A 59-year-old woman was admitted with a chief complaint of cough. Two months before admission she had had a generalized upper respiratory tract infection which cleared up except for a cough productive of a nonpurulent mucoid sputum. Paroxysms of coughing occurred during both the day and night.
Past medical history revealed no previous symptoms of sinus disease or allergy, although she did complain of mild frontal headaches occurring infrequently over the previous year. Other than a mild postnasal dis- charge, she had no other otorhinolaryngic symptoms and physical examination disclosed no abnormalities.
Routine sinus radiographs showed erosion of the clivus and floor of the posterior pituitary fossa. Radiographs showed destruction of the rostral aspect of the clivus, base of the dorsum sella, posteriormost floor of the pituitary fossa, and compact bone at the posterior margins of the larger left sphenoidal compartment. A representative lateral view polytome laminograph is shown (Fig