New headache for 7 months There is no evidence of acute ischemic or hemorrhagic lesion on this scan.There is however about 10.5mmx9.8mmx15mm sized well circumscribed mass on the left parotid gland. The mass shows low signal intensity on T2, iso signal intensity with muscles on T1 with diffuse but more on peripheral enhancement on Gad infusion. On DWI and ADC map, the lesion shows restricted diffusion. These findings suggest possibility of benign neoplasm such as Warthin's tumor but a malignant lesion cannot be completely excluded thus, biopsy is recommended. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. Bilateral Pcom arteries and Acom artery are patent.There is no intracranial arterial aneurysm or arterial luminal narrowing or irregularity.
1. 10.5mmx9.8mmx15mm sized left parotid gland mass. Diagnostic possibility includes Warthin's tumor but needs to exclude malignant lesion, thus consider biopsy.2. No evidence of acute ischemic or hemorrhagic lesion. No mass.3. Normal intracranial MRA.