Multimedia
 | Media file 1: Elderly woman with chronic headaches. A nonenhanced computed tomography (CT) scan of the head demonstrates a well-circumscribed, cystic, low-attenuating lesion located at the cranial midline in the suprasellar region, posterior to the third ventricle. A small focus of calcification is noted at the posterior margin of the tumor. |
 | Media file 2: The suprasellar lesion (same patient as in Image 1) is hypointense on a subsequent axial T1-weighted image. The crescentic posterior rim of hyperintensity represents the fat chemical–shift artifact. |
 | Media file 3: Gadolinium-enhanced axial T1-weighted image demonstrating nodular focus of enhancement in the right side of the suprasellar lesion (same patient as in Images 1-2). |
 | Media file 4: Axial T2-weighted fast spin-echo magnetic resonance image demonstrating a hyperintense cystic component in the lesion (same patient as in Images 1-3). |
 | Media file 5: Coronal computed tomography (CT) scan of the paranasal sinuses in a 26-year-old man with sinusitis. A large, well-circumscribed, low-attenuating, cystic lesion is present in the right temporal lobe, lateral to the cranial midline. Note the peripheral, marginal calcification in the lesion. No erosion is seen in the adjacent bone of the sella. |
 | Media file 6: Contrast-enhanced axial computed tomography (CT) scan of the same lesion as in Image 5 shows partial marginal enhancement. The attenuation measurements in the center of the lesion are consistent with fat. |
 | Media file 7: Axial gadolinium-enhanced T1-weighted image demonstrating a hyperintense signal (same lesion as in Images 5-6. In addition, multiple small foci of hyperintense signal are present along the sulci of the right temporal lobe. These represent fat droplets in the subarachnoid space, left by the focal rupture of the dermoid tumor. |
 | Media file 8: The lesion (the same as in Images 5-7) is hyperintense on this gadolinium-enhanced coronal T1-weighted image. Note the heterogeneity of the lesion posteriorly. The hyperintensity results not from the gadolinium contrast enhancement but instead from the short T1 of fat. Multiple hyperintense foci consistent with fat droplets are demonstrated in the subarachnoid spaces. A mild midline septal shift to the left is noted; this is due to compression of the right lateral ventricle by the dermoid tumor. A chemical-shift artifact is also noted at the superior marginal surface of the lesion. |
 | Media file 9: Sagittal T1-weighted image of the same lesion as in Images 5-8 again demonstrating hyperintensity consistent with fat content. |
 | Media file 10: This epidermoid tumor is isointense relative to cerebrospinal fluid (CSF) on a nonenhanced T1-weighted axial image. The lobulated extra-axial mass surrounds the right cerebral peduncle and extends to the suprasellar region and the interpeduncular cistern. In contrast, a dermoid tumor will demonstrate a high T1 signal intensity because it contains fat constituents. |
 | Media file 11: Epidermoid tumor (same as in Image 10) demonstrating no enhancement in this contrast-enhanced T1-weighted image. |
 | Media file 12: T2-weighted axial image demonstrating a hyperintense signal (in the same epidermoid tumor as in Images 10-11) that is similar to the signal intensity of cerebrospinal fluid (CSF). Compression by the epidermoid tumor mass has widened the interpeduncular cistern and narrowed the right cerebral peduncle. |
 | Media file 13: Coronal T1-weighted image demonstrating a hypointense epidermoid tumor (same tumor as in Images 10-12). Note that the epidermoid has higher signal intensity than the adjacent CSF. There is a compressive mass effect on the third ventricle, but hydrocephalus is minimal. |
 | Media file 14: Sagittal T1-weighted image demonstrating the suprasellar, prepontine, and interpeduncular cistern location of the epidermoid tumor (same tumor as in Images 10-13). |
More on Dermoid Tumor, CNS |
| Overview: Dermoid Tumor, CNS |
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References
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Further Reading
Keywords
dermoids, dermoid cysts, inclusion cysts, congenital epidermoid tumors, acquired epidermoid tumors, brain tumor, spinal dermoid tumors
