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  3. Warthin tumor/ intracanalicular vestibular schwannoma

Warthin tumor/ intracanalicular vestibular schwannoma

Findings:
Heterogeneously enhancing lesion is noted in the intracanalicular segment of the right internal auditory canal measuring about 11 x 4.3 mm and mildy expanding into the right cerebellopontine angle. No significant mass effect.
The brain parenchyma is unremarkable. The ventricles and sulcal spaces are within normal limits. There is no midline shift.

A well-defined rounded mass is seen in the retromandibular right parotid tail measuring approximately 3 x 2.3 cm in axial dimensions and 3.1 centimeters superoinferiorly. The lesion elicits hypoattenuating signal on the T1 sequence with heterogenous, predominantly high T2 signal and heterogenous enhancement. Medially the lesion extends into the deep lobe of the parotid.
Anteriorly the lesion abuts the retromandibular vein and external carotid artery. No extra-capsular extension.
7 x 5 mm measuring right parotid lymph node is seen.
Borderline bilateral submandibular space lymph nodes.
The left parotid is unremarkable.

Hyperostosis frontalis interna is noted. The orbits, paranasal sinuses and mastoid air cells are clear.

Conclusion:
Known, intracanalicular vestibular schwannoma on the right.
Heterogeneously enhancing, partially cystic mass lesion in the right parotid tail, suspicious of Warthin tumor, DDX salivary gland neoplasm. Histological evaluation is advised.

Updated on 7. June 2023

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