Giant Basal Cell Carcinoma of the Scalp with Intracranial Invasion: MRI Findings with Tract Visualisation

Figure 2

3.0 T MRI with and without administration of paramagnetic contrast agent. On axial postgadolinium T1w-FFE image, there is evidence of (a) an extensive enhancing lesion of the scalp showing, in axial T2-TSE images, infiltration of (b) skin, bones, dura mater, and subdural spaces at the level of the right middle and inferior frontal gyrus. Compression of the right orbital and straight gyrus is also noted, as seen on axial FLAIR-T2w images (c). Axial T2-TSE images show also that (d) the right orbit is fully invaded by the lesion, with proptosis of the globe, which appears compressed, and compression of the optic nerve and that (e) there is invasion of ethmoidal cells, pterygopalatine fossa, and foramen rotundum. Axial FLAIR-T2w images show elevated signal intensity in some white matter fibers, like the right frontal lobe (f).

(a)

(b)

(c)

(d)

(e)

(f)