A 55-year-old woman presents with slowly progressive hearing loss and tinnitus on the left side. MRI shows a well-defined mass at the left cerebellopontine angle extending into the internal acoustic meatus. The most likely diagnosis is:

• A Vestibular schwannoma ✓
• B Meningioma
• C Arachnoid cyst
• D Glomus jugulare tumor

Explanation

Vestibular schwannoma arises from Schwann cells of the vestibular branch of cranial nerve VIII within the internal acoustic meatus and produces unilateral tinnitus, hearing loss, and later facial nerve involvement. Bilateral vestibular schwannomas are diagnostic of neurofibromatosis type 2 due to NF2 gene mutation. Meningioma can occur at the cerebellopontine angle but does not extend into the meatus in this classic dumbbell pattern.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.