Presentation
Right sided hearing loss.
Patient Data
Widening of the right internal acoustic meatus consistent with an expanding lesion projecting into the right cerebellopontine angle cistern, consistent with a vestibular schwannoma. No other acute middle or inner ear abnormality.
Large, heterogeneous, avidly enhancing mass in the right cerebellopontine angle with extension into expanded internal auditory canal. Moderate mass effect with distortion of the pons, right cerebellar peduncle and effacement of the aqueduct, partial effacement of the fourth ventricle. No evidence of hydrocephalus. Conclusion: Right CP angle mass consistent with a schwannoma.
Case Discussion
The patient went on to have a resection.
Histology
Microscopic description: The sections show a moderately cellular schwannoma. It mainly contains Antoni A areas with fascicles of spindle cells. There is focal palisading with Verocay body formation. A small amount of Antoni B areas with microcystic change is also seen. The tumor cells show no significant nuclear pleomorphism. Mitoses are inconspicuous. No evidence of malignancy is identified.
Final diagnosis: Vestibular schwannoma.
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