior extension is also noted filling the retroclival prepontine space with dural thickening and enhancement extending to the ipsilateral jugular foramen.
Severe narrowing of the ipsilateral internal carotid artery on the MRA.
Case Discussion
MRI features are most consistent with meningioma of the cavernous sinus, encasing the ipsilateral internal carotid artery.
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