Vestibular disorders: epidermoid cyst of the cerebellopontine angle: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Vestibular disorders: epidermoid cyst of the cerebellopontine angle

Sample item

MRI of an adult with a cerebellopontine angle lesion shows a lobulated mass that follows CSF signal on T1 and T2, does not enhance, insinuates around cranial nerves and shows restricted diffusion. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Epidermoid cyst

Epidermoid cysts mimic CSF on routine sequences but show restricted diffusion on DWI, do not enhance and grow around nerves and vessels. Arachnoid cysts also follow CSF but suppress completely on DWI. Schwannomas and meningiomas enhance avidly.

Option by option

  • A. Vestibular schwannoma

    A vestibular schwannoma enhances strongly and widens the internal acoustic canal.

  • B. Arachnoid cyst

    An arachnoid cyst follows CSF but does not restrict diffusion and tends to displace structures.

  • C. Meningioma

    A meningioma enhances with a dural tail and a broad dural base.

  • D. Epidermoid cyst (correct)

    Correct. CSF-like signal with restricted diffusion and no enhancement is characteristic of an epidermoid.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Epidermoid cyst. Epidermoid cysts mimic CSF on routine sequences but show restricted diffusion on DWI, do not enhance and grow around nerves and vessels.

Why is "Vestibular schwannoma" not the answer?

A vestibular schwannoma enhances strongly and widens the internal acoustic canal.

Why is "Arachnoid cyst" not the answer?

An arachnoid cyst follows CSF but does not restrict diffusion and tends to displace structures.

Why is "Meningioma" not the answer?

A meningioma enhances with a dural tail and a broad dural base.

What concept does this question test?

It tests Vestibular disorders: epidermoid cyst of the cerebellopontine angle in ENT. Arachnoid cysts also follow CSF but suppress completely on DWI. Schwannomas and meningiomas enhance avidly.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vestibular disorders: epidermoid cyst of the cerebellopontine angle?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.