File:Acoustic schwannoma - eroding petrous apex (Radiopaedia 39674-42004 Axial T2 14).png

Summary:

• Radiopaedia case ID: 39674
• Image ID: 15869317
• Image stack position: 14/72
• Plane projection: Axial
• Aux modality: T2
• Study description: MRI Brain (CPA protocol)
• Study findings: A large mass is seen centered in the right cerebellopontine angle. Laterally the mass extends into the porous acousticus/IAC which is remodeled. Inferiorly, there is moderate expansion of the jugular foramen. The hypoglossal canal appears intact. Superiorly the mass appears to extend through the tentorial hiatus. Moderate mass effect on the pons and right middle cerebellar peduncle. Post administration of contrast there is largely homogeneous enhancement with minor linear areas of non enhancement. Impression: Large right cerebellopontine angle mass lesion. Given the where the lesion centered, the involvement of the internal acoustic meatus and symptoms, the lesion most likely represents an acoustic schwannoma. However, expansion of the jugular foramen is noted, raising the possibility that the lesion represents a schwannoma of the 9-11th cranial nerves.
• Modality: MRI
• System: Central Nervous System
• Findings: Large enhancing spherical mass at the right cerebellopontine angle, eroding the apex of the petrous bone, almost reaching the labyrinth. The tumor significantly indents the right pons and cerebellar hemisphere and mildly deviates the fourth ventricle to the left. No hydrocephalus. The right middle ear cavity and mastoid air cells are clear. A lipoma layers over the corpus callosum, which appears normal in size Small mucous retention cysts in in the maxillary sinuses.
• Published: 21st Sep 2015
• Source: https://radiopaedia.org/cases/acoustic-schwannoma-eroding-petrous-apex
• Author: Bruno Di Muzio
• Permission: http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)