Today's Medical Mysterie
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https://pubs.rsna.org/doi/10.1148/radiol.230033
A 52-year-old woman presented with a painless, gradually enlarging scalp swelling that had been present since childhood. At examination, there was a 15 × 10 × 12–cm mass in the parieto-occipital region. MRI scan showed a large cystic lesion in the subgaleal plane of the scalp. It was hypointense with T1-weighted images and hyperintense with T2-weighted images and contained multiple nodules of varying sizes floating in the cyst, giving it a “sack of marbles” appearance (Figure). The nodules had thick outer rims that were iso- to hyperintense with T1-weighted sequences and hypointense with T2-weighted sequences and thin inner cores that were hypointense with T1-weighted sequences and hyperintense with T2-weighted sequences. The nodules demonstrated restricted diffusion (Figure) and had low apparent diffusion coefficient values. After completing surgical excision, the cyst was found to contain sebum-like material, hard spherules, and multiple strands of hair,
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