Amyloidoma of the Skull Base

William A. Simoens; Luc van den Hauwe; Eddy Van Hedent; Fabienne Warson; Roland Demaeseneer; David Williams; Arthur M.A. De Schepper

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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)