Charles F. Lanzieri

Meningioma with intratumoral fat

Fat within meningiomas is histologically not uncommon. Focal areas of low density on computed tomography scans within meningiomas have been demonstrated and are most often intratumoral cysts. The case presented demonstrates a focal area of low density within a meningioma that is proved histologically to be fat.

Intraosseous petrous apex neuroma: CT findings

An avascular, contrast enhancing intraosseous petrous apex mass was discovered on CT in a patient with prior colonic carcinoma and acute myelocytic leukemia. A normal bone scan made metastasis unlikely and surgery revealed a neuroma. The differential diagnosis is discussed.

Coexistence of a nasal mucoepidermoid carcinoma and sphenoid mucoceles: CT diagnosis and treatment implications

Mucoepidermoid carcinomas of minor salivary gland origin rarely arise in the nasal cavity. A patient with such a tumor in association with bilateral sphenoid sinus mucoceles is presented. This diagnosis was established preoperatively by CT and allowed an attempt at curative surgery to be made. The CT and pathological findings are discussed.

Malignant teratoma of the parapharyngeal space in an adult: A rare lesion presenting as cervical cord compression

The 12th case of a cervical teratoma in an adult is presented. This malignant lesion, located in the parapharyngeal space, presented clinically with signs and symptoms of a cervical cord compression secondary to metastases. The computed tomography, dynamic scan, and angiography workup of this patient is presented, and the literature is reviewed.

Cystic adult medulloblastomas

The computed tomography scans of four patients who had a medulloblastoma are reviewed. In all the cases, atypical findings were present--specifically, cystic or lucent areas within the tumor. The importance of this uncommon finding associated with adult medulloblastoma is discussed.

Differentiation of large suprasellar masses by evaluation of the superior margin

Differentiation of suprasellar masses by computed tomography criteria depends on intrasellar extension, patterns of calcification and enhancement, associated bony reaction, and cystic changes. In the case of a homogeneously enhancing suprasellar mass that does not exhibit any of these differentiating findings, separating a suprasellar meningioma from a large suprasellar pituitary adenoma has been quite difficult. We reviewed the computed tomography findings of 42 such tumors. There were 19 meningiomas and 23 pituitary adenomas chosen that had few or none of the commonly applied findings used in differentiation. Evaluation of the superior contour of these masses seems a reliable sign to use in this situation. A single upward convex curve correlated with a meningioma in 15 of 19 cases (78%), whereas a multiple upward convex curve correlated with a pituitary adenoma in 19 of 23 cases (82%). Although some pitfalls were encountered when employing this sign--such as pseudolobulations caused by the adjoining cavernous sinus, dural, or vascular structures--it nonetheless led to the correct diagnosis in approximately 80% of cases.

Total internal carotid artery occlusion by a benign carotid body tumor: a rare occurrence.

A rare case of a carotid body tumor that completely occluded the internal carotid artery is presented. To our knowledge this is only the second such case documented by angiography. In the present computed tomography era, the role of vascular imaging in these tumors is discussed and the varied clinical presentations of these neoplasms are reviewed. The confusion between the locally malignant behavior of some of these lesions and the accepted definition of a malignant carotid body tumor is discussed.

Radiology of large transincisural masses

A large, potentially resectable mass that crosses the tentorial incisura may present unique problems for the neurosurgeon. Fifteen patients with large transincisural extraaxial masses were reviewed. The computed tomography and angiography findings are discussed. The importance of altering the clinician to the presence of a transincisural mass and accompanying computed tomography and angiography findings are emphasized.