Amyloidoma of the Skull Base
William A. Simoens
,a,
Luc van den Hauwea,
Eddy Van Hedenta,
Fabienne Warsona,
Roland Demaeseneera,
David Williamsa and
Arthur M.A. De Scheppera
a From the Departments of Radiology (W.A.S., E.V.H.), Pathology (F.W.), Internal Medicine (R.D.), and ENT (D.W.), Algemeen Stedelijk Ziekenhuis Campus Aalst, Aalst, and the Department of Radiology (W.A.S., L.v.d.H., A.M.A.D.S.), Universitair Ziekenhuis Antwerpen, University of Antwerp, Antwerp, Belgium.
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FIG 1. Images from the case of a 54-year-old man with primary skull base amyloidoma.
A, High-resolution coronal temporal bone CT scan shows a permeated aspect of the normal bone of the basiocciput, with scattered foci of calcifications or remnants of destructed bone within. The lesion (asterisk) is centered on the right petro-occipital fissure (curved black arrow) and crosses the midline. The petro-occipital fissure on the opposite side (straight black arrow) is intact.
B, High-resolution axial temporal bone CT scan. A soft-tissue component (white arrows) extends through the posterior wall of the sphenoid sinus.
C, Sagittal spin-echo T1-weighted (840/12/3 [TR/TE/excitations]) MR image displays the lesion (arrows) as iso- to hypointense to muscle.
D, Coronal spin-echo T1-weighted (840/12/3) MR image.
E, Sagittal turbo spin-echo T2-weighted (4416/128/1) MR image shows the lesion affecting the clivus (arrows) with very low signal intensity, similar to that of the air in the sphenoid sinus (S).
F, Coronal contrast-enhanced spin-echo T1-weighted (840/12/3) MR image shows poor localized contrast enhancement (arrows).
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FIG 2. Microscopic image. Congo red staining of the mass found in the sphenoidal sinus shows a marked thickening of the mucosa due to deposits of amyloid presenting as dark amorphous structures (arrows). The ciliary epithelium is well shown (curved arrows)
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