Diagnosis: Other disorders of orbitClinical question: New headaches and outside CT scan suggests mass at right posterior orbit and other calcified dural lesionsSigns and Symptoms: headache MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated within the brain parenchyma. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is redemonstration of a 3 mm extra-axial lesion at the right tentorial leaf which is bright on T1 and suppresses on the fat suppressed imaging. It is stable compared to the prior examNormal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate small mucous retention cysts. The visualized portions of the mastoid air cells are clear. MRI orbits:There is an 18 x 14 mm axial dimension right intraconal space mass present which previously measured similar dimensions. It is located between the right lateral rectus muscle and the optic nerve and splays the 2 apart. It enhances homogeneously. It has similar signal characteristics to the extraocular muscles on T1. On the prior exam it had a fluid fluid level in it. This is also present on the prior exam and is more subtle.The eyeballs are intact. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .
1.There is redemonstration of an intraconal space mass on the right side which displaces adjacent structures (right optic nerve and right lateral rectus muscle). Its signal characteristics suggest that this may represent a venolymphatic lesion. It is stable when compared to the prior exam2.A tiny lesion along the right tentorial leaf is present which could represent a lipoma, a lipomatous meningioma or a dermoid. It is also stable compared to the previous exam.