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Congress: ECR25
Poster Number: C-25138
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-25138
Authorblock: M. Bukovac, M. Pastorčić Grgić, I. Ivković, I. Botica, A. Jovic; Zagreb/HR
Disclosures:
Martina Bukovac: Nothing to disclose
Marija Pastorčić Grgić: Nothing to disclose
Irena Ivković: Nothing to disclose
Iva Botica: Nothing to disclose
Andrijana Jovic: Nothing to disclose
Keywords: Ear / Nose / Throat, Head and neck, CT, MR, Diagnostic procedure, Infection, Neoplasia
Learning objectives To present a pictorial essay of temporal bone mass lesions.To present key features in distinguishing malignant from benign and don’t touch lesions.
Read more Background Temporal bone lesions encompass a wide range of pathologies.Imaging plays a key role in diagnosing temporal bone lesions. High-resolution CT evaluates bone anatomy, detecting destruction, remodeling, calcifications, and congenital anomalies. MRI provides detailed soft-tissue characterization, with T1 identifying hyperintense hemorrhagic, protein or cholesterol signal, T2 highlighting cystic structures, and contrast enhancement revealing vascularity or inflammation. DWI and ADC mapping are essential for identifying cholesteatomas with restricted diffusion and assessing vascularity, hemorrhage, and intracranial spread.
Read more Findings and procedure details Malignant TumorsSquamous Cell Carcinoma (SCC)Most common malignant tumor of the temporal bone, typically arising in the external auditory canal or middle ear1. On high-resolution CT, it often manifests as aggressive, “moth-eaten” bone destruction with possible extension into the mastoid air cells or petrous apex. [fig 1] MRI usually reveals an irregular, heterogeneously enhancing soft-tissue mass, with perineural invasion or intracranial extension in advanced cases.Metastatic DiseaseMetastases can originate from breast, lung, prostate, and kidney malignancies. On CT, these lesions may appear lytic...
Read more Conclusion Temporal bone imaging requires a systematic approach, combining clinical history, high-resolution CT, and MRI to distinguish treatable masses from "don’t touch" lesions. This strategy prevents unnecessary interventions and ensures timely treatment. Challenges, such as overlapping imaging features and artifacts, highlight the need for clinical correlation and multidisciplinary collaboration. Applying this approach enhances diagnostic accuracy, optimizes outcomes, and supports evidence-based care.
Read more References   De Foer B, Kenis C, Vercruysse JP, Somers T, Pouillon M, Offeciers E, Casselman JW. Imaging of temporal bone tumors. Neuroimaging Clin N Am. 2009;19(3):339–366. Shimanuki T, Nishiyama T, Hosoya M, Wakabayashi T, Ozawa H, Oishi N. Imaging of temporal bone mass lesions: a pictorial review. Diagnostics (Basel). 2023;13(16):2665. De Foer B, Vercruysse JP, Spaepen M, Somers T, Pouillon M, Offeciers E, et al. Diffusion-weighted magnetic resonance imaging of the temporal bone. Neuroradiology. 2010;52(9):785–807. Juliano AF, Ginat DT, Moonis G. Imaging review of...
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