A 45-year-old man presents with progressive unilateral sensorineural hearing loss and tinnitus. Contrast-enhanced MRI shows a well-defined, enhancing mass at the cerebellopontic angle with a component extending into the internal auditory canal, creating an 'ice cream cone' appearance. The most likely diagnosis is:
- A Meningioma
- B Vestibular schwannoma ✓
- C Epidermoid cyst
- D Trigeminal schwannoma
Correct answer: B. Vestibular schwannoma
Explanation
Vestibular schwannoma classically presents with unilateral sensorineural hearing loss and shows the 'ice cream cone' sign on MRI, with a cerebellopontic angle component extending into the internal auditory canal. Meningioma often shows a dural tail and broad dural base without IAC extension. Epidermoid cyst shows restricted diffusion and no enhancement. Trigeminal schwannoma is centered in Meckel's cave.
Reference: Brant and Helms Fundamentals of Diagnostic Radiology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.