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Vestibular (Acoustic) Schwannoma

Harris JNH - MedPix (2005)

View Article: MedPix Image - MedPix Case

Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Vestibular (Acoustic) Schwannoma

History: Patient is a 34 year old man who presented with a 2 year history of increasing hearing loss, tinnitus and occasional vertigo. In the last few months he has developed L. facial numbness in the V1-V2 distribution.

Findings: The MRI reveals an "ice-cream cone" shaped lesion originating from the L. IAC, with extension into the CPA, extending rostrally to compress the left CN V. It is not invading the brain stem but is compressing it. On T1, the mass is hypointense with adjacent brain parenchyma and hyperintense on T2 imaging. There is avid post-gadolinium enhancement on T1 imaging in a slightly heterogenous manner throughout the mass.

Ddx: Vestibular (Acoustic) Schwannoma Meningioma

Dxhow: Intraoperative frozen section and final pathology report consistent with Schwannoma.

Exam: Physical exam: VSS, afeb, patient in NAD. AOx4. The physical exam revealed decreased hearing in the left ear consistent with a sensorineuronal process. Sensation to light touch and pin prick was also diminished in the V1-V2 distribution of the left side of his face. The patients exam, to include coordination and gait testing was otherwise completely normal. Labs: Thyroid, liver, renal panels as well as Chem 7 and calcium were all normal. CBC w/ diff was normal. Audiometry was not performed as hearing was grossly decreased in the left ear.

No MeSH data available.


Mass lesion evident in axial section in the CPA with "ice-cream cone" morphology, originating from the IAC.  It is  hyperintense compared to the surrounding brain parenchyma.
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MPX1147_synpic27150: Mass lesion evident in axial section in the CPA with "ice-cream cone" morphology, originating from the IAC. It is hyperintense compared to the surrounding brain parenchyma.


Vestibular (Acoustic) Schwannoma

Harris JNH - MedPix (2005)

Mass lesion evident in axial section in the CPA with "ice-cream cone" morphology, originating from the IAC.  It is  hyperintense compared to the surrounding brain parenchyma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1147&req=5

MPX1147_synpic27150: Mass lesion evident in axial section in the CPA with "ice-cream cone" morphology, originating from the IAC. It is hyperintense compared to the surrounding brain parenchyma.

View Article: MedPix Image - MedPix Case

Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Vestibular (Acoustic) Schwannoma

History: Patient is a 34 year old man who presented with a 2 year history of increasing hearing loss, tinnitus and occasional vertigo. In the last few months he has developed L. facial numbness in the V1-V2 distribution.

Findings: The MRI reveals an "ice-cream cone" shaped lesion originating from the L. IAC, with extension into the CPA, extending rostrally to compress the left CN V. It is not invading the brain stem but is compressing it. On T1, the mass is hypointense with adjacent brain parenchyma and hyperintense on T2 imaging. There is avid post-gadolinium enhancement on T1 imaging in a slightly heterogenous manner throughout the mass.

Ddx: Vestibular (Acoustic) Schwannoma Meningioma

Dxhow: Intraoperative frozen section and final pathology report consistent with Schwannoma.

Exam: Physical exam: VSS, afeb, patient in NAD. AOx4. The physical exam revealed decreased hearing in the left ear consistent with a sensorineuronal process. Sensation to light touch and pin prick was also diminished in the V1-V2 distribution of the left side of his face. The patients exam, to include coordination and gait testing was otherwise completely normal. Labs: Thyroid, liver, renal panels as well as Chem 7 and calcium were all normal. CBC w/ diff was normal. Audiometry was not performed as hearing was grossly decreased in the left ear.

No MeSH data available.