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White epidermoid cyst

Case contributed by Elshan Abdullayev
Diagnosis probable

Presentation

Dizziness for around one year.

Patient Data

Age: 15 years
Gender: Male

Brain

mri

There is a rounded T1, T2, FLAIR hyperintense lesion which is favored to lie within the cerebellar parenchyma, although may be within the 4th ventricle. No perilesional edema. There are several regions of diffusion restriction, with no significant contrast enhancement. The fourth ventricle is largely effaced, although no hydrocephalus is demonstrated.

Case Discussion

The lesion is most compatible with a white epidermoid cyst. Epidermoid cysts are typically T1 isointense and FLAIR hypointense but in this case, we see T1 and FLAIR hyperintensity probably due to high protein content.

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