Radiologic findings, histology, and follow-up in 6 patients with a nonmalignant mass in the sphenoid sinus
| Case | Radiologic Features | Histology | Follow-Up | ||
|---|---|---|---|---|---|
| Size, cm | % Granulation Tissue:Fibrin | Cells (0–3) MC, IC, and EC | |||
| 6 | Mucosal thickening and enhancement along the walls of the sphenoid sinus and a large bony defect in the floor forming a direct communication with the nasopharynx; mass inside the sinus cavity/nasopharyngeal roof of low nonenhancing signal intensity on T1 weighted images and heterogeneous, mainly intermediate, signal intensity on T2 weighted images “rhinolith” at surgery (Fig 5) | 2.0 | 50:50 | MC (0) IC (1) EC (2) | No local tumor recurrence on endoscopy or MR imaging at 10 mo |
| 7 | See radiologic features in 6 above | 0.5 | 80:20 | MC (0) IC (3) EC (2) | Multiple biopsies over the next 24 mo showed no local tumor recurrence, re-epithelialization of the nasopharyngeal roof with no tumor recurrence after 104 mo |
| 8 | See radiologic features in 6 above | 1.2 | 30:70 | MC (0) IC (3) EC (3) | No local tumor recurrence on endoscopy; died from meningitis 3 y later |
| 9 | See radiologic features in 6 above plus polypoidal enhancing mucosal thickening in the wall of the sphenoid sinus extending into the nasopharynx | 2.0 | 40:60 | MC (0) IC (3) EC (1) | No local tumor recurrence on endoscopy at 27 mo |
| 10 | Sphenoid sinus is expanded and filled by a heterogeneous mass that on T2 is of mixed signal intensity (high, intermediate, and low) on T1 is mainly of homogeneous intermediate signal intensity (with a few small areas of high T1 retained secretions) and mixed contrast enhancement ranging from marked enhancement to no enhancement (Fig 6) | 2.0 | 90:10 | MC (0) IC (2) EC (2) | No local tumor recurrence on endoscopy but developed blindness and died 48 mo later after repeated CSF leaks and intracranial infections |
| 11 | Mass in the sphenoid sinus progressively increasing in size to 5 cm over 3 years; signal intensity of the mass is heterogeneous with mixed signal intensity on T2 (very low signal areas, especially centrally, and very high signal areas, especially peripherally), mainly homogeneous intermediate signal intensity on T1 (with a few small areas of high T1 retained secretions), and mixed contrast enhancement ranging from marked enhancement to no enhancement | 3.0 | 10:90 | MC (0) IC (1) EC (1) Organized hematoma | Static appearances on MR imaging at 39 months and no local tumor recurrence on endoscopy at 44 mo |
Note:—No cells (0), some cells (1), many cells (2), abundant cells (3). MC indicates malignant cells; IC, inflammatory cells; EC, epithelial cells.