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RSNA-COTD Infected Dermoid Cyst

Nguyen TKN - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: RSNA-COTD Infected Dermoid Cyst

History: 21 month old male with high fever, mental status changes and possible seizure.

Findings: Contrast head CT is significant for a multiloculated cystic posterior fossa midline mass that is adjacent to the torcula with a portion extending into the occipital calvarium. This mass is low in density with HU measuring 17. There is rim enhancement with several internal septations. There is distortion of the 4th. ventricle with associated dilatation of the temporal horns. Bone windows demonstrate smooth calvarial remodeling of the occiput with a small focal dehiscence within the bone that may represent a sinus tract. The overlying skin is unremarkable. Brain MRI again demonstrates this intra- extraaxial posterior fossa mass with homogeneous increased T2 , decreased T1 signal. DWI demonstrates marked restricted diffusion which darkens on the ADC map suggesting an abscess, epidermoid,dermoid or other process with restricted diffusion. Mass effect with hydrocephalus is again demonstated. Findings are consistent with a multiloculated intra and extraaxial posterior fossa mass most consistent with cerebritis/abscess. Given the bony remodeling and midline location, findings are most consistent with a congenital process such as dermoid which has become secondarily infected.

Ddx: Epidermoid Arachnoid Cyst Hemangioblastoma Cystic Astrocytoma

Dxhow: Pathology

Exam: On admission, the patient was febrile and irritable.Physical examination revealed a palpable soft tissue nodule over the occiput. CSF and laboratory examinations were consistent with bacterial meningitis.

No MeSH data available.


Multiloculated intra- and extra-axial posterior fossa mass
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MPX1387_synpic17044: Multiloculated intra- and extra-axial posterior fossa mass


RSNA-COTD Infected Dermoid Cyst

Nguyen TKN - MedPix

Multiloculated intra- and extra-axial posterior fossa mass
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1387&req=5

MPX1387_synpic17044: Multiloculated intra- and extra-axial posterior fossa mass

View Article: MedPix Image - MedPix Case

Affiliation: Naval Medical Center San Diego

ABSTRACT

Diagnosis: RSNA-COTD Infected Dermoid Cyst

History: 21 month old male with high fever, mental status changes and possible seizure.

Findings: Contrast head CT is significant for a multiloculated cystic posterior fossa midline mass that is adjacent to the torcula with a portion extending into the occipital calvarium. This mass is low in density with HU measuring 17. There is rim enhancement with several internal septations. There is distortion of the 4th. ventricle with associated dilatation of the temporal horns. Bone windows demonstrate smooth calvarial remodeling of the occiput with a small focal dehiscence within the bone that may represent a sinus tract. The overlying skin is unremarkable. Brain MRI again demonstrates this intra- extraaxial posterior fossa mass with homogeneous increased T2 , decreased T1 signal. DWI demonstrates marked restricted diffusion which darkens on the ADC map suggesting an abscess, epidermoid,dermoid or other process with restricted diffusion. Mass effect with hydrocephalus is again demonstated. Findings are consistent with a multiloculated intra and extraaxial posterior fossa mass most consistent with cerebritis/abscess. Given the bony remodeling and midline location, findings are most consistent with a congenital process such as dermoid which has become secondarily infected.

Ddx: Epidermoid Arachnoid Cyst Hemangioblastoma Cystic Astrocytoma

Dxhow: Pathology

Exam: On admission, the patient was febrile and irritable.Physical examination revealed a palpable soft tissue nodule over the occiput. CSF and laboratory examinations were consistent with bacterial meningitis.

No MeSH data available.