37-year-old female with nasal congestion and discharge. Recurrent sinusitis. Extensive postsurgical findings of a large bifrontal craniotomy with underlying encephalomalacia and gliosis of the anterior frontal lobes presumably postprocedural in etiology. Abnormal bone mineralization involving the anterior cranial fossa, cribriform plate, and extending into the sinus septae. Within the bilateral ethmoids and abutting the aforementioned abnormal bone, there is an extensive irregular enhancing soft tissue mass which measures approximately 58 x 40 mm (AP x TR, series 501 image 40) with the osseous abnormality measuring approximately 32 x 34 x 27 (AP x TR x CC, series 6 image 20, series 80434 image 28). This mass extends inferior into the nasal vault and appears contiguous with dural thickening along the left rectus gyri. Deformity and mass effect on the left medial orbital wall with lateral displacement of the left medial rectus, which abuts the left optic nerve, although the thinned medial orbital wall appears intact. These findings are suggestive of an ethesioneuroblastoma.There is complete opacification of the sphenoid sinuses likely due to obstruction from the mass. There is right maxillary sinus mucosal thickening and frothy debris compatible with acute sinusitis. No intracranial hemorrhage.Slight ex vacuo dilatation of the frontal horn of the left lateral ventricle. Otherwise, the CSF spaces are appropriate for the patient's stated age with no midline shift. Normal 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 mastoid air cells are clear.
1.CT and MRI demonstrate extensive bifrontal postsurgical findings with extensive destructive soft tissue mass centered just below the region of the cribriform plate and ethmoids suggestive of residual esthesioneuroblastoma. Correlate with clinical history, imaging, and pathology from outside institutions. 2.Postobstructive sphenoid sinusitis. Acute right maxillary sinusitis.