28 year-old female with symptoms of chronic rhinosinusitis. Medtronic nonenhanced CT of sinuses:Frontal sinuses.No evidence of disease.Ethmoid sinuses.Very minimal mucosal thickening in bilateral anterior ethmoid air cells.Sphenoid sinus.Mucosal thickening in the dependent portion of the left chamber sphenoid sinus. Patent ostia of sphenoid sinuses.Maxillary sinuses. Mild mucosal thickening and retention cysts in the dependent portion of bilateral maxillary sinuses. Mucosal thickening at the level of bilateral ostiomeatal units with resultant occlusion of bilateral ostiomeatal units.Nasal cavity.Unremarkable.There is a primarily fatty density tissue posterior to the left pterygoid bone in the infratemporal fossa. There is suggestion of remodeling of the left pterygoid bone likely result of chronic long-standing mass effect. This fatty density measures approximately 17.6 X 22.6-mm in transaxial dimensions measured on axial image 11 of series 4. The finding is believed to represent a lipoma. This mass also causes some thinning of the floor of the left middle cranial fossa at the level of foramina ovale. There is no involvement of the left carotid canal. The musculature immediately adjacent to this fatty tissue demonstrate no abnormality. The fascial planes are well preserved and unremarkable. Recommend follow-up with an enhanced MRI of brain and skull base to entirely exclude the possibility of a mass other than simple lipoma.
1.Chronic bilateral maxillary sinus disease with occluded bilateral ostiomeatal units. Minimal sinus disease in bilateral ethmoids and left chamber of sphenoid sinus.2.There is a primarily fatty density mass in the left infratemporal fossa immediately posterior to the left pterygoid bone with resultant bony remodeling however with no destruction of bony changes. This is believed to represent a lipoma however to entirely exclude other possibilities recommend follow-up with a pre-and post enhanced MRI of brain and skull base.