Case 29-1996

Presentation of CaseA 59-year-old man was admitted to the hospital because of a painful preauricular mass.He had been well until five months earlier, when he noticed a mild hearing impairment in the right ear. Several weeks later, the hearing loss worsened. Evaluation by an otologist showed no evidence of an acoustic neuroma. A cranial magnetic resonance imaging (MRI) scan (Figure 1) showed that the articular disk was absent; there was gross expansion of the joint capsule, with heterogeneous signal characteristics on T1-weighted and T2-weighted images, as well as heterogeneous enhancement. Low-signal regions were interpreted . . .