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Case No. 364
2015-02-02~2015-02-28
출제자 : 최진우
Hit : 356
| Period | 2015-02-02~2015-02-28 |
|---|---|
| Diagnosis | Intralabyrinthine Schwannoma |
| Clinical information | 79/M C/C : Vertigo Onset : 3 months ago |
| Discussion | Intralabyrinthine Schwannoma - Tumors arising primarily from within the membranous labyrinth: cochlea, vestibule, or semicircular canals Symptom : Hearing loss (M/C) > tinnitus, imbalance, vertigo, aural fullness The range of symptom duration ; 1–252 months (average 40 months) Treatment : Surgery is only indicated for intractable vertigo or evidence of tumor growth leaving the membranous labyrinth into the IAC or middle ear. MR findings: T2-weighted images: focal filling defects with replacement of the normal high-signal-intensity fluid Postgadolinium imaging, :focal homogeneously enhancing masses Differential Diagnosis 1. Labyrinthitis : Diffuse enhancement or In rare case of focal enhancement : no soft-tissue mass or filling defect in the labyrinth 2. Labyrinthitis ossificans : History of previous meningitis or suppurative otomastoiditis. Thin section temporal bone CT scan ; bony encroachment on the membranous labyrinth. 3. Hemorrhage and lipoma, though rare, : Precontrast T1-weighted imaging : high signal intensity without enhancement. References 1. Intralabyrinthine Schwannomas: Imaging Diagnosis and Classification AJNR 2012 33 ; 104-109 |
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