The petrous apex may be affected by a range of lesions, commonly encountered as incidental and asymptomatic findings on imaging performed for other clinical reasons. Symptoms associated with petrous apex lesions commonly relate to mass effect and/or direct involvement of closely adjacent structures. Petrous apex lesions are optimally assessed using a combination of high-resolution CT and MRI of the skull base. Management of petrous apex lesions varies widely, reflecting the range of possible pathologies, with imaging playing a key role, including lesion characterization, surveillance, surgical planning, and oncological contouring.
Chondromyxoid fibroma (CMF) is the least commonly occurring bone tumor of cartilaginous origin. It is usually situated in the metaphysis of long bones of the lower limbs. Localization of the tumor in the skull is extremely rare. The definitive diagnosis is challenging and depends on radiological and histological examinations. To the best of our knowledge, only 14 cases of CMF involving the temporal bone have been reported to date, 7 of which were within the mastoid. The most common clinical symptom is headache; however, these symptoms vary greatly according to site, size, and extension of the lesion. Surgical removal is the treatment of choice. A literature review of the diagnostic challenges, histological difficulties in differential diagnosis, imaging, clinical features, and recommended modalities of treatment have been discussed in the present case.
This report describes a congenital case of chondromyxoid fibroma (CMF) arising from the ethmoid bone. We believe it to be the second case of congenital CMF that has been documented, and the third case of CMF arising in the ethmoid. We describe the radiographic features of this rare entity and indicate the necessity for careful correlation between radiographic and histological findings to distinguish CMF from chondrosarcoma.
We present the case of a 44-year-old woman with chondromyxoid fibroma of temporal bone origin. Since this is the least common bone tumor of cartilaginous origin, it is highly unusual to find this tumor in the skull. In fact, the literature describes 18 cases of this form of neoplasia arising in the skull, only 4 of these having originated in the temporal bone. To date, the radiological features of these tumors, and especially features detected using the latest imaging modalities, have not been described in detail. This report is unique in that it is the first to present a case of chondromyxoid fibroma of the temporal bone accompanied by detailed CT and MRI findings.
Intracranial chordoma is a locally aggressive and relatively rare tumor of the skull base that is thought to originate from embryonic remnants of the primitive notochord. Both computed tomography (CT) and magnetic resonance (MR) imaging are usually required for evaluation of intracranial chordomas due to bone involvement and the proximity of these tumors to many critical soft-tissue structures. At CT, intracranial chordoma typically appears as a centrally located, well-circumscribed, expansile soft-tissue mass that arises from the clivus with associated extensive lytic bone destruction. However, MR imaging is the single best imaging modality for both pre- and posttreatment evaluation of intracranial chordoma. On T1-weighted MR images, intracranial chordomas demonstrate intermediate to low signal intensity and are easily recognized within the high-signal-intensity fat of the clivus. On T2-weighted MR images, they characteristically demonstrate very high signal intensity, a finding that likely reflects the high fluid content of vacuolated cellular components. Moderate to marked enhancement is common and often heterogeneous on contrast material-enhanced images. Combination treatment with radical surgical resection and proton beam radiation therapy achieves the best results.