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Clinical Problem Solving: Radiology
July 2002

Diagnosis Radiology Quiz Case

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(7):856. doi:

Endolymphatic sac tumors (ESTs) are predominantly found in female patients approximately 25 to 35 years of age. To our knowledge, there have been no reports of ESTs in children. The duration of symptoms before diagnosis is usually long, ranging from several months to 30 years. The symptoms are primarily otologic but nonspecific, consisting of tinnitus, progressive or sudden loss of hearing, and vertigo.1 Hearing loss always occurs and leads to diagnosis of the disorder in 60% of cases.1 Facial paralysis is present at the time of the diagnosis in 30% to 40% of cases.1 The condition is local, with no metastasis described in the literature. Long-term follow-up shows periods of rapid growth, which suggests hemorrhage around the tumor.2

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