CALCIFIED MASS

Q.A 35-year-old woman has noticed that over the past 3 to 5 months she has had some difficulties with balance, particularly when she closes her eyes. On examination, she has decreased hearing in her left ear and also left body dysdiadochokinesia. Her physician orders a head CT. Given this CT scan, which was obtained without contrast enhancement, the physician must assume that the posterior fossa mass at the arrow is-
a. Normal
b. Calcified
c. Highly vascular
d. Granulomatous
e. Highly cystic

Ans: b. calcified.
Exp:

Calcified masses appear hyperdense without contrast enhancement,

 whereas highly vascular lesions may

appear dense on CT scanning after the patient has received intravenous contrast material. Tumors, granulomas, and other intracranial lesions enhance

because of a breakdown in the blood-brain barrier. More cystic lesions may

exhibit enhancement limited to the periphery of the cyst.



Q. If a patient exhibits café au lait spots and reports a family history of bilateral hearing loss at a relatively young age, a gene abnormality should be suspected on chromosome-
a. 5
b. 13
c. 17
d. 21
e. 22 

Ans: e. 22.
Exp:

Meningiomas occur with increased frequency in type 2 neurofibromatosis, a dominantly inherited disorder arising

with a deletion on the long arm of chromosome 22. Women with breast

cancer and other gynecologic cancers are also at increased risk of developing

meningiomas, perhaps because of sex steroid receptors on these tumors

that enhance their growth when gynecologic disturbances occur. Estrogen

or progesterone antagonists may be useful in the management of these

tumors, but tamoxifen, an estrogen inhibitor, paradoxically stimulates the

growth of meningioma cells .