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MRI and CT Imaging of an Intrasphenoidal Encephalocele: A Case Report.

Agladioglu K, Ardic FN, Tumkaya F, Bir F - Pol J Radiol (2014)

Bottom Line: In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses.ISE is differentiated from other entities by demonstrating continuity with normal brain tissue.MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Pamukkale University, Denizli, Turkey.

ABSTRACT

Background: Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value.

Case reports: We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue.

Conclusions: MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.

No MeSH data available.


Related in: MedlinePlus

Contrast-enhanced T1W coronal (A) and axial (B) images: herniation of the temporal lobe into the sphenoid sinus is noticed (white arrows).
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f2-poljradiol-79-360: Contrast-enhanced T1W coronal (A) and axial (B) images: herniation of the temporal lobe into the sphenoid sinus is noticed (white arrows).

Mentions: Otolaryngologic examination was normal except for rhinorrhea. Hemogram was normal. In order to determine the etiology of CSF rhinorrhea, paranasal sinus CT was obtained and a bone defect in the lower part of the lateral wall of the left sphenoid sinus was determined. Moreover, polypoid mass with the same density as the brain tissue beside the defect was seen in the left sphenoid sinus (Figure 1). What is more, bilateral, apparent petrous apex pneumatization was noticed. In order to identify the structure of the polypoid mass in the left sphenoid sinus, brain magnetic resonance imaging (MRI) with contrasting agent was obtained. In brain MRI, intrasphenoidal encephalocele was seen (Figure 2). With those findings, the patient underwent transnasal endoscopic surgery. Incisional biopsy was taken from the polypoid mass in the sphenoid sinus (Figure 3). The histological examination of the specimens taken from the sphenoid sinus revealed glial tissue in fibrovascular connective tissue fragments of mucosa coated by respiratory-type epithelium (Figure 4A). Immunohistochemical stains for glial fibrillary acidic protein (GFAP) and S-100 confirmed the diagnosis (Figure 4B).


MRI and CT Imaging of an Intrasphenoidal Encephalocele: A Case Report.

Agladioglu K, Ardic FN, Tumkaya F, Bir F - Pol J Radiol (2014)

Contrast-enhanced T1W coronal (A) and axial (B) images: herniation of the temporal lobe into the sphenoid sinus is noticed (white arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4199461&req=5

f2-poljradiol-79-360: Contrast-enhanced T1W coronal (A) and axial (B) images: herniation of the temporal lobe into the sphenoid sinus is noticed (white arrows).
Mentions: Otolaryngologic examination was normal except for rhinorrhea. Hemogram was normal. In order to determine the etiology of CSF rhinorrhea, paranasal sinus CT was obtained and a bone defect in the lower part of the lateral wall of the left sphenoid sinus was determined. Moreover, polypoid mass with the same density as the brain tissue beside the defect was seen in the left sphenoid sinus (Figure 1). What is more, bilateral, apparent petrous apex pneumatization was noticed. In order to identify the structure of the polypoid mass in the left sphenoid sinus, brain magnetic resonance imaging (MRI) with contrasting agent was obtained. In brain MRI, intrasphenoidal encephalocele was seen (Figure 2). With those findings, the patient underwent transnasal endoscopic surgery. Incisional biopsy was taken from the polypoid mass in the sphenoid sinus (Figure 3). The histological examination of the specimens taken from the sphenoid sinus revealed glial tissue in fibrovascular connective tissue fragments of mucosa coated by respiratory-type epithelium (Figure 4A). Immunohistochemical stains for glial fibrillary acidic protein (GFAP) and S-100 confirmed the diagnosis (Figure 4B).

Bottom Line: In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses.ISE is differentiated from other entities by demonstrating continuity with normal brain tissue.MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Pamukkale University, Denizli, Turkey.

ABSTRACT

Background: Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value.

Case reports: We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue.

Conclusions: MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.

No MeSH data available.


Related in: MedlinePlus