Weekly Image Challenge – July 30, 2023

What is the most likely diagnosis for this 43-year-old lady who had headaches & generalized tonic-clonic seizures for 1 year?

  1. Arachnoid cyst
  2. Schwannoma
  3. Epidermoid cyst
  4. Pilocytic astrocytoma
  5. Abscess

Answer

Congratulations to those who diagnosed it as an epidermoid cyst. Diffusion restriction is the key factor differentiating it from an arachnoid cyst. Pilocytic astrocytoma can be cystic but there is an enhancing mural nodule as well.