Wegener Granulomatosis Involving the Pterygopalatine Fossa: An Unusual Case of Trigeminal Neuropathy
Kathlyn Marsot-Dupucha,
Sebastien Clement De Givryb and
Michel Ouayounc
a Department of Radiology, Hopital Bicêtre 78, Le Kremlin-Bicêtre, France
b Department of Radiology, Hopital Tenon, Paris, France
c Department of Otorhinolaryngology, Hopital Avicenne, Bobigny, France
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FIG 1. CT and MR imaging at presentation
A, Axial nonenhanced CT scan shows subtle bony lysis of the posterior wall of the left maxillary sinus (arrowhead). Note mucosal thickening of the left maxillary sinus.
B, Axial contrast-enhanced T1-weighted (550/15/3) MR image of the infratemporal fossa shows a poorly defined enhancing mass within the left PPF (arrow).
C, Coronal contrast-enhanced T1-weighted (550/15/3) MR image of the infratemporal fossa shows a soft-tissue mass of intermediate signal intensity (arrow), encasing the maxillary artery (arrowhead) and extending into the inferior orbital fissure.
D, Coronal contrast-enhanced T1-weighted (550/15/3) MR image, 8 mm posterior to C, shows enhancement of the left foramen rotundum (arrow).
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FIG 2. CT and MR images obtained 2 years after presentation.
A, Sagittal reconstructed high-resolution CT section. Note persistence of the mucosal thickening of the left maxillary sinus with regression of the palatine bony lysis (arrow).
B, Postcontrast T1-weighted image with fat saturation, coronal section. There is no enhancing soft-tissue mass involving the PPF or the inferior orbital fissure. Reduced signal intensity surrounds the pterygoid canal and the foramen rotundum (arrow).
C, Delayed (obtained 1 hour later) postcontrast T1-weighted image with fat saturation, axial section. Subtle enhancement of the PPF and foramen rotundum (arrow) exists compared with that of the normal contralateral side.
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