45-year-old male with anosmia. History of stereotactic brain biopsy in frontal lobe. CT of brain with infusion:Dural based enhancing tumor is noted in bifrontal regions (right greater than left). The mass extends along the false bilaterally for approximately 24 mm from the inner table of the skull in the frontal region. Bifrontal dural based enhancing tissue extends to mid convexity of calvarium. There is also suggestion of extension of dural based mass along the floor of bilateral anterior cranial fossa which appears to extend along the greater wings of the sphenoid in bilateral middle cranial fossa. In comparison with the prior MRI examination of brain with infusion no definitive evidence of interval change can be appreciated. There is evidence of subtle mass effect on the brain parenchyma however no vasogenic edema is detected. The density of brain parenchyma, vertical sulci and ventricular system remains within normal. No definite osseous abnormality is noted. The immediate prior CT examination of the brain was performed without the infusion and cannot be compared with the current study. Comparison with any CT of brain dated 9 -- 20 -- 2008 demonstrate significant interval reduction in the size of dural based mass and also resolution of previously noted edema brain parenchyma.CT of paranasal sinuses with infusion:The paranasal sinuses are well pneumatized and with no evidence of acute or chronic sinus disease. The ostiomeatal units of maxillary sinuses are patent bilaterally. No evidence of any osseous abnormality is detected. Images at the level of the skull base including palnum sphenoidale, cribriform plate and fovea ethmoidalis demonstrate no abnormality. 80 cc of Omnipaque 350 was utilized for the above study.
1.Bilateral frontal dural based enhancing lesion likely represents patient's known sarcoidosis. In comparison with prior MRI from 6 -- 30 -- 2009 no definitive interval change is noted however in comparison with prior CT examination from 9 -- 3 -- 2008 there is significant reduction in size as described.2.Subtle mass effect on bifrontal lobes with no evidence of edema or enhancement of brain parenchymal or pia matter.3.Well pneumatized paranasal sinuses and with patent bilateral ostiomeatal units.