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Acoustic schwannoma - trumpeted internal acoustic meatus sign

Case contributed by Mohammad Taghi Niknejad
Diagnosis probable

Presentation

Sensorineural hearing loss and tinnitus.

Patient Data

Age: 40 years
Gender: Male

A well-defined mass at the left cerebellopontine angle widens the porous acusticus and extends into the internal auditory canal. The mass shows low signal on T1-weighted images and high signal on T2-weighted images. After contrast media injection, moderate homogenous enhancement is noted.

Case Discussion

This enhancing cerebellopontine angle mass in a patient with sensorineural hearing loss and tinnitus most likely represents acoustic (vestibular) schwannoma. Most acoustic schwannomas have an intracanalicular component and often result in widening of the porus acusticus resulting in the trumpeted internal acoustic meatus sign, which is present in up to 90% of cases.

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