Left cerebellopontine angle meningioma
Long-standing but worsening hearing loss.
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Extra-axial left cerebellopontine angle mass centred on the petrous ridge with dural tail. Extends to the posterior edge of the internal acoustic meatus but not in with the 7th/8th nerves appearing stretched across the anterior aspect of the the mass. It demonstrates homogeneous enhancement.
The differential diagnosis of cerebellopontine angle masses include vestibular schwannoma (most common), meningioma, and epidermoid cyst. This patient had the mass excised.
Microscopic description: The sections show a moderately cellular meningioma. The tumour forms whorls. No sheeting arrangement is seen. The tumour cells have ovoid nuclei with no nuclear pleomorphism. Mitoses are inconspicuous. There is no necrosis. No brain parenchyma is present. No evidence of atypical or malignant change is identified.
Final diagnosis: Left cerebellopontine angle tumour: meningioma (WHO grade I).
This is centred is centred posteriorly to the internal acoustic meatus, and has imaging characteristics that are characteristic of a meningioma.