Epidermoid cyst with abducent nerve palsy

Case contributed by Ammar Haouimi
Diagnosis almost certain


Left abducens nerve palsy.

Patient Data

Age: 45 years
Gender: Female

The MRI sequences demonstrate a well-defined oblong lesion (20 X 9 X 7 mm) at the left anterolateral aspect of the prepontine cistern, anterior to the facial and vestibulocochlear nerves at the level of the cisternal portion of the left abducent, and trigeminal nerves. It shows a low signal intensity on T1, a high signal on T2, a heterogeneous high signal on FLAIR, and an intermediate signal on Fiesta with restricted diffusion. No enhancement seen on postcontrast sequences. 

Case Discussion

MRI features characteristic of a prepontine cistern epidermoid cyst, compressing the left abducens nerve (6th cranial nerve).

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