Trochlear and abducens nerve neurinomas accompanied by a cerebellopontine angle meningioma--case report

A 66-year-old male presented with cerebellovestibular symptoms and hypesthesia of the V2 area of his face. Neuroimaging only detected a cerebellopontine angle (CPA) meningioma. The CPA meningioma was removed using the lateral suboccipital approach, which exposed small neurinomas arising from the trochlear and abducens nerves. Both neurinomas were removed intracapsularly. Postoperatively hypesthesia resolved, but other symptoms were unchanged. A karyotypic analysis of chromosome 22 and estrogen receptor analysis suggested absence of neurofibromatosis II, but the cause(s) of the genesis of the multiple diverse tumors was not determined. This extremely rare combination of neurinomas and meningioma was probably incidental, as there are no reports of any case which a combination of the trochlear and the abducens nerve neurinomas, much less one accompanied by a meningioma.