Table 2.
Patient | Imaging study | Time to 1st image | 1st image at other hospital | No of imaging before diagnosis | Initial imaging finding | Time interval to follow up image | Interval progression | Reason for diagnostic delay |
---|---|---|---|---|---|---|---|---|
1 Skin SCC |
MR Head | 13 | no | 2 | FN enhancement | 9 | More prominent FN enhancement | Nonspecific FN enhancement |
2 Parotid ACC |
MR Head | 5 | yes | 1 |
Normal (report only, other hospital) |
N/A* | N/A | Normal in initial MR |
3 Skin SCC |
MR Head | 14 | yes | 2 | Normal | 6 | Multiple cranial nerve enhancement | Normal in initial MR |
4 Parotid ACC |
MR Head | 5 | yes | 2 | FN enhancement | 11 | More prominent FN enhancement | Nonspecific FN enhancement |
5 Skin SCC |
MR Head | 3 | yes | 2 |
Normal (report only, other hospital) |
24 | Multiple cranial nerve enhancement | Unknown |
6 Skin SCC |
MR Head | 6 | yes | 2 |
Normal (report only, other hospital) |
7 | abnormal enhancement in FN and parotid gland | Unknown |
7 Facial nerve schwannoma |
MR Head | 4 | yes | 2 |
Normal (report only, other hospital) |
2 | Facial nerve focal tumor | Unknown |
8 Facial nerve schwannoma |
MR Head | 6 | yes | 2 |
Normal (report only, other hospital) |
174 | Facial nerve focal tumor | Unknown |
9 Parotid malignancy |
MR Head | 5 | yes | 3 |
Normal (report only, other hospital) |
12 | Parotid tumor with multiple neck metastasis | Misdiagnosis† |
No number; FN facial nerve; SCC squamous cell carcinoma; ACC adenoid cystic carcinoma
*The occult tumor was identified at exploration surgery without follow-up MR
†Although the formal radiologic reports of the initial MR image from the radiologist at the outside hospital were compatible with Bell’s palsy, our neuroradiologist re-evaluated the initial MR image and found a small suspicious lesion in the parotid deep lobe