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Cavernous sinus lesion
#1
Please excuse my intrusion into the neurosurgery board, but thought I'd throw an odd case out there.  I'm a radiologist, and have been shown a case of a smoothly marginated, nonenhancing lesion in the cavernous sinus.  It contains a nodular component surrounded by fluid, and the nodular component is approximately isointense to brain on various sequences.  On the coronal images, the soft tissue/nodular component is not well separated from the temporal lobe tissue above, so my primary consideration is a small encephalocele or less likely ectopic rest.  The lesion is causing a 6th nerve palsy.  A quick search has found a potentially similar case:

(Cavernous Sinus Encephalocele: Surgeon Beware

ArticleinJournal of Neurological Surgery, Part B: Skull Base 78(S 01):S1-S156 · March 2017 with 48 Reads
DOI: 10.1055/s-0037-1600820


My question lies in the feasibility of fixing such a lesion, and if there are certain centers or individuals that would be more experienced or receptive to such a case.  Would a typical academic center have a skull base surgeon that deals with this kind of case?Thanks for any guidance.  
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#2
Yes, send to an academic, tertiary care center with a neurosurgery service to review images and discuss options.
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