Clinical question: Rule out bleed. Signs and symptoms: History of mass. Non-enhanced CT of brain:Examination demonstrates a high density extra axial mass along the clivus and dorsum sella. This mass abuts the clivus however no definitive bony changes of the clivus. The mass is well-demarcated and measures 26-mm in cranial cephalad axis and 12.4-mm in AP axis on sagittal reformatted image 26. On axial image 9 the largest transaxial dimension of this tumor are 16.8 x 19.2-mm.superior A. the mass projects into the basal cistern and inferiorly in mid section of clivus. There is no evidence of any edema of brain parenchyma associated with this mass. Subtle mass effect on the pons and posterior displacement is noted. The exact etiology of this finding is not clear. The mass is not correctly state of any particular tumor. Differentials could include a hamartoma, mesenchymal type tumor, neuroepithelial cysts, aneurysm as well as less likely possibility of a meningioma. Follow-up with an enhanced MRI examination is recommended. There is normal density and morphology of brain parenchyma and no evidence of hemorrhage, edema, midline shift or hydrocephalus. The gray -- white matter differentiation is well preserved.
1.Nonspecific extra axial mass in the prepontine cistern extending along the clivus and superiorly terminates and is inseparable from the floor of the third ventricle. Follow-up with an MRI exam is recommended. There is no associated parenchymal edema.2.Unremarkable CT examination of brain otherwise.