Fig 3.

A 1-month-old boy with a 1-month history of left facial weakness and otorrhea (patient 4). A, Coronal T2-weighted MR image shows a mass that is hypointense compared with the cortex. Tumor involves the infratemporal fossa (long arrow), erodes the skull base and tegmen tympani, and involves the middle ear space (arrowhead) and epidural space in the middle cranial fossa. There is edema of the adjacent temporal lobe (short arrow). Scalp swelling is due to recent surgical debulking of the intracranial component at another institution. B, Coronal contrast-enhanced, fat-suppressed T1-weighted MR imaging shows the homogeneously enhancing mass extending into the middle ear space and the epidural space (arrow). C, On this axial DWI ADC image, the lesion (arrows) demonstrates decreased diffusivity. Axial CT image (D) shows lytic destruction of the mastoid temporal bone retroauricular cortex (short arrow). Tumor extends into the left middle ear space with erosion of the short process of the incus (long arrow) along its medial aspect and erosion of the otic capsule bone around the oval window and lateral semicircular canal (arrowhead).