[Trans-sphenoidal spread of rhinopharyngeal neoplasms. Correlations between computerized tomography and magnetic...

In 1957 Teoh observed, in an autopsic series of 31 patients with nasopharyngeal carcinoma, 3 cases of neoplastic spread through the marrow spaces of the base of the skull, without macroscopic bone alterations. In order to demonstrate in vivo this kind of neoplastic spread, CT and MR examinations of 35 patients with nasopharyngeal carcinoma were reviewed. In 3/26 cases the invasion of the marrow spaces of the clivus was demonstrated. In these cases CT showed only minimal alterations in spongiosa and cortices of the clivus, associated with intracranial soft-tissue tumoral components. MR imaging demonstrated, with great accuracy, the replacement of bone marrow in the clivus by neoplastic tissue of intermediate signal intensity on T1-weighted images. Tumor tissue was characterized by high signal intensity on T2-weighted images. The authors stress the greater utility of MR imaging in evaluating the permeative involvement of the base of the skull.