A 60-year-old man presents with progressive right-sided hearing loss, tinnitus, and facial numbness. MRI shows a 3.5 cm cerebellopontine angle mass extending into the internal auditory canal with a 'ice cream cone' appearance. What is the diagnosis?
- A Meningioma
- B Vestibular schwannoma ✓
- C Epidermoid cyst
- D Trigeminal schwannoma
Correct answer: B. Vestibular schwannoma
Explanation
Vestibular schwannoma (acoustic neuroma) is the most common cerebelloponta angle tumor. The 'ice cream cone' appearance on MRI, with the cone in the CPA and the ice cream in the internal auditory canal, is pathognomonic. It presents with unilateral sensorineural hearing loss, tinnitus, and later facial numbness or weakness. Meningioma typically shows a dural tail and does not extend into the IAC. Epidermoid shows restricted diffusion. Trigeminal schwannoma is centered on Meckel's cave.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.