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Mucocele involving the anterior clinoid process: MR and CT findings
C C Lim1, W P Dillon, M W McDermott
1Department of Diagnostic Imaging, Tan Tock Seng Hospital, Singapore.
Abstract:
We report two patients with surgically proved mucoceles involving the anterior clinoid process. One patient had a mucocele of an Onodi cell and the other had a mucocele isolated to the anterior clinoid process. The MR signal was increased on both T1- and T2-weighted images in the first patient but was isointense on both sequences in the second patient, a finding that resulted in misdiagnosis. The developmental and anatomic features, as well as the diagnostic pitfalls, are discussed.
Insights
Two patients with anterior clinoid process mucoceles, including an Onodi cell mucocele, highlight diagnostic challenges. Varying MR signal intensities can lead to misdiagnosis, emphasizing the need for careful evaluation of these rare lesions.
Area of Science:
- Neurosurgery
- Radiology
- Otolaryngology
Background:
- Mucoceles are rare, benign lesions that can occur in the paranasal sinuses and skull base.
- Anterior clinoid process mucoceles are particularly uncommon and can present diagnostic difficulties.
Observation:
- This report details two surgically confirmed cases of mucoceles involving the anterior clinoid process.
- Case 1: Mucocele of an Onodi cell with increased T1 and T2 MR signal.
- Case 2: Mucocele isolated to the anterior clinoid process with isointense T1 and T2 MR signal.
Findings:
- Magnetic Resonance (MR) imaging findings can be variable, with increased signal intensity on T1- and T2-weighted images in one case and isointensity in another.
- The isointense signal in the second case led to a misdiagnosis, underscoring imaging interpretation challenges.
Implications:
- Understanding the diverse MR signal characteristics of anterior clinoid process mucoceles is crucial for accurate diagnosis.
- Awareness of these developmental and anatomical variations can help avoid diagnostic pitfalls in skull base pathology.
- Surgical confirmation remains essential for definitive diagnosis and management of these rare lesions.