Incidental detection of recurrent cholesteatoma in a patient being evaluated for an unrelated indication. Incidental detection of recurrent cholesteatoma.

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Presentation transcript:

Incidental detection of recurrent cholesteatoma in a patient being evaluated for an unrelated indication. Incidental detection of recurrent cholesteatoma in a patient being evaluated for an unrelated indication. A, A 68-year-old woman with a history of 2 prior tympanomastoidectomies for cholesteatoma underwent MR imaging for unrelated reasons (meningioma evaluation) and was found to have increased DWI signal intensity (arrow) in the left temporal bone on EPI-DWI. B−D, This area is isointense on T2 (arrow, B) and T1 (arrow, C) and shows mild peripheral enhancement (arrow, D). E and F, Temporal bone CT shows soft-tissue opacification of the mastoid bowl, epitympanum, and mesotympanum (arrow, E) with thinning of the tegmen tympani (arrow, F). Surgery confirmed cholesteatoma in the area of DWI hyperintensity, with surrounding granulation tissue and encephalocele in the areas of soft-tissue opacification on CT without corresponding DWI abnormality. Fig 6A, B, and E reproduced with permission from Ear, Nose & Throat Journal (Schwartz KM, Lane JI, Neff BA, et al. Diffusion-weighted imaging for cholesteatoma evaluation. 2010;89:E14-19).32 K.M. Schwartz et al. AJNR Am J Neuroradiol 2011;32:430-436 ©2011 by American Society of Neuroradiology