UNASSIGNED: A 57-year-old woman presented with diplopia that started a few days before the presentation. She had transient diplopia at the right lateral gaze and upper gaze with normal eye movement. The symptoms disappeared spontaneously 1 week later. She had no other complaints or neurological deficits. Computed tomography revealed an intraosseous mass lesion and bone erosion of the middle and lower clivus, extending laterally to the right occipital condyle. Magnetic resonance imaging (MRI) showed hyperintense and hypointense components on T2- and T1-weighted images, respectively. The lesion was larger than on MRI performed 10 years earlier. Chordoma or chondroma was considered a possible preoperative diagnosis. An endoscopic transsphenoidal approach removed the tumor. In the operating view, the lesion appeared as \"moth-eaten\" bony interstices filled with vascular soft tissue. Histologically, an intraosseous cavernous hemangioma was diagnosed.
UNASSIGNED: Diagnosis before surgery is difficult without characteristic radiographic findings. When making a differential diagnosis of malignant skull lesions, PICH should be considered.
■一名57岁女性出现复视,在出现前几天开始。她在正常的眼球运动下在右侧注视和上注视处有短暂的复视。1周后症状自行消失。她没有其他抱怨或神经功能缺损。计算机断层扫描显示骨内肿块病变和中下坡骨侵蚀,横向延伸到右枕骨髁。磁共振成像(MRI)在T2和T1加权图像上显示出高信号和低信号成分,分别。病变大于10年前的MRI。脊索瘤或软骨瘤被认为是可能的术前诊断。内窥镜经蝶入路切除肿瘤。在操作视图中,病变表现为“蛾食”骨间隙,充满血管软组织。组织学上,诊断为骨内海绵状血管瘤。
■如果没有特征性的影像学表现,手术前的诊断是困难的。在对恶性颅骨病变进行鉴别诊断时,应该考虑PICH。