CPA epidermoid cyst

Congenital lesion arising from inclusion of ectodermal elements
3rd most common CPA lesion
Insinuating CP angle lesion, engulfs cranial nerves and vessels
Pathologically pearly white beautiful cauliflower tumor

Clinical presentation:
20-70 years (40)
Headache, trigeminal or facial neuralgia, SNHL
May be clinically silent

MR:
low on T1, high on T2 similar to CSF (dirty CSF signal)
No suppression on FLAIR
Restricted diffusion on DWI (high signal)
Irregular or scalloped margins
No enhancement

CT:
Low attenuation lesion
Calcium in 20%

Management:
Complete removal