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Mass around the cavernous sinus - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
User :   My mother had at CT done and this is what it says. Her symptoms are nauseous. THis what the CT says: IMPRESSION: 1. Prominent cavernous sinuses bilaterally which bow laterally more prominent on left
than right. Neoplasm might cause this finding along with tortuous carotids and
infectious diseases such as can be seen at skull base.
2. Findings compatible with right mastoiditis and sinusitis in left aspect of sphenoid.
Doctor :   Hi
User :   hello
User :   Can you please tell me what this means.IMPRESSION: 1. Prominent cavernous sinuses bilaterally which bow laterally more prominent on left than right. Neoplasm might cause this finding along with tortuous carotids and infectious diseases such as can be seen at skull base. 2. Findings compatible with right mastoiditis and sinusitis in left aspect of sphenoid.
User :   Hello????
Doctor :   1. Prominent cavernous sinuses bilaterally which bow laterally- Mean- There is this blood filled cavity in the centre of the skull
Doctor :   which has become prominent due to a tumor or any mass
Doctor :   in its vicinity
Doctor :   mastoid- is a another air filled cavity near the ear
Doctor :   mastoiditis- means this cavity is infected
User :   SO this CT is saying that she has blood filled cavatity that is infected caused by a tumor?
Doctor :   sinusitis- is infection of the normally present air sinuses in & around the nose
Doctor :   From this CT all one can say is that there is a Mass in the cranium/skull
Doctor :   which is pushing the normal contents
User :   mass meaning tumor
Doctor :   Yes, most often
Doctor :   Especially in this location
Doctor :   Other possibilities- aneurysm, parasitic cysts, edema
User :   Let me send you the findings: Soft tissue density noted in many right mastoid air cells with sclerosis and thickening of several septae in right mastoid suggesting right mastoiditis. Soft tissue density is noted in the middle ear on right. Serous otitis media could cause this finding; other causes are possible. No definite bone destruction. Abnormal soft tissue density is noted in the left aspect of sphenoid sinus. Frothy sputum and an air-fluid level are thought to be present. No definite abnormality noted in the other paranasal sinuses nor left mastoid as visualized on this CT scan of head. The cavernous sinuses appear enlarged and bow laterally bilaterally more prominent on the left than right. This may reflect expansion of cavernous sinuses such as can be caused by neoplasm such as lymphoma. Infectious causes might cause these findings. The infundibulum appears midline and the sella appears intact as does the anterior sphenoid. Tortuous atherosclerotic internal carotids noted bilaterally in their cavernous portions which may contribute or even explain the finding. MRI offers further evaluation. There is no hydrocephalus, cortical atrophy. Septum pellucidum, third ventricle, pineal gland and fourth ventricle are midline. no acute bleed nor additional mass lesion nor infarct in major vascular territory. No additional abnormal enhancement following intravenous contrast.
Doctor :   OK, it is clear as I said earlier that there is a mass that
Doctor :   is causing these
Doctor :   what exactly the mass is,
Doctor :   is difficult to say conclusively
User :   Could a mass be fluid.
Doctor :   it could be a cancerous disease called lymphoma
Doctor :   or infection like- parasite
Doctor :   or Tb
Doctor :   Mass could be fluid if elsewhere
User :   So there is a major problem correct? Who should she see for help? A neurosurgeon?
Doctor :   but here, in this location it is most often a tumor
Doctor :   Yes a neurosurgeon
Doctor :   These abnormalities could also be due to atherosclerosis
User :   Should we take her to the ER right away to deal with this? Or just wait to make an appointment. Her family doctor didn't tell us anything.
Doctor :   of the vessels that drain this cavity, which causes
Doctor :   increase in size of the cavernous sinus
User :   The only symptom she has rt. now is nauseuos and really bad back pain from sponosis.
Doctor :   You have to take an appointment with the neurosurgeon
User :   Is this urgent like the appt needs to be asap. They are booking into July.
Doctor :   The prognosis & need for surgery has to be decided after assessment of the patient by the neurosurgeon
Doctor :   You can ask your family physician about it
User :   Ok thank you. Anything else that I need to know from these findings?
Doctor :   Yes
Doctor :   Is she a known sufferer of sinusitis?
User :   Yes she has had sinus infections.
Doctor :   If yes from how long?
Doctor :   The CT also says that there is ear disease
User :   She has had sinus infections on and off. No set time. She has hearing loss and ear dr. said hearing loss is worse in last year.
User :   This is terrible. I am in shock,
Doctor :   Mastoiditis as seen by CT, seems to have caused by this.
Doctor :   So she will need an ENT surgeon too
User :   What is mastoiditis?
User :   So she has a mass and ear disease correct?
Doctor :   Mass is in the centre portion of skull
Doctor :   & her right ear is diseased
User :   Does it say that the mass is large
Doctor :   Also her sphenoid sinus which is situated closer to the mass
Doctor :   too seems to be infected
User :   So this is not good
Doctor :   So, there is a fair chance that the mass is nothing but this sphenoid sinus itself
Doctor :   in that case it is better for the patient
User :   I am confused. What is sphenoid sinus?
Doctor :   It is an air filled cavity, normally present in all,
Doctor :   located deep in the
Doctor :   skull, behind the nasal cavity
Doctor :   In her case it is infected
User :   So we all have this air cavity and the infection could be treated with meds?
Doctor :   So, an infected sphenoid sinus can become bigger in size, & pose as the mass that is causing her other nearby structures to deviate
Doctor :   Yes, only the infection
Doctor :   not the other abnormalities caused by this infection
User :   But not the mass? So this could be just an infection.
Doctor :   Yes
User :   Thank you so much!
Doctor :   Is there any thing else I can help you with?
User :   No thank you.
Doctor :   Please fill the feedback form say done when done.
User :   Ok
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
User :   k
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