Acoustic schwannoma

Case contributed by Dr Bruno Di Muzio

Presentation

Hearing loss.

Patient Data

Age: 70 years
Gender: Male
CT

CT Brain

There is an ill-defined hypoattenuating mass obliterating the left cerebellopontine angle with extension into and enlargement of the left internal acoustic meatus. Age-related changes are also present.

MRI

MRI Brain

The MRI confirms a solid tumour within the left cerebellopontine cistern expanding the internal acoustic meatus and characterised by vivid contrast enhancement, cystic degeneration, and a few punctate susceptibility foci, likely representing haemorrhagic components. 

Case Discussion

Typical imaging features of an acoustic schwannoma: extension and expansion of the IAC (ice-cream cone appearance), cystic degeneration, and likely microhaemorrhagic foci.  

Microscopic description: the sections show a moderately cellular schwannoma. It mainly contains Antoni A areas with fascicles of spindle cells. There is focal palisading but Verocay body formation is inconspicuous. The tumour cells show no significant nuclear pleomorphism. There are abundant foamy macrophages in the stroma. No evidence of malignancy is identified.

Diagnosis: brain tissue: schwannoma.

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Case information

rID: 55729
Case created: 22nd Sep 2017
Last edited: 6th Oct 2017
Inclusion in quiz mode: Included

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