Presentation
Vertigo.
Patient Data
There is a 15 x 25 x 40 mm abnormal signal mass lesion (low on T1 and high on T2) in the pre-pontine cistern with right lateral extension to the cerebellopontine angle exhibiting restricted diffusion on DWI images.
The lesion displays a moderate mass effect on the anterior surface of the pons, right cerebellar peduncle, and right trigeminal nerve.
The poserior aspect of the lesion is adjacent to the pons and basilar artery and the superior surface abuts the right posterior cerebral artery.
The posterolateral extension of the lesion comes in proximity to the origin of the seventh and eighth nerves without a definite mass effect.
Case Discussion
Based on MRI features, cerebellopontine angle arachnoid cysts, and intracranial epidermoid cysts are in the differential diagnosis because of their typical location and mimic the CSF signal on MRI sequences. The imaging diagnosis of intracranial epidermoid cyst is confirmed on diffusion-weighted imaging (DWI) and (ADC) which demonstrates restricted diffusion.
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