MR imaging, CT, and angiography features of endolymphatic sac tumors: report of two cases

Abstract

Low-grade adenocarcinoma of endolymphatic sac origin is a rare tumor of the temporal bone. There are some difficulties in its differential diagnosis from other vascular and non-vascular tumors of the temporal bone. However its radiological differentiation from other tumors of the temporal bone is important for surgical planning. We present a report on two endolymphatic sac tumors with some specific radiological findings which can support a correct diagnosis.

Imaging features of endolymphatic sac tumours: case report with review of literature

“…Flow voids are generally absent in small tumours 10 . Similar findings were reported by Baltacioglu et al in their report of two cases of ELSTs measuring less than 3 cm 11 …”

“…However, the primary retrolabyrinthine location and intratumoural bone are characteristic of ELSTs, while infralabyrinthine location and flow voids on MR are characteristic of paragangliomas larger than 2 cm 14 . Discrete tumour blush with early venous drainage is seen on angiography in paragangliomas as compared with ill‐defined temporal blush with lack of early venous drainage in ELSTs 11 . The other differential diagnosis include choroid plexus papillomas of the foramen of luschka, meningiomas and schwannoma, all of which show dense contrast enhancement and do not have destructive properties.…”

“…10 Similar findings were reported by Baltacioglu et al in their report of two cases of ELSTs measuring less than 3 cm. 11 Although small ELSTs show characteristic imaging features, those of larger tumours are variable with difficulty in localizing their centre. There is extensive aggressive bone destruction which is surgically important as radical resection is required to prevent recurrence.…”

“…14 Discrete tumour blush with early venous drainage is seen on angiography in paragangliomas as compared with ill-defined temporal blush with lack of early venous drainage in ELSTs. 11 The other differential diagnosis include choroid plexus papillomas of the foramen of luschka, meningiomas and schwannoma, all of which show dense contrast enhancement and do not have destructive properties. In addition, extension into the IAC is characteristic of schwannoma while a dural tail accompanied with sclerotic/hyperostotic bone changes is characteristic of meningioma.…”

Metastatic Squamous Carcinoma with Features Typical of an Endolymphatic Sac Tumor

“…cularly in the region of the posterior semicircular canal, best seen on high-resolution axial computed tomography scan of bony windows (2,3).…”