Fat deposition in the cavernous sinus in Cushing disease

Area of Science:

• Radiology
• Endocrinology
• Neurosurgery

Background:

• Cushing disease diagnosis can be challenging, often requiring identification of pituitary masses.
• Computed tomography (CT) is a common imaging modality for evaluating sellar and parasellar regions.

Purpose of the Study:

• To investigate the prevalence of fat density within the cavernous sinus on CT scans of patients with Cushing disease.
• To assess the potential diagnostic utility of this finding for pituitary masses.

Main Methods:

• Retrospective review of CT scans from 16 patients diagnosed with Cushing disease.
• Comparison with CT studies from 30 control subjects and one patient with acromegaly.

Main Results:

• Fat density in the cavernous sinus was identified in 6 out of 16 (37.5%) patients with Cushing disease.
• This specific finding was absent in control CT studies of the sella.
• Incidental parasellar fat was noted in one patient with acromegaly.

Conclusions:

• Cavernous sinus fat density on CT may serve as a specific imaging biomarker for Cushing disease.
• This radiological sign could assist in the diagnosis of pituitary masses, particularly in Cushing disease.