MRI
Axial T1
Axial FLAIR
Axial T2
Axial
Coronal T2
Axial DWI
Axial ADC
Sagittal T1
Axial T1 C+
Coronal T1 C+ fat sat
Right cerebellopontine angle mass is seen to extend into the right internal acoustic canal which it enlarges. It demonstrates mass effect and slight distortion on the right middle cerebellar peduncle but no evidence of abnormal T2/FLAIR signal to suggest oedema or gliosis.
The mass is characterised by low T1 signal, intermediate T2 signal with areas of cystic change and demonstrates heterogeneous enhancement.
Small right Meckels cave enhancing lesion likely represents a small right trigeminal nerve schwannoma and measures 6 x 5 x 7 mm (AP x RL x CC).
The left internal acoustic canal is normal with no suggestion of mass.
Conclusion:
1. Right cerebellopontine angle mass demonstrates features characteristic for an acoustic neuroma.
2. Right trigeminal schwannoma.
Presence of two (presumed) schwannomas raises the possibility of NF2 although in the absence of other tumours, and in this age group this is less likely.