Acoustic schwannoma

Case contributed by Frank Gaillard

Patient Data

Age: 60 years
Gender: Male

MRI brain


MRI of the brain with contrast demonstrates a mass in the right cerebellopontine angle. It is heterogeneous in signal, enhances vividly, and extends a tongue of tissue into the internal acoustic meatus. It appears to be an isolated abnormality. 

This patient went on to have a resection. 

MICROSCOPIC DESCRIPTION:  The sections show  multiple fragments  of tumor, comprising  spindle cells forming  loose  fascicles  and  sheets,  with  occasional  foci of  nuclear  palisading  (Verocay body formation).   There are  scattered  thick-walled vessels,  and  there are  extensive  areas  of foam  cell  and lymphocytic infiltration within the  tumor.  Foci of hemosiderin  deposition are also  noted.  There  is no  necrosis and  mitotic activity  is minimal.   In some  foci, tumor  cell nuclei  show some  hyperchromasia  and  atypia, (ancient change). 

FINAL DIAGNOSIS: Right acoustic schwannoma.

Case Discussion

This case illustrates the typical appearances of acoustic schwannomas, including heterogeneity of signal and enhancement - a common feature of larger tumors. 

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