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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.
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11 topics, 42 min.
11 topics, 29 min.
11 topics, 21 min.
11 topics, 17 min.
11 topics, 21 min.
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Interactive Transcript
Report
Patient History
Left sided tinnitus.
Findings
Midline structures are within normal limits. The ventricular size, shape and configuration are within normal limits and unchanged. There is a partially empty sella. There is no evidence of vasogenic edema or mass effect. The contrast-enhanced T1-weighted images show no abnormal intraaxial enhancing masses. Incidental note is made of partial pneumatization of both mastoid air cells. Diffusion-weighted imaging shows no evidence of recent infarct. Gradient-echo imaging shows no evidence of hemosiderin staining.
Internal Auditory Canal: Thin-section imaging performed through the internal auditory canal shows a heterogeneous mass involving the left cerebellopontine angle. The mass has a frond-like appearance which is best appreciated on the heavily T2-weighted images. The mass can be detected on the T2-weighted images but has greater conspicuity on the FLAIR sequences.
The lesion is centered just lateral to the left porous acusticus and directly abuts the cisternal segment of the left 7th and 8th nerve complex. The superior component of the mass abuts the lateral aspect of the left cisternal segment of the trigeminal nerve. The inferior component extends just inferior to the cisternal segment of the 7th and 8th nerve complex. There is no appreciable enhancement. The lesion is high signal on diffusion-weighted imaging. Mild mucosal thickening involving the anterior aspect of the left mastoid air cells.
Conclusions
1. Heterogeneous nonenhancing mass involving the left cerebellopontine angle that has a frond-like appearance which has increased diffusion and FLAIR signal. Findings are most consistent with epidermoid tumor.
2. No evidence of vasogenic edema or mass effect.
3. No abnormal intraaxial or extraaxial enhancing masses.
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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