Gliosarcoma with Primary Skull Base Invasion

Figure 1

MRI and CT findings prior to surgery. (a) Sagittal T1-weighted imaging (T1WI) demonstrated a heterogeneous T1 hypointense mass involving a majority of the anterior temporal lobe with associated mass effect and surrounding vasogenic edema. Tumor extends through the greater wing of the sphenoid into the infratemporal fossa. (b) Sagittal postgadolinium T1WI demonstrates avid heterogeneous enhancement. The anterior portion in the soft tissues solidly enhances and intracranially has central necrosis. (c) 3D reconstruction from head CT demonstrates aggressive destruction of the greater wing of the sphenoid. (d) Axial FSE T2-weighted imaging demonstrates the mass to be heterogeneous iso/hypointense tumor with surrounding vasogenic edema suggesting increasing cellularity. (e) Axial postgadolinium T1WI demonstrates avid heterogeneous enhancement with central necrosis intracranially.

(a)

(b)

(c)

(d)

(e)