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Imaging of giant tumours involving the anterior skull base

¹Department of Neuroimaging, King's College Hospital, Denmark Hill, London SE5 9RS and ²Department of Radiology, City Hospital NHS Trust, Birmingham B18 7QH, UK

View larger version (80K): [in a new window]   Figure 1. Coronal (a) and sagittal (b) T1 weighted spin echo MR images post-gadolinium demonstrate a large, intermediate signal squamous cell carcinoma which is centred on the ethmoid sinus. It extends into orbits, upper nasal cavity, right maxillary antrum and into the upper clivus. There was very limited enhancement following gadolinium administration.

View larger version (90K): [in a new window]   Figure 2. (a) Post-gadolinium coronal T1 weighted spin echo MR image demonstrates a giant anterior cranial base meningioma. The non-enhancing intermediate signal in the ethmoid air cells (arrowheads) did not enhance and represented hyperostosis. (b) Hyperostosis of the anterior skull base is confirmed on the axial CT image in the same patient.

View larger version (164K): [in a new window]   Figure 3. Post-gadolinium sagittal T1 weighted spin echo MR image demonstrates giant recurrent (note craniotomy, arrowheads) anterior cranial base meningioma which extends into the ethmoid sinus and upper nasal cavity. There is intense gadolinium enhancement.

View larger version (158K): [in a new window]   Figure 4. Post-gadolinium coronal T1 weighted spin echo MR image shows a heterogeneously enhancing esthesioneuroblastoma, which is centred on the cribiform plate, and extends in to the anterior cranial fossa and to the nasal cavity.

View larger version (104K): [in a new window]   Figure 5. Coronal T1 weighted spin echo MR images (a) pre- and (b) post-gadolinium, demonstrating a bilateral mixed cystic and solid giant haemangiopericytoma extending into both frontal lobes from the ethmoid sinus. The solid portion intensely enhances. A cystic component is a recognized but atypical feature of a haemangiopericytoma.

View larger version (123K): [in a new window]   Figure 6. (a) Axial CT scan demonstrates groundglass appearance in fibrous dysplasia of the anterior skull base. Post-gadolinium T1 weighted spin echo coronal (b) and STIR sagittal (c) images demonstrate extensive frontoethmosphenoid fibrous dysplasia. The cortical bone in the anterior cranial base is elevated but intact. The high signal on STIR images represents cystic component and there is marked enhancement of the intervening septae compared with the pre-contrast image (not shown).

View larger version (117K): [in a new window]   Figure 7. (a) Coronal CT scan showing bony destruction of the floor of the anterior cranial fossa by a giant chondrosarcoma which contains clumps of calcification. (b) Contrast enhanced T1 weighted spin echo coronal MR image demonstrating peripheral inhomogeneous enhancement and areas of signal void centrally in keeping with areas of calcification.

View larger version (161K): [in a new window]   Figure 8. Post-gadolinium T1 weighed spin echo sagittal MR image shows a giant pituitary macroadenoma which extends from its suprasellar origin into the anterior fossa where it may mimic an anterior skull base lesion.