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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Practice Cases
Worklist 1
11 topics, 31 min.
Practice Cases
Worklist 2
11 topics, 39 min.
Practice Cases
Worklist 3
11 topics, 42 min.
Practice Cases
Worklist 4
11 topics, 29 min.
Practice Cases
Worklist 5
11 topics, 21 min.
Practice Cases
Worklist 6
11 topics, 17 min.
Practice Cases
Worklist 7
11 topics, 21 min.
Practice Cases
Worklist 8
11 topics, 18 min.
Practice Cases
Worklist 9
11 topics, 18 min.
Practice Cases
Worklist 10
11 topics, 28 min.
Wk 8, Case 4 - Review
HIDEInteractive Transcript
Report
Patient History
Left-sided mandible lesion. Prior MRA demonstrated no hypervascularity within the mass.
Findings
There is a mass involving the left pterygopalatine fossa extending laterally along the masticator space to involve the left mandible. This abnormality expands the pterygopalatine fossa and homogeneously enhances. The mass appears to superiorly displace the internal maxillary artery. The lesion appears to arise in the left pterygopalatine fossa and extends laterally and erodes the inner cortex of the mandible with extension into the medullary cavity. There is enhancement involving the region of the left mandibular notch and the lesion appears to surround the expected location of the inferior alveolar nerve within the ramus of the mandible. The superior aspect of the lesion extends to the condylar neck. No obvious involvement is identified involving the left masseter muscle.
Imaging of the neck demonstrates some asymmetrically prominent left-sided lymph nodes. There also appears to be slight asymmetrical enhancement involving the left submandibular gland. Significance of this is unclear. No evidence of obstructive lesions identified within the floor of mouth.
Conclusions
1. Diffusely homogeneously enhancing mass involving the left pterygopalatine fossa extending laterally along the masticator space to involve the mandible. The lack of hypervascularity makes juvenile angiofibroma less likely. Differential diagnosis includes low-grade mesenchymal tumor, neurogenic tumor, fibromatosis, IgG4 associated disease, or, less likely, lymphoma.
2. Asymmetrically enlarged left level 2 and level 5 lymph nodes.
3. Findings suggestive of asymmetrical enhancement involving the left submandibular gland.
Case Discussion
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Suresh K Mukherji, MD, FACR, MBA
Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging
Tags
Neuroradiology
MRI
Head and Neck
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