Presentation
Right trigeminal pain.
Patient Data
A right cerebellopontine angle high T2, low T1 mass with incomplete FLAIR suppression and prominent high DWI signal and ADC values similar to adjacent brain encases of the upper basilar artery and right superior cerebellar artery. The right 6th nerve is difficult to identify and right 7th and 8th nerves are encased with their cisternal course distorted by the mass. The right 5th nerve traverses the mass with no displacement and the right lower cranial nerves are also surrounded. The right 3rd nerve is displaced. Unchanged mass effect on the ventral pons, middle cerebellar peduncle and right cerebellar hemisphere.
Persistent left trigeminal artery and partial empty sella noted.
Conclusion
Right cerebellopontine angle epidermoid cyst.
Case Discussion
Typical appearances of a cerebellopontine angle epidermoid cyst. The relationship with cranial nerve and vessels makes this lesion essentially impossible to fully resect.
Incidental persistent left trigeminal artery.
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