Trigeminal schwannoma

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Patient presented with diplopia.

Patient Data

Age: Middle aged
mri
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Axial
T1 C+
This study is a stack
Coronal
T1 C+
This study is a stack
Axial
DWI
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Info

MRI through the brain demonstrates a large cerebellopontine angle mass on the right, with a component extending anteriorly into Meckle's cave. The mass is heterogenous on all sequences, and relatively high signal on T2, with avid contrast enhancement, and areas which are presumably cystic. 

Annotated image

Annotated image
T1
C+
T2
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Info

The mass has a dumbbell configuration, with a component in Meckle's cave (red arrow) and a larger one in the cerebellopontine angle (blue arrow). The fourth ventricle is markedly distorted (yellow arrow), as is the basilar artery (green arrow). 

Case Discussion

This patient went on to have a craniotomy and resection of the mass. Histology confirmed a trigeminal schwannoma

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