Presentation
Headaches with visual disturbances.
Patient Data
Right parasellar mass centered on the cavernous sinus encasing completely the internal carotid artery. It displays an isosignal to the cortical grey matter on T1, T2 and FLAIR with a vivid homogeneous enhancement on postcontrast sequences. No calcification or hemorrhagic component is seen on the GE sequence.
There is a medial extension to the sellar region compressing the pituitary gland as well as to the sphenoid sinus and suprasellar cistern compressing the optic chiasma.
Posteriorly, there is extension to the retroclival prepontine space compressing the right aspect of the pons with dural thickening and enhancement.
Anteriorly, there is an extension to the inferior orbital fissure and intraconal space.
Complete obliteration of the ipsilateral internal carotid artery on the MRA.
Another small enhancing extra-axial lesion is noted in the right frontal region (small meningioma).
Case Discussion
The MRI features are most consistent with meningioma of the cavernous sinus with multidirectional extension, encasing the ipsilateral internal carotid artery.
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