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Cerebellopontine angle meningioma

Case contributed by Ahmed Abdrabou
Diagnosis almost certain

Presentation

Headache and tinnitus

Patient Data

Age: 35 years
Gender: Female

Right cerebellopontine angle mass, displays isointense signal in T1, slightly bright T2 and FLAIR signal and exerts positive mass effect in form of compression of right side of pons.

The mass is durally based and exhibits avid enhancement after contrast administration. No intracanalicular extension.

Case Discussion

This case illustrates typical appearances of a cerebellopontine angle meningioma, a diagnosis which in this instance can be made with a great deal of confidence. The general differential to be considered when evaluating a CPA mass includes:

  • meningioma
  • vestibular shwannoma - in this case there is no intracanalicular extension
  • other clearly non-viable alternative diagnoses
    • epidermoid cyst: no enhancement
    • arachnoid cyst: no enhancement and follow CSF signal in all sequences
    • lipoma: follow fat signal without enhancement

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