The patient went on to have a resection. 

Histology

MICROSCOPIC DESCRIPTION:

Paraffin sections show fragments of a moderately hypercellular neurilemmoma (Schwannoma). This is composed of both Antoni-A and B type tissues. Well formed Verocay bodies are noted in Antoni-A areas and blood vessels have thickened hyalinised walls. Tumor cells show mild nuclear pleomorphism. No mitotic figures, densely hypercellular areas or areas of necrosis are identified.

DIAGNOSIS:

Neurilemmoma (Schwannoma).

Discussion

This case highlights how in some instances the differentiation between a meningioma and schwannoma can be difficult. The slight heterogeneity of enhancement and FLAIR signal and lack of CT hyperdensity or increased diffusion restriction are helpful in suggesting that this mass is a schwannoma.