Imaging Sci Dent.  2015 Mar;45(1):67-72. 10.5624/isd.2015.45.1.67.

Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

• Jalali E
• Tadinada A

• KMID: 2116794
• DOI: http://doi.org/10.5624/isd.2015.45.1.67

Abstract

Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

Keyword

Pneumatization; Sphenoid Sinus; Cone-Beam Computed Tomography; Skull Base

MeSH Terms

Adipose Tissue
Chondrosarcoma
Chordoma
Cone-Beam Computed Tomography
Dental Implants
Diagnosis
Diagnosis, Differential
Fibroma, Ossifying
Humans
Lipoma
Pathology
Skull Base*
Sphenoid Sinus*
Dental Implants

Figure

• 

  Fig. 1 The axial (A), coronal (B), and sagittal (C) images of a CBCT scan show the area of the arrested pneumatization of the right sphenoid sinus. The well-defined sclerotic borders, curvilinear internal calcifications, soft tissue density zones, and absence of any evidence of expansion or effect on the surrounding structures are visualized. The external morphology of the sphenoid bone appears to be normal.

• 

  Fig. 2 A. A schematic diagram shows the normal pneumatization of the sphenoid sinus and the surrounding anatomic structures in this area. B. A schematic diagram shows arrested pneumatization of the left sphenoid sinus. The lesion has multiple foci of fat, narrow sclerotic margins, and internal curvilinear calcifications. The left vidian canal passes through the region of arrested pneumatization. Note the well-preserved bony cortex of the canal.

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