Mucous retention cyst of temporal bone: a mimic of cholesteatoma on DW-MRI

Use of Non-Echo-Planar Diffusion-Weighted MR Imaging for the Detection of Cholesteatomas in High-Risk Tympanic Retraction Pockets

“…False-negatives are rare, often caused by motion artifacts or self-evacuating "mural" cholesteatomas, and false-positives are very infrequent. 10,12,15,30 Other advantages to DWI are its short acquisition times (2-5 minutes) and avoidance of intravenous contrast. 22,31 One of the most studied uses for non-EP DWI in middle ear disease is as an alternative to second-look surgery in canal wall-up mastoidectomies, 32 in which the posterior wall of the external ear canal is preserved.…”

Primary mucocele of the mastoid: An incidental finding

“…The presence of hyperintense foci on DWI sequence depends on restriction of fluid content. Rim enhancement after gadolinium enhancement indicates peripheral inflammatory tissue …”

“…Rim enhancement after gadolinium enhancement indicates peripheral inflammatory tissue. 1 Classical treatment of mucoceles is marsupialization, enlarging the usual drainage pathways, while sparing the mucosa. In case of mastoid mucoceles, surgical treatment is indicated because of their expansive tendency causing bone erosion and invasion of surrounding structures with the risk of developing infections and intra-extracranial complications.…”

“…Mucoceles can be primary or secondary to chronic inflammation, trauma, scarring from previous surgery, or radiotherapy and more rarely neoplasms. The obstruction of a natural drainage pathway is considered the pathogenetic basis of a mucocele, although a mucous retention cyst that gradually enlarges has been suggested as an alternative hypothesis in temporal bone . Within temporal bone, primary or secondary mucoceles have been only rarely observed with few descriptions prevalently in the mastoid .…”

“…The obstruction of a natural drainage pathway is considered the pathogenetic basis of a mucocele, although a mucous retention cyst that gradually enlarges has been suggested as an alternative hypothesis in temporal bone. 1,2 Within temporal bone, primary or secondary mucoceles have been only rarely observed with few descriptions prevalently in the mastoid. [1][2][3][4][5][6][7][8][9][10][11] We present a new case of primary mastoid mucocele that was an incidental finding during work-up for progressive sensorineural hearing loss.…”