Left: Enhanced CT image of the neck shows irregular bony changes of C2,
associated with enhancing ventrolateral epidural masses.
Right: With bone windowing, the CT image demonstrates an irregular,
destructive process involving the C-spine with loss of cortical definition anteriorly.
Left: axial CT image with bone windowing shows destructive and lytic
lesion in the skull base, more severely on the right.
Top and bottom right: both C-1 and C-2 vertebrae are also involved.
Left: sagittal T1WI shows isointense lesion posterior to C2-3 compressing the thecal
sac. There is some heterogeneity of the bone marrow signal in the C-2, 3 vertebrae.
Middle two: sagittal T1WI's with gadolinium show enhancement of the C-2, 3
vertebrae and of soft tissue masses in the prevertebral and epidural spaces.
Right: axial T1WI with gadolinium shows an enhancing soft tissue mass destroying
the left lateral mass of C1.
Key words: mri skull base tumor neoplasia