Fig. 10

Skull base metastasis.A 66-year-old man with a history of oropharynx carcinoma treated with radiation therapy 1 year earlier presenting with left VCP. FDG-PET revealed a hypermetabolic lesion in the left skull base presumed to be a metastasis. a Axial T1-weighted contrast-enhanced images at the level of the skull base showed a heterogeneously enhancing mass in the left cerebellomedullary cistern (arrow). The mass shows infiltrative growth into the skull base and jugular foramen, and thereby the vagal nerve, causing left VCP. The imaging findings were suspicious for metastatic disease. b Follow-up T1-weighted contrast-enhanced images with fat saturation showed progression of the skull-base mass with infiltrative growth into the nasopharynx (long arrow) and mass effect on the cerebellum and pons (short arrow)