PMC4273534_01
Axial (a) and coronal (b) CT images demonstrating a destructive abnormality (black arrows demarcating extent) involving the right geniculate ganglion extending into the right attic and eroding the bone around the right cochlea.
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Computed tomography (CT) demonstrated that bone around the right geniculate ganglion and right cochlea was eroded with extension into the roof of the attic (Figure 1). Imaging review (Figures 1 and 2) alongside further diffusion weighted MRI showing a lesion with restricted diffusion meant that a congenital cholesteatoma was more likely (Figure 3).
Pre- (a) and postcontrast (b) T1 weighted axial MRI imaging showing a largely isointense signal abnormality at the site of the mass seen on CT. There is no significant enhancement (white arrows).
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However, the mass on MRI was isointense to brain and showed no enhancement suggesting that a vestibular schwannoma was unlikely (Figure 2). Imaging review (Figures 1 and 2) alongside further diffusion weighted MRI showing a lesion with restricted diffusion meant that a congenital cholesteatoma was more likely (Figure 3).
ADC imaging (a) and diffusion imaging (b) demonstrating restricted diffusion of lesion (white arrows).
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Imaging review (Figures 1 and 2) alongside further diffusion weighted MRI showing a lesion with restricted diffusion meant that a congenital cholesteatoma was more likely (Figure 3).