Iconocerf: Clinical case

Cas 2479

French version

Speciality : Orl

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Clinical case : man : 38 years

History : @ 38 years old patient, operated there are 9 year sd' a cerebral tumour by right temporal way, rehospitalized for an epileptic fit.

Diagnosis : @ CYST epidermal.

Consult the links (ADM, EdiCerf, ...)

Diagnosis comments : @ The tumoral lesion identified by the imagery presents a cystic behavior. Are discussed a cyst epidermoid and a cyst arachnoid. The primitive cyst epidermoid or cholesteatoma develops starting from blastic inclusions ear. It siegepreferentiellement in the ponto-cerebellar angle and the area supra-sellaire. Their behavior in CT and IRM depends on their content keratin. If this one is weak, they appear hypo-dense in CT and present a signal in IRM close to that of the LCR. the existence of relatively irregular edges, of a syndrome of mass and of a moderately intense, heterogeneous signal into sequenceprotonic plead in favour of a cyst epidermoid.

MeSH keys : EPIDERMOID, CYST| PETROUS, APEX| TEMPORALBONE, MR STUDIES

Authors :


imageInfos

Comments :
@ CT CEREBRAL after IV, cut of 5 mmd' thickness: to note the asymmetrical aspect of the ponto-cerebellar angles, with deviation of the bulb towards the left. Lesion hypodense of the petrous apex right.

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ CT, even cut that the preceding one, fenestrates osseous: puffed up aspect of the petrous apex, energy of the occipital condyle ahead up to the level of the aqueduct of the cochlea behind. Rolling of the channel carotidien ahead, bilateral filling of the cells mastoid.

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ CT, cut 5 mm higher, osseous window: broad expansive lesion of the petrous apex rolling the oval channel carotidien (head of arrow) and holes (small head of arrow).

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ CT CEREBRAL, cut 15 mm higher:formation hypodense, bilobate, breech ant on the level of space supra and under-tentorial. Effect of mass on the level of the aqueduct of sylvius and protuberance. Print arciform of the side wall of the sphenoid. Hypodensity of the temporal pit. Surgical clip in regard(head of arrow).

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ CT CEREBRAL, cut 5 mm lower, osseous window: print arciform on the level of the side wall of the sphenoid until compared to the optical channel. Former initially surgical way (head of arrow).

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ MRI, sequence tonic pro balanced in T2,coupe axial, TR: 19 20; TE: 50:processus occupying of the petrous apex of signal similar in this sequence to the cerebral hyperdense, discreetly heterogeneous parenchyma. Hypersignal of the cells mastoid had to their obliteration.

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ MRI, sequence balanced in T2, 2nd echo, axial cut: the formation of the petrous apex presents a hypersignal which follows the channel of the liquid cerebro-rachidian(LCR). Of the same formation signal than the LCR in the ponto-cerebellar angle, with effect of mass on the bulb on the average cerebellar stalk and the adjacent cerebellar hemisphere.

Compression mode : GROSS

Picture's date or number : 03/07/96

Comments :
@ MRI, sequence balanced in T1, cut coronale passing the internal auditory canal: hypo-intense formation, of the same signal than the LCR, filling the cistern of the ponto-cerebellar angle right, driving back the cerebral trunk and invaginating in the internal auditory canal. Prolongation in wallet of the mass, extending in under and supra-tentorial, cutting down the petrous apex, extending to the cavernous sine, driving back the carotid in its intra-cavernous portion which keeps a normal signal however.

Compression mode : GROSS

Picture's date or number : 03/07/96


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