Fig. 9

PPF involvement in ROCM. Unenhanced axial CT scan of the brain (a) reveals soft tissue within the right PPF (thick arrow). Note the normal fat density and branches of the internal maxillary artery seen in the contralateral, uninvolved PPF (dotted arrow). Soft tissue is also noted in the right retro-antral fat (thin arrow) and the right anterior periantral fat (arrow head) as well. Based on the imaging signs, the possibility of ROCM was suggested and a prompt CE MRI of the neck was performed. Unenhanced axial T1W (b) and coronal T2-FS (c) images of the neck confirm the presence of soft tissue in the right PPF (thick arrows in b, c), right retro-antral fat (thin arrow in b) and right anterior periantral fat (arrow head in b). CE FS axial T1W image (d) reveals heterogeneous enhancement of the soft tissue in the right PPF (thick arrow) as well as in the right retro-antral fat (thin arrow) and right anterior periantral fat (arrow head)