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Clinical Problem Solving: Radiology
October 2002

Diagnosis Radiology Quiz Case 1

Author Affiliations
 

R. NICKBRYANMDS. JAMESZINREICHMD

Arch Otolaryngol Head Neck Surg. 2002;128(10):1215. doi:

The complete set of MRIs show bulbous enlargement of the left IAC, as well as meningeal thickening and enhancement of the left parietal convexity and the inferior left margin of the tentorium. The patient elected to undergo a translabyrinthine approach to the IAC. Intraoperative frozen section suggested malignant disease, which meant that the patient would require postoperative radiation therapy as the primary treatment modality. As complete tumor resection was impossible without sacrificing the seventh cranial nerve, a thorough, but incomplete dissection of the tumor was undertaken, which allowed the facial nerve to remain intact. Also, the dura over the posterior fossa remained completely intact, which avoided the possibility of the tumor spreading intradurally. The residual tumor was addressed with whole-brain radiation therapy.

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