ZocdocAnswersMy MRI showed a cystic lesion adjacent to the clivus, possibly osteolytic and expansile. Could this be cancer?

Question

My MRI showed a cystic lesion adjacent to the clivus, possibly osteolytic and expansile. Could this be cancer?

Recently had a head injury in which I hit my temple area on right side, black eye on same side. Also hit left side temple area.

Answer

I am sorry to hear that you had a recent trauma in which you hit your temple and got a black eye. I am also sorry to hear that an MRI showed a cystic lesion adjacent to your clivus that is possibly osteolytic and expansile. I recommend that you make an appointment with an Ear Nose Throat (aka otolaryngologist) physician. If the trauma wasn't that bad (meaning fractured bones, etc), then I have a hard time seeing how an expansile lesion near your clivus could be related to the trauma. Unless there was a dissection/aneurysm of an artery due to trauma, but that typically takes a very significant force and would likely give you much worse injuries than a black eye. Which makes me think that the lesion seen in your clivus was an incidental finding on the MRI ('incidental' meaning we weren't looking for it, but found it there). There are a number of different disease processes that can cause osteolytic lesions in the clivus. The clivus is a wedge of bone at your skull base behind your sphenoid sinus and nasopharynx, and in front of your brain stem. Thus it is an important area. When there is constant pressure on bone, it can breakdown which is what it seen and described on imaging studies as 'osteolytic'. I would recommend that you make an appointment with an Ear Nose Throat (aka otolaryngologist) physician, or a neurosurgeon to get your imaging reviewed and have them examine you. Looking at the images will give the surgeon an idea about what might be going on, but they may ultimately need to get a small piece of tissue (i.e. biopsy) in order to get a diagnosis. I hope this helps, and I wish you the best.

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