Acoustic schwannoma

Case contributed by Ahmed Abdrabou
Diagnosis almost certain

Presentation

Right side hearing impairment and tinnitus of 3 weeks duration.

Patient Data

Age: 40 years
Gender: Male
mri

Right cerebellopontine space occupying lesion exhibiting low signal on T1, high signal on T2 and FLAIR with avid enhancement on the post contrast study. There is also extension into the internal auditory canal (intracannilucular extension) and compression on the adjacent brain stem and 4th ventricle, with resultant of hydrocephalus more proximally. 

Case Discussion

Differential consideration of cerebellopontine angle lesions includes vestibular schwannoma, meningioma, epidermoid cyst and arachnoid cyst. Extension into the internal auditory canal favors the diagnosis of schwannoma over meningioma.

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