Article Figures & Data
Figures
- FIG 1.
Initial MR imaging of the lesion demonstrates a well-circumscribed mass (straight arrows) in the left cavernous sinus with hyperintense signal on FLAIR (A). The left ICA is medialized and encased by the mass (curved arrows). Intralesional signal is notably heterogeneous and coarsened on T2 SPACE (B); enhancement is also heterogeneous (C–E). Coronal postcontrast images delineate encroachment of the mass into the sella, with mild mass effect on the pituitary (asterisks); the infundibulum (dashed arrow) has slightly deviated to the right.
- FIG 2.
Preoperative CTA (A and B) demonstrates prominent bony remodeling about the margins of the mass (curved arrows). The mass itself is essentially isodense to the parenchyma (between the short straight arrows). Its inferior border is close to but does not appear to originate from the petroclival fissure (not shown). Small enhancing intralesional vessels are appreciated (dashed arrow). A subsequent technetium Tc-99m-tagged RBC SPECT scan (C) shows intense radiotracer accumulation within the mass on delayed images.
- FIG 3.
Dynamic contrast imaging. On precontrast (A) image, the mass is slightly isointense to nearby gray matter. Sequential postcontrast images (B–D) show progressive filling-in with contrast preferentially going to the periphery of the mass.
- FIG 4.
Histopathologic examination reveals that the mass is composed of numerous, predominantly thin-walled, anastomosing vascular channels (asterisk) embedded within delicate collagenous stroma. The vessels are predominantly thin-walled, with few vessels showing thickened muscular walls (arrowhead) (A, original magnification, ×40). Higher-power magnification shows that these abnormal vascular channels are lined with cytologically bland endothelial cells (arrow) and lack internal elastic laminae (B, original magnification, ×100). The specimen is stained with H&E.
- FIG 5.
Illustration of a cavernous sinus vascular venous malformation with typical lesion characteristics. The mass has multiple benign characteristics, including remodeling of the adjacent bone and displacement—or encasement—of the ICA without high-grade luminal narrowing. Reproduced with permission from the Mayo Foundation for Medical Education and Research, all rights reserved.
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