Intradural dermoid cyst with complete dermal sinus of the posterior fossa: Contribution of 3D imaging with histopathological correlation

A 5-year-old girl who presented with two episodes of meningitis, had a patchy red area and a small skin dimple in the midline of the occiput on physical examination. Imaging revealed a well-demarcated oval intradural lesion of the posterior fossa with restricted diffusion and peripheral enhancement, raising the possibility of an abscess. The 3D volume rendering of CT images of the inner surface of bone showed chronic bone remodeling and a tiny bone defect of the outer table. This detailed anatomical evaluation has an added value to MRI characteristics to orient for a preoperative diagnosis of an intradural dermoid cyst with a dermal sinus, that was confirmed by histopathological analysis after surgical excision.     

Dermal sinus with dermoid cyst in the upper cervical spine: case note

We describe a 5 year-old girl who had a skin dimple of the back of her upper neck. MRI showed a dermal sinus tract in the upper cervical spine, associated with an intramedullary dermoid cyst at C 2–3, and spina bifida. A laminectomy was performed, the dermoid cyst and the sinus tract were completely removed. This congenital complex is very rare. Received: 28 March 1999/Accepted: 4 May 1999     

MR of multiple intraspinal abscesses associated with congenital dermal sinus.

We describe the MR features in a case of multiple intraspinal abscesses involving almost the whole of the spinal cord in a 3-year-old child. The presence of a dermal sinus helped us in the preoperative diagnosis.     

Nasal dermoid cyst with a sinus tract extending to the frontal dura mater: MRI

We report a child with a nasal dermoid cyst, the intracranial extension of which was shown on contrast-enhanced MRI, facilitating complete surgical removal Received: 10 October 1996 Accepted: 10 December 1996     

Thoracocervical dorsal dermal sinus associated with multiple vertebral body anomalies

Congenital dermal sinus is a type of closed spinal dysraphism. Cervical and thoracic regions are the rare sites for dorsal dermal sinuses. Dermal sinuses are frequently associated with dermoid or epidermoid tumor and osseous abnormalities such as bifid spinous process. The association of dorsal dermal sinuses with vertebral body anomalies is very rare. We present MR imaging features of a case of thoracocervical dorsal dermal sinus associated with multiple vertebral body anomalies.     

CT and MR appearance of multiple intracranial lesions associated with suprasellar dermoid cyst

Multiple lesions associated with suprasellar dermoid cyst are well demonstrated preoperatively on computed tomography (CT) and magnetic resonance (MR) imaging. Although the presence of multiple fatty globules in ventricles and/or subarachnoid space has been thought to be evidence of ruptured dermoid cyst, there are no signs or symptoms, including operative findings, attributable to dermoid cyst rupture in our case. The distinctive CT and MR appearance is described and possible etiology of the multiple lesions is discussed.     

Computed tomography of the trapped fourth ventricle.

A dilated fourth ventricle due to outlet obstruction is a clinical-radiologic entity with symptoms similar to those of a posterior fossa space-occupying lesion. Computed tomography reveals cystic dilatation of the fourth ventricle and hydrocephalus supratentorially. Frequently the symptoms resolve completely and the fourth ventricle returns to normal following lateral ventricular shunting. If there is actual obliteration of the aqueduct, the fourth ventricle must be shunted directly. While the exact mechanism by which the fourth ventricle becomes trapped is not fully known, outlet obstruction must be present. It is most frequently related to previous episodes of meningitis or subarachnoid hemorrhage. In a review of 48 cases of an abnormally enlarged fourth ventricle demonstrated on CT, six were found to have a trapped fourth ventricle. Careful attention to densities and configurations on CT allows its differentiation from other lesions such as cystic tumors and cysts.     

