White epidermoid cyst
Presentation
Dizziness for around one year.
Patient Data
Age: 15 years
Gender: Male
From the case:
White epidermoid cyst
MRI
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Sagittal T1
There is a rounded T1, T2, FLAIR hyperintense lesion which is favoured to lie within the cerebellar parenchyma, although may be within the 4th ventricle. No perilesional oedema. There are several regions of diffusion restriction, with no significant contrast enhancement. The fourth ventricle is largely effaced, although no hydrocephalus is demonstrated.
Case Discussion
The lesion is most compatible with a white epidermoid cyst. Epidermoid cysts are typically T1 isointense and FLAIR hypointense but in this case, we see T1 and FLAIR hyperintensity probably due to high protein content.