Male, 48 years old, with headaches, history of meningioma the right cavernous sinus. Evaluate for changes. A smoothly marginated, very T2 hyperintense homogeneously enhancing lesion is present within the right cavernous sinus. The lesion causes bowing of the lateral cavernous sinus wall as well as anterior displacement of the ICA, but no ICA narrowing is observed. Minimal if any interval growth is seen of the lesion which measures 16 x 14 mm in the coronal plane (image 21 series 901), previously 16 x 12 mm when measured similarly.Two or three scattered punctate foci of white matter T2 hyperintensity are seen in the cerebral hemispheres, unchanged and nonspecific. No evidence of parenchymal edema or mass effect is seen. No pathologic parenchymal enhancement is observed. The ventricles are normal in size and morphology. No abnormal intracranial fluid collections are detected. Maxillary sinus mucosal thickening and a fluid level on the right are noted.
No definite interval change in the size or morphology of a right cavernous sinus lesion. The slight interval change in measurements could represent differences in technique. This lesion could represent a meningioma, though a hemangioma would also be in the differential diagnosis.