Presentation
Hearing loss.
Patient Data
There is an ill-defined hypoattenuating mass obliterating the left cerebellopontine angle with extension into and enlargement of the left internal acoustic meatus. Age-related changes are also present.
The MRI confirms a solid tumor within the left cerebellopontine cistern expanding the internal acoustic meatus and characterized by vivid contrast enhancement, cystic degeneration, and a few punctate susceptibility foci, likely representing hemorrhagic components.
Case Discussion
Typical imaging features of an acoustic schwannoma: extension and expansion of the IAC (ice-cream cone appearance), cystic degeneration, and likely microhaemorrhagic foci.
Microscopic description: the sections show a moderately cellular schwannoma. It mainly contains Antoni A areas with fascicles of spindle cells. There is focal palisading but Verocay body formation is inconspicuous. The tumor cells show no significant nuclear pleomorphism. There are abundant foamy macrophages in the stroma. No evidence of malignancy is identified.
Diagnosis: brain tissue: schwannoma.
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