[Cerebellopontine angle xanthogranuloma: report of a surgical case]

A Case of xanthogranuloma at the cerebellopontine angle is reported here in detail with a review of the literature. A 36-year-old male suffered from tinnitus and hearing disturbance for five months before admission. View of the internal auditory canal showed widening and destruction on the right side. Auditory brain stem response did not clarify any of wave. A slight high density area was revealed by CT with some degree of enhancement. A right paramedian suboccipital craniectomy revealed an encapsulated tumor at the right cerebellopontine angle extending into the internal auditory canal. The tumor was reddish-brown, creamy and 2 cm in diameter, which was totally extirpated. Twenty two days after the operation, the patient was discharged with a slight improvement of the right tinnitus. Seventeen surgical cases of intracranial xanthogranuloma were reviewed including the presented case. There were 10 males and seven females, and the age ranged from six to 57 years. Many of them were located in the choroid plexus or the dura mater. The presented case was the first reported one documenting a xanthogranuloma at the cerebellopontine angle. A solitary lesion was seen in 13 cases, and multiple lesions in four cases, among which Hand-Schüller-Christian disease was observed in two, and Weber-Christian disease in one. A high density area was revealed in eight out of nine cases, and some degree of enhancement was seen in nine. Surgical removal was performed totally in nine cases, subtotally in six, and partially in one. The outcome was excellent in eight cases, good in three, fair in one, poor in two, and dead in three.