Imaging Quiz Case 1
André Cheng; John K. Niparko, MD; Baltimore, Md
A 37-YEAR-OLD man presented with a 3-year history of diminished hearing, persistent fullness, and pulsatile tinnitus of the left ear. He experienced frequent bouts of otitis media with serous effusions that did not respond to antibiotic therapy or myringotomy and tube placement. He was otherwise healthy.
Otoscopic examination revealed a highly vascularized lesion of the left middle ear space effacing the left tympanic membrane. The lesion did not blanche with positive pressure. The findings of the rest of the head and neck examination were unremarkable.
An audiogram showed mild conductive hearing loss in the left ear. A computed tomographic scan (Figure 1), a magnetic resonance imaging scan (Figure 2), and an angiogram (Figure 3) were obtained.
What is your diagnosis?
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