Epidermoid cyst - intracranial

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Epilepsy

Patient Data

Age: 30 years
Gender: Male

The MRI images reveal an ill-defined lobulated cystic mass of extra-axial location, filling the right cerebellopontine angle, prepontine and ambient cisterns with mass effect on the right middle cerebellar peduncle, 4th ventricle/right lateral ventricle, brainstem, midbrain and right temporal lobe which is compressed and displaced laterally. This cystic mass shows a low signal intensity on T1WI (slightly higher than that of CSF), high signal intensity on T2WI, heterogeneous/dirty signal on FLAIR, and high signal on DWI (restricted diffusion). No enhancement is noted on the postcontrast sequences. Note this mass encases the basilar artery with extension into the ipsilateral internal auditory canal (ICA).

Case Discussion

MRI features characteristic of an intracranial epidermoid cyst.

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