Giant cell tumor of the greater wing of the sphenoid: an unusual presentation

Possible cerebrospinal fluid pathways in the middle fossa floor and pterional diploe: a magnetic resonance imaging study

PURPOSE

There has not been a study documenting the distribution of cerebrospinal fluid (CSF) pathways in the anterolateral base of the middle fossa (ALB) and diploe of the pterional region (Pt). The present study aimed to delineate these pathways using magnetic resonance imaging.

METHODS

Thin-sliced, axial, and coronal T2-weighted sequences were performed for a total of 358 outpatients, including 20 pediatric patients.

RESULTS

Adult population: CSF-filled channels were identified on axial images in the ALB in 57% and in the diploe of the Pt in 65% of 338 patients. These pathways showed variable morphology and number bilaterally. CSF-filled channels were identified on coronal images in the ALB in 14% and in the diploe of the Pt in 100% of 59 patients. These were delineated as linear structures of variable number and thickness. Eleven percent of the pathways identified in the ALB was connected with extracranial channels. Pediatric population: CSF-filled channels were identified on axial images in the ALB in 75% and in the diploe of the Pt in 80% of 20 patients.

CONCLUSIONS

The ALB and diploe of the Pt may function as CSF pathways in children and adults. The pathways in the ALB can be a CSF-drainage route connecting to the extracranial sites.

Recurrent Giant Cell Tumor of Skull Combined with Multiple Aneurysms

Giant cell tumors are benign but locally invasive and frequently recur. Giant cell tumors of the skull are extremely rare. A patient underwent a surgery to remove a tumor, but the tumor recurred. Additionally, the patient developed multiple aneurysms. The patient underwent total tumor resection and trapping for the aneurysms, followed by radiotherapy. We report this rare case and suggest some possibilities for treating tumor growth combined with aneurysm development.

[A rare tumor of the infratemporal fossa]

INTRODUCTION

Giant cell tumors of bone (GCT) are usually benign and relatively rare. They have an aggressive behavior and an unpredictable prognosis. They occur mainly in the young adult, with a preferential localization in long bones. We report a giant cell infratemporal fossa tumor.

OBSERVATION

A 55-year-old female patient consulted for swelling in the right cheek. Surgical excision was incomplete because of the subtemporal tumor localization. Histological assessment proved a GCT. Forty-five grays postoperative external radiotherapy was applied to the surgical site. The patient had local control at the 12-month follow-up.

DISCUSSION

GCTs are seldom observed in the facial skeleton (2%). The recommended treatment is surgery. Radiotherapy can be indicated in case of incomplete or impossible surgical excision, or when surgery would be responsible for a major functional deficit.