Osteosarcoma of the skull base presenting as a petrocavernous pseudoaneurysm and masquerading as an intracranial abscess: illustrative case
Open Access
- 5 July 2021
- journal article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery. Case Lessons
- Vol. 2 (1), CASE20148
- https://doi.org/10.3171/case20148
Abstract
Telangiectatic osteosarcoma (TOS) is a rare and aggressive high-grade malignant neoplasm composed of blood-filled or empty cystic spaces resembling aneurysmal bone cysts. Uncommonly, TOSs can occur in the skull base. The authors present a case of a TOS that presented as a petrocavernous carotid pseudoaneurysm and then masqueraded as an intracranial abscess. The prognosis for TOSs with intracranial involvement is typically unfavorable and inversely related to the degree of intracranial involvement. Skull-based malignancies should be part of the differential diagnosis for a rapidly progressing lesion. Recovery of polymicrobial organisms during endoscopic sinus surgery should prompt reconsideration of the differential diagnosis. Postinflammatory changes from endovascular coiling have been described and can confound imaging and clinical findings. Telangiectatic osteosarcoma (TOS) is a rare and aggressive high-grade malignant neoplasm composed of blood-filled or empty cystic spaces resembling aneurysmal bone cysts. Uncommonly, TOSs can occur in the skull base. The authors present a case of a TOS that presented as a petrocavernous carotid pseudoaneurysm and then masqueraded as an intracranial abscess. The prognosis for TOSs with intracranial involvement is typically unfavorable and inversely related to the degree of intracranial involvement. Skull-based malignancies should be part of the differential diagnosis for a rapidly progressing lesion. Recovery of polymicrobial organisms during endoscopic sinus surgery should prompt reconsideration of the differential diagnosis. Postinflammatory changes from endovascular coiling have been described and can confound imaging and clinical findings.Keywords
This publication has 8 references indexed in Scilit:
- An update on bacterial brain abscess in immunocompetent patientsClinical Microbiology & Infection, 2017
- Neurological Changes with Abnormal Brain Reactivity Following Coiling of Cerebral Aneurysm. Possible Reactivity to Endovascular Devices and Material?2015
- Telangiectatic osteosarcoma: a review of literatureOncoTargets and Therapy, 2013
- Telangiectatic OsteosarcomaArchives of Pathology & Laboratory Medicine, 2012
- Bacteriology of the Sinus Cavities of Asymptomatic Individuals after Endoscopic Sinus SurgeryThe Journal of Otolaryngology, 2007
- Postneurosurgical Nosocomial Bacterial Brain Abscess in AdultsInfection, 2006
- Bacterial Infection After Endoscopic Sinus Surgery: A Controlled Prospective StudyThe Laryngoscope, 2004
- Telangiectatic osteosarcoma of the skull base.1998