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Cerebellopontine tumor

Case contributed by Townsville radiology training

Presentation

Admission for stereotactic craniectomy and resection of cerebellopontine (CP) angle tumor. Presentation history not available.

Patient Data

Age: 60 years
Gender: Male
MRI

CP angle lesion on post gadolinium T1w axial MRI head.

Lobulated margin with peripheral enhancement. Appears to arise adjacent to jugular foramen (NOT internal auditory canal). Extra-axial in location. CN VII, VIII are displaced but not infiltrated.
No infiltration of pons, left superior cerebellar peduncle or cerebellar lobe.

Case Discussion

This is likely to be a neurogenic tumor arising from left CN IX, X, XI rather than an acoustic neuroma. Meningioma is less likely given it does not have a broad based interface with the dura.

Other possibilities for an enhancing CP mass include: berry aneurysm, trigeminal/facial nerve schwannoma, ependymoma. Metastasis are unlikely to be extra-axial (usually parenchymal) but rarely present in this region.

The differential would also be wider if non-enhancing, hyperintense on T2w, or hyperintense on T1w. This was mostly isointense pre-contrast.

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Case information

rID: 19331
Published: 29th Aug 2012
Last edited: 4th Oct 2019
Inclusion in quiz mode: Included

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