Osteoma of the posterior wall of the sphenoid sinus in a 29-year-old woman – a case report

Abstract

Skull base osteomas are rare tumors, typically asymptomatic and without specific clinical manifestations. These are slow-growing benign tumors that, in some cases, can reach signifi cant sizes and exert a mass eff ect on surrounding neural and vascular structures located at the skull base, leading to corresponding clinical symptoms. Tumors located on the posterior wall of the sphenoid sinus may appear on magnetic resonance imaging (MRI) and computed tomography (CT) as osteomas, polyps originating from the mucosa of the sphenoid sinus, chordomas, or chondrosarcomas. During the second and third decades of life, chordomas and osteomas are commonly encountered tumors. The two imaging modalities are interrelated and complementary since CT visualizes bony structures eff ectively, while MRI is superior for soft tissues and brain parenchyma. In the present case report, we describe a 29-year-old woman presenting with symptoms of numbness in the right limbs, dizziness, and nausea, without vomiting. She reported dropping objects with her right hand. An MRI of the brain was performed, revealing a lesion localized on the posterior wall of the sphenoid sinus, extending to the clivus and infiltrating the inferior surface of the sella turcica. The lesion showed increased signal intensity on T2-weighted sequences. Given the small size of the tumor and the absence of corresponding clinical manifestations, the lesion is subject to clinical monitoring. Surgical approaches for the removal of such tumors include the endoscopic transsphenoidal approach to the skull base or the sublabial transsphenoidal approach. Complications associated with these surgical interventions may involve dural laceration and subsequent cerebrospinal fluid leakage, as well as potential damage to critical vessels or nerves.