Answer for CoW 19 Nov 2017
CP Angle Epidermoid cyst
Findings
T2 hyperintense lesion with mixed solid & cystic components noted in right cerebello pontine angle, causing internal auditory canal widening & compression of 7th & 8th nerve complex. The lesion compresses & displaces the cerebellar foliae & insinuates along perimesencephalic cisterns displacing the 4th ventricle, pons & midbrain to opposite side & extends upto meckels cave insinuating the 5th nerve & right para sellar region. Features suggestive of right CP angle epidermoid cyst
Discussion
Third most common cerebellopontine angle mass, after acoustic schwannomas and meningiomas Intracranial epidermoid cysts appear as lobulated lesions that fill and expand CSF spaces and exert a gradual mass effect, insinuating between structures and encasing adjacent nerves and vessels. A common feature of posterior fossa cysts is displacement of the basilar artery away from the pons. MR Imaging features : Iso intense to CSF in T1 & T2, heterogenous signal in FLAIR, thin rim of enhancement in contrast & shows diffusion restriction. The incidence of epidermoid cyst causing nerve palsy is very rare (0.3-2.5)
Findings
T2 hyperintense lesion with mixed solid & cystic components noted in right cerebello pontine angle, causing internal auditory canal widening & compression of 7th & 8th nerve complex. The lesion compresses & displaces the cerebellar foliae & insinuates along perimesencephalic cisterns displacing the 4th ventricle, pons & midbrain to opposite side & extends upto meckels cave insinuating the 5th nerve & right para sellar region. Features suggestive of right CP angle epidermoid cyst
Discussion
Third most common cerebellopontine angle mass, after acoustic schwannomas and meningiomas Intracranial epidermoid cysts appear as lobulated lesions that fill and expand CSF spaces and exert a gradual mass effect, insinuating between structures and encasing adjacent nerves and vessels. A common feature of posterior fossa cysts is displacement of the basilar artery away from the pons. MR Imaging features : Iso intense to CSF in T1 & T2, heterogenous signal in FLAIR, thin rim of enhancement in contrast & shows diffusion restriction. The incidence of epidermoid cyst causing nerve palsy is very rare (0.3-2.5)
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!