Acoustic Neuroma

1-Forms about 90% of the cerebello-pontine angle masses, here you should search for intra canalicular extension.

2-Forms about 85% of all intra cranial neuroma.

3-Age:Adults 35-60 years old.

4-If seen bilateral gives diagnosis of type 2 neurofibromatosis.

5-Radiological Appearance:

-Iso or hypo dense space occupying lesion in cerebello-pontine angle.

-Shows intense homogenous enhancement.

-No calcification.

-It could be cystic. In this case if no enhancement of of little enhancement,  you can differentiate between it and epidermoid cyst by looking for intra canalicular extension, if it is present, this will exclude the epidermoid cyst, if not present no differentiation could be made.

-In CT in case of small lesion, look to the internal auditory canal if it is filled by enhancing soft tissue or not if possible.

-Nowadays, no surgical removal is adviced by surgeon as the growth of the tumor is very slow at one hand, and on the other hand the complication of the operation is very aggressive, patient can compensate hearing loss resulted from the presence of the lesion by medical phone.
- In case of small lesion, it is seen by using MRI with contrast which is the best investigation for such a lesion.