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J Neurol Surg Rep 2015; 76(01): e18-e22
DOI: 10.1055/s-0034-1390020
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Aneurysmal Bone Cyst of the Temporal Bone Presenting with Headache and Partial Facial Palsy

Stephanie N. Kletke
1   Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Snezana Popovic
2   Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
,
Almunder Algird
3   Division of Neurosurgery, McMaster University, Hamilton, Ontario, Canada
,
Abdullah Alobaid
3   Division of Neurosurgery, McMaster University, Hamilton, Ontario, Canada
,
Kesava K. V. Reddy
3   Division of Neurosurgery, McMaster University, Hamilton, Ontario, Canada
› Author Affiliations
Further Information

Publication History

23 February 2014

07 July 2014

Publication Date:
16 January 2015 (online)

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Abstract

Background Aneurysmal bone cysts (ABCs) are benign bony lesions that rarely affect the skull base. Very few cases of temporal bone ABCs have been reported. We describe the first case of a temporal bone ABC that was thought to be consistent with a meningioma based on preoperative magnetic resonance imaging (MRI) findings.

Clinical Presentation An otherwise healthy 23-year-old woman presented with a pulsatile noise in her left ear and a 4-week history of throbbing headache with nausea. There was no associated emesis, visual or auditory changes, or other neurologic features. Neurologic examination revealed a left lower motor neuron facial paresis. Computed tomography and MRI studies demonstrated a large lesion in the left middle cranial fossa skull base with erosion of the petrous temporal bone. Based on the presence of a “dural tail” on preoperative contrast-enhanced T1-weighted imaging, the lesion was interpreted to likely be consistent with a meningioma. An orbitozygomatic approach was utilized for surgical excision. Histopathologic evaluation was consistent with an ABC.

Conclusion Postoperatively the patient had improvement in the lower motor neuron facial paresis. It is important to consider ABC in the differential diagnosis of intracranial lesions accompanied by the dural tail sign on MRI.

Keywords

aneurysmal bone cyst - dural tail sign - skull base - temporal bone
 

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