Sphenoid masses in children: radiologic differential diagnosis with pathologic correlation

Area of Science:

• Radiology
• Pediatric Oncology
• Otolaryngology

Background:

• Childhood central skull base masses are rare and present diagnostic challenges due to overlapping imaging features.
• Accurate diagnosis is crucial for appropriate management and improved patient outcomes.

Purpose of the Study:

• To provide an overview of pediatric sphenoid bone and sinus masses, focusing on imaging characteristics.
• To correlate radiologic findings with pathology and present an imaging-based algorithm for differential diagnosis.

Main Methods:

• Review of epidemiology, clinical findings, and management of pediatric sphenoid bone and sinus masses.
• Emphasis on imaging findings differentiating benign and aggressive lesions.
• Radiologic-pathologic correlation and development of an imaging-based diagnostic algorithm.

Main Results:

• Masses are categorized by their effect on bone: nonaggressive remodeling (e.g., mucocele, fibrous dysplasia) versus aggressive bone changes (e.g., chordoma, rhabdomyosarcoma).
• Specific imaging features aid in distinguishing between various pediatric skull base lesions.
• An algorithm is proposed to guide radiologists in narrowing differential diagnoses.

Conclusions:

• Imaging plays a critical role in differentiating pediatric central skull base masses.
• Understanding lesion-specific imaging patterns is essential for accurate diagnosis and management planning.
• The presented algorithm can assist radiologists in evaluating these rare pediatric tumors.