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There is a large extra-axial mass with mass effect on the temporal lobe and brainstem. It appears to be arising from the either the posterior aspect of the right cavernous sinus or the right posterior clinoid process and clivus. On the sagittal sequences it has a broad dural attachment and protrudes superiorly and posteriorly. The lesion demonstrates variable signal intensity on T1 and T2 imaging and variable contrast enhancement. Extensive punctate loss of signal on T2 and extensive susceptibility on gradient echo imaging suggests blood products and/or calcium, with the former favoured due to high signal on phase imaging. There is no restricted diffusion. The mass appears separate from the internal carotid artery and the sella. On image 8 of the axial T2 sequence, the mass appears separate from Meckel's cave which is displaced laterally and the lower margin of the cisternal trigeminal nerve. The lateral margin of the lesion effaces the right medial temporal lobe. The posterior margin displaces the upper pons, midbrain and cerebral peduncle posteriorly and medially. There is however no temporal lobe or brainstem oedema. No other mass lesion. The remainder of the brain is normal. No evidence of demyelination.
The differential for this mass is relatively broad, including chondrosarcoma, chordoma or dural masses (less likely). Further assessment with CT is recommended.