Pathology of the Cavernous Sinus

摘要

Several pathologic entities involve the cavernous sinus. Some arise from the sinus and others spread into the sinus. Lesions of the cavernous sinus can be classified into benign and malignant lesions. The benign lesions involving the cavernous sinus include neoplastic lesions such as meningiomas, pituitary adenomas, and trigeminal schwannomas. The nonneoplastic benign lesions include vascular lesions such as in-tracavernous carotid artery aneurysms, cavernous malformations and carotid cavernous fistulas. Other benign processes involving the cavernous sinus include cholesterol granuloma and infiltrating granulomas such as the Tolosa-Hunt syndrome. Malignant lesions involving the cavernous sinus mostly spread to the cavernous sinus from adjacent compartments. Adenoid cystic carcinomas are notorious in spreading along cranial nerves to the cavernous sinus region. Chordomas can involve the region of the cavernous sinus arising from adjacent notochord remnants. Squamous cell carcinoma of the paranasal sinuses can also spread into the cavernous sinus. The cavernous sinus is a crossroad of several anatomic structures and as a result it is involved with different pathologic entities. Understanding the potential pathologic lesions involving the cavernous sinus will help with its differential diagnosis and establishing a good management plan.