Presentation
An adult female with persistent increasing headache long time ago.
Patient Data
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A fairly defined left cerebellopontine angle isodense mass lesion is seen. It shows homogenous enhancement in post-contrast study. It is surrounded by significant low attenuation vasogenic edema. Both the mass and surrounding edema exert mass effect in the form of compression of the 4th ventricle & compression of the nearby brain stem and vital structures. Consequent supratentorial hydrocephalus is seen with periventricular transependymal CSF permeation a type of cerebral edema.
The current CT findings are impressive of left cerebellopontine angle extra-axial large SOL likely meningioma.
Post microsurgical decompression of huge left cerebellopontine angle mass.
Left occipital craniectomy. The surgical bed has some little blood remnants.
After surgical excision and histopathological examination that proved to be mesothelial meningioma.
Case Discussion
The most common cerebellopontine angle masses are: two common solid that are homogenously enhanced, meningioma and 8th cranial nerve schwannoma as well as two cysts, namely arachnoid and epidermoid.
The case is courtesy of Dr/ Nabeeh Bajunaid, Neurosurgeon Consultant, RCMC.
Thanks to prof.Dr / Mamdouh Radwan Consultant of histopathology, RCMC.
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