Female, 56 years old, with history of right-sided cholesterol granuloma, slow tumor regrowth status post resection, yearly surveillance examination. No new symptoms. Prior history of hearing loss. Redemonstrated is evidence of right middle cranial fossa and mastoid approach surgery for the right petrous apex lesion. As before, a small amount of the right cerebellum prolapses into the mastoid surgical defect.A lobular T1 hyperintense, T2 heterogeneous lesion is again seen affecting a majority of the right petrous apex. This lesion seems to have increased slightly in size now measuring 31 x 24 mm (on axial image 9 of series 1001), previously 29 x 22 mm.As before, this lesion exerts mass effect upon the right aspect of pons as well as the cisternal segment of the right cranial nerve five and the right seventh/eighth nerve complex. The lesion also encroaches upon the right Meckel's cave.As on prior examinations, the right IAC is deformed by this lesion. Also noted is lack of complete visualization of the fluid-filled structures of the right cochlea and vestibular system.A bubbly T2 hyperintense lesion with a rim of hemosiderin staining in the right centrum semiovale is unchanged and compatible with a cavernoma. No other significant parenchymal lesions are seen. No pathologic parenchymal enhancement is detected. The ventricular system is stable in size and configuration.
1.Slight interval increase in the size of a right petrous apex cholesterol granuloma.2.No other significant interval changes.