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A Unified Methodological Framework for Vestibular Schwannoma Research
Published on: June 20, 2017
Primary melanocytic tumor of the cerebellopontine angle mimicking a vestibular schwannoma: case report
Mark P Piedra1, Bernd W Scheithauer, Colin L W Driscoll
1Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55901, USA.
Objective:
The majority of tumors of the cerebellopontine angle (CPA) are benign. We report the case of a primary malignant melanoma of the CPA that mimicked a vestibular schwannoma (acoustic neuroma). We discuss the differential diagnosis and prognosis of melanotic lesions at this location.
Clinical Presentation:
A 49-year-old man presented with a 7-year history of unilateral deafness and a several month history of imbalance, intractable nausea and vomiting, as well as weight loss. A neurological work-up revealed a large tumor in the left CPA radiographically diagnosed as a vestibular schwannoma.
Intervention:
A translabyrinthine approach revealed a pigmented, vascular neoplasm encasing vessels and cranial nerves of the left CPA. The tumor was subtotally resected, and a histopathological diagnosis of melanoma was made. The patient had no history of cutaneous melanoma and no other site of disease was ever discovered.
Conclusion:
This case most likely represents primary melanoma of the central nervous system that mimicked a vestibular schwannoma. The differential diagnosis of melanotic lesions of the CPA is discussed as are the prognostic implications of each diagnosis.