Wegener granuloma in the fourth ventricle

We report the case of a 57-year-old man with a known history of antineutrophil cytoplasmic antibody-positive Wegener granulomatosis with initial involvement of the upper and lower respiratory tract. MR imaging of the brain was performed because of new onset CNS symptoms (nausea, altered mental status). The images revealed a mass in the fourth ventricle. The mass diminished in size after systemic steroid treatment, as shown by follow-up MR imaging. The patient died in acute respiratory distress secondary to pneumonia. Histopathologic findings confirmed a Wegener granuloma of the fourth ventricle.     

MRI findings of an ovarian dermoid cyst with malignant transformation.

The ovarian dermoid cyst is the most common ovarian tumor. However, malignant transformation developing from a dermoid cyst is very rare. Because of this rarity, few reports exist of preoperative diagnosis of this tumor by MRI. We report MRI findings from a 69-year-old patient with a malignant transformation (squamous cell carcinoma with sarcomatoid features) in a right ovarian dermoid cyst.     

Angiography of incomplete lobulation of the cerebellar vermis with small fourth ventricle associated with callosal hypoplasia

Summary Primary calcium oxalosis is a rare, inherited metabolic disease that is associated with calcium oxalate deposits in both renal and extrarenal tissues. An unusual angiographic appearance results from subintimal oxalate crystal deposition.     

颈部皮样囊肿伴肉芽肿超声表现1例

患者女,35岁。自诉6年前发现颈前一无痛包块,渐长大,近1年又见一包块,来我院就诊。查体:颈前正中线的两侧隆起,皮肤无红肿,可触及3 cm×3 cm和4 cm×3 cm 2个包块,质软,无压痛,不随吞咽动作上下活动。余未见异常。超声检查:颈前正中线的左右侧分别见2·2 cm×2·0 cm,3·8 cm×     

Imaging study of ossifying fibroma with associated aneurysmal bone cyst in the paranasal sinus

Objective

To determine the CT and MR imaging features of ossifying fibroma with aneurysmal bone cyst of the paranasal sinus.

Materials and methods

We retrospectively reviewed 15 patients with histopathology-proven ossifying fibromas with aneurysmal bone cysts in the paranasal sinus. All 15 patients underwent CT and MR imaging. The following imaging features were reviewed: location, shape, margin, CT findings, and MR imaging appearances and time-intensity curve of dynamic contrast-enhanced MR imaging.

Results

Ossifying fibromas occurred in the maxillary sinus in one patient, sphenoid sinus in 2, frontal sinus in 3, frontoethmoid sinuses in 3, and ethmoid sinus in 6 patients. Ossifying fibromas showed an elliptic-shape and aneurysmal bone cysts revealed a multicystic appearance, with well-demarcated margins. On unenhanced CT, ossifying fibromas appeared isodense to gray matter with scattered calcifications in nine, ground-glass appearance in 6 patients and aneurysmal bone cysts showed mixed density. Ossifying fibromas appeared isointense to gray matter in 12 and slightly hypointense in three patients on T1-weighted images, and isointense in 4 and hypointense in eleven patients on T2-weighted images, with moderate or marked enhancement after administration of contrast material. The time-intensity curves of eight ossifying fibromas exhibited a rapidly enhancing and rapid washout pattern. The intracystic components of aneurysmal bone cysts showed heterogeneous signal intensity on MR images, with fluid–fluid levels identified clearly by T2-weighted images, without enhancement. The periphery and septa of aneurysmal bone cysts appeared isointense on MR images, with marked enhancement.

Conclusions

Fluid–fluid levels within an elliptic-shape mass with scattered calcifications or ground-glass appearance is highly suggestive of this complicated entity in the paranasal sinus.     

Unusual imaging appearance of an intracranial dermoid cyst.

Intracranial dermoid cysts have characteristic CT and MR imaging findings that generally make preoperative diagnosis straightforward. Enhancement of uncomplicated intradural dermoid cysts on CT or MR studies has been reported but is rare. We present a case of a posterior fossa dermoid cyst that was not only hyperattenuating on CT scans but also contained a mural nodule with clear evidence of enhancement on MR images.