case_images: PMC9887545_01
case_images: Axial (A) and coronal (B) T2-weighted images, and sagittal T1-weighted images before (C) and after (D) contrast administration. The lesion has a heterogeneous signal on spontaneous T1 (C) and T2 images (A and B) - it is slightly hyperintense on T2 and markedly hyperintense on T1 peripherally, and iso/hypointense on T2 and hypointense on T1 centrally. On postcontrast images, there is a diffuse enhancement (D). Axial bone window CT image showing an ill-defined ground-glass density lesion centered in the clivus, with loss of normal bone cortication; The lesion has a maximum antero-posterior extension of 35mm, but there is no significant mass effect. (1-E)
case_images: cureus-0015-00000033206-i01.jpg
case_images: PMC9887545_01_cureus-0015-00000033206-i01.jpg
case_images: FIG1
case_images: MRI imaging showed a cystic sphenoidal extradural lesion, isointense on T1-weighted images (WI) with peripheral gadolinium enhancement and hyperintense on T2 WI (Figure 1).
case_images: Cystic lesion surrounded by bone tissue and lined by respiratory epithelium with no atypia, consistent with the diagnosis. Respiratory-type epithelium lining cyst (*), surrounded by mature osseous bone (#). A: 40x, B: 100x
case_images: cureus-0015-00000033206-i02.jpg
case_images: PMC9887545_01_cureus-0015-00000033206-i02.jpg
case_images: FIG2
case_images: Histopathological examination was also conducted on part of the cyst wall (Figure 2).
case_images: PMC9887545_02
case_images: Axial (A) and sagittal (B) bone window CT images of the same patient, after endoscopic surgical approach. There was partial removal of the lesion.
case_images: cureus-0015-00000033206-i03.jpg
case_images: PMC9887545_02_cureus-0015-00000033206-i03.jpg
case_images: FIG3
case_images: Headaches disappeared after one week, and the patient didn't develop neurologic symptoms or post-operative complications from the endoscopic surgery (Figure 3).