Presentation
Chronic headache.
Patient Data
The sagittal T2-weighted images of the brain show a large, cauliflower-like intracranial mass in the left middle cranial fossa. The mass has a short stem connecting it to the left mastoid bone. It appears dark on T2-weighted images and FLAIR with focal hyperintense parts and minimal surrounding oedema. On T1-weighted images, the mass is moderately hypointense with focal hyperintense parts. Heterogeneous enhancement is seen after contrast injection. The mass causes a compressive effect on the left temporal lobe and left lateral ventricle with midline shift to the right side. Mucosal thickening in the paranasal sinuses is seen as well.
Case Discussion
Intracranial osteochondromas are very rare, representing only 0.1-0.2% of all intracranial tumours. Their occurrence can be seen at any age, with the peak incidence in the third decade.
The symptoms of the disease are usually due to tumour mass and location. Intracranial osteochondromas typically present with chronic headaches, seizures, and cranial nerve palsies. This patient only reports chronic headaches.
The tumour in this case shows the typical appearance of osteochondroma in general, with a stem and a cauliflower part.
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