Acoustic schwannoma - cystic
Citation, DOI and case data
Sensory hearing neural loss
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There is a left extraaxial mass measuring approximately 2.7 x 2.5 cm in transverse diameter, which causes distortion upon the left middle cerebellar peduncle and fourth ventricle.
There is no evidence of supratentorial hydrocephalus. The mass demonstrates foci of increased density within the central aspect of the lesion.
The left internal auditory canal is enlarged measuring approximately 11 mm (on the right it measures 6 mm).
The facial nerve canal is symmetric (3mm).
Normal symmetric mastoid air cells and middle ear cavity.
Left mastoid air cells and anterior middle ear cavity demonstrate fluid/mucus.
Normal grey white matter differentiation with no evidence of acute infarct.
Likely co dominant transverse sinuses.
Left extra axial mass with distortion upon the left middle cerebellar peduncle and fourth ventricle.
No evidence of supratentorial hydrocephalus.
There is widening of the left internal auditory canal and in association with the incorporated MRI, the findings are likely consistent with an acoustic neuroma. Given the cystic appearance on MRI a meningioma is thought less likely.
The sections show a moderately cellular schwannoma. It mainly contains Antoni A areas with fascicles of spindle cells. There is focal palisading with Verocay body formation. The tumor cells show focal ancient change with moderate nuclear enlargement and smudged chromatin. Mitoses are inconspicuous. Scattered foamy macrophages are noted. There is no evidence of necrosis. No evidence of malignancy is identified.
Brain tumor: Schwannoma.
1 case question available
- 1. Fortnum H, O'Neill C, Taylor R et-al. The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technol Assess. 2009;13 (18): iii-iv, ix-xi, 1-154. doi:10.3310/hta13180 - Pubmed citation