Papillary endolymphatic sac tumors: CT, MR imaging, and angiographic findings in 20 patients

Radiology. 1997 Mar;202(3):801-8. doi: 10.1148/radiology.202.3.9051037.


Purpose: To determine the computed tomographic (CT), magnetic resonance (MR) imaging, and angiographic findings of papillary endolymphatic sac tumors.

Materials and methods: Clinical and imaging studies in 20 patients (aged 17-65 years) with histopathologically proved papillary endolymphatic sac tumors were retrospectively reviewed. Patients underwent CT (n = 18), MR imaging (n = 15), or angiography (n = 12). CT scans were evaluated for bone erosion and calcification; MR images, for signal intensity, enhancement patterns, and flow voids; and angiograms, for tumoral blood supply.

Results: All tumors were destructive and contained calcifications centered in the retrolabyrinthine region at CT. The MR imaging appearance varied with lesion size; 12 of 15 tumors showed increased signal intensity at T1-weighted imaging. The high-signal-intensity area was circumferential in lesions 3 cm or smaller and was scattered throughout the lesion in advanced tumors. Only tumors larger than 2 cm had flow voids. The blood supply arose predominantly from the external carotid artery. Large tumors had additional supply from the internal carotid and posterior circulation.

Conclusion: Papillary endolymphatic sac tumors are destructive, hypervascular lesions that arise from the temporal bone retrolabyrinthine region. Increased signal intensity at unenhanced T1-weighted MR imaging is common and may help distinguish these lesions from more common, aggressive temporal bone tumors.

MeSH terms

  • Adenocarcinoma / blood supply
  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / diagnostic imaging
  • Adenoma / blood supply
  • Adenoma / diagnosis*
  • Adenoma / diagnostic imaging
  • Adolescent
  • Adult
  • Aged
  • Angiography*
  • Carotid Artery, External / diagnostic imaging
  • Diagnosis, Differential
  • Ear Neoplasms / blood supply
  • Ear Neoplasms / diagnosis*
  • Ear Neoplasms / diagnostic imaging
  • Endolymphatic Sac*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed*
  • Vestibular Diseases / diagnosis*
  • Vestibular Diseases / diagnostic imaging