AJR teaching file: facial mass in a child.

摘要

Clinical History A 3-year-old girl with a medical history of shunted hy-drocephalus, seizures, and cranial reconstruction for cranial synostosis at 7 months of age, presents to the emergency department after a fall. Physical examination reveals a palpable mass. Previous MRI at birth revealed no mass lesions. CT and MRI were performed. Radiologic Description An axial unenhanced CT scan obtained using the soft-tissue window setting shows a well-circumscribed, isodense mass in the right masticator space (Fig. 1A). Axial unenhanced CT scan obtained using the bone window setting shows erosion of the right mandibular ramus and the right temporal bone (Fig. IB). Axial T1-weighted image shows a mixed-signal (isointense to hyperintense) lesion in the right masticator space (Fig. 1C). Coronal T2-weighted image shows a mixed-signal (isointense to hyperintense) lesion in the right masticator space (Fig. ID). A coronal contrast-enhanced fat-saturated Tl-weighted image shows homogeneous enhancement and extension of the mass into the right infratemporal fossa (Fig. IE).