Presentation
Medically free, presented with headache, dizziness, and facial numbness.
Patient Data
A large lobulated non-enhancing cystic lesion occupies and expands the fourth ventricle and extends through the left foramen of Luschka. It has scalloped margins and a very high T2 signal which only partially attenuates on FLAIR without calcification or enhancement. It measures about 2.9 x 2.3 x 2.8 cm.
Diffusion-weighted imaging demonstrates very high DWI signal and intermediate ADC values similar to the adjacent cerebellum.
Case Discussion
The imaging shows a sizable, lumpy cystic growth outside of the brain which does not appear to be enhancing and has some suppression on flair images. Additionally, it displays high DWI, which is consistent with the features of an epidermoid cyst.
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