Cerebellopontine angle meningioma
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Solid extra-axial mass in the left cerebellopontine angle region with extension into the left IAC and left hypoglossal canal, showing low T1 and high T2 signal, restricted diffusion compared to the adjacent brain, and vivid contrast enhancement. Dural tail sign is observed together with the inferior portion of the clivus. It is hard to appreciate the degree of involvement if any of the left sigmoid sinus. Mastoid air cells are obliterated on the left.
Multiple high T2/FLAIR signal foci scattered through the supratentorial white matter is non specific and most likely rekated to chronic small vessels changes.
This case demonstrates a posterior fossa extra-axial tumor that extends into the left IAC and left hypoglossal canal. These features associated with the signal pattern and dural tail sign make meningioma the most likely diagnosis. A vestibular schwannoma would be the main differential for a lesion with those features, however, the spread meningeal distribution and involvement of the hypoglossal canal make this hypothesis unlikely.
Unfortunately, there is no histological confirmation and the diagnosis was based on the images only.