Presentation
Headaches.
Patient Data
A vividly-enhancing mildly heterogenous (predominantly T1 hypointense / mildly T2 hyperintense) ovoid mass is centred within the left Meckle's cave, indenting the left cavernous sinus, sella and petrous apex.It is uncertain whether this represents a trigeminal Schwannoma or meningioma, with the former slightly favoured.
The left cavernous ICA is mildly effaced/displaced, with no overt compression.
Note is made of a mildly expanded "empty sella".
The left MCA bifurcation appears mildly dilated and follow-up MRA could be used to exclude the presence of an aneurysm in this location.
The remainder of the study is unremarkable.
Case Discussion
The Imaging findings are those of a trigeminal schwannoma.
Possible Meckel's cave tumours include:
- trigeminal schwannoma: most common, ~33% of cases
- meningioma
- pituitary macroadenoma
- metastases
- epidermoid cyst
- lipoma
- base of skull tumours