Presentation
Elderly male with long standing headaches and visual disturbance.
Patient Data
MRI shows at the level of the skull base sphenoid sinus filled and expanded with T1 and T2 heterogeneous lesion. No cavernous sinus invasion and intracranial extension.
This MR appearance of the lesion is likely attributable to the fibro-osseous stroma.
CT demonstrates classic ground-glass attenuation in the sphenoid sinus with a sclerotic rim. No bone destruction was noted.
Findings suggestive with isolated sphenoid sinus fibrous dysplasia.
Case Discussion
Fibrous dysplasia is an idiopathic skeletal developmental anomaly, which can affect one or multiple bones.
Isolated sphenoid sinus fibrous dysplasia is a relatively uncommon entity.
Fibrous dysplasia can have extreme heterogenicity on MR imaging and can be indistinguishable from malignant lesions. Correlation with CT should always be done to make the appropriate diagnosis.
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