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Findings: There is a unilateral 4mm x 3mm x 2mm enhancing ovoid lesion in the left auditory canal near the left CPA.

Key points - Vestibular schwannoma:

* Benign tumor of Schwann cells that encircle the vestibulocochlear nerve in the CPA and IAC
* Most common mass in CPA
* Often presents with progressive hearing loss
* 100% enhance; appears as "filling defect" in CSF on T2
* Rarely associated with dural tail or arachnoid cyst
* Unilateral enhancing CPA mass is vestibular schwannoma until proven otherwise.
* Usually slow growing with peak age 40-60yrs
* If complete hearing loss has occurred, resection will not help restore hearing.

Work this case at http://education.auntminnie.com/QMachine.ASP?UID=2HM0WVID&PageId=1&Sess=7463800

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Comment by jose arturo castillo lima on January 9, 2010 at 4:47pm
BUEN CASO Y ADECUADA SELECCION DEL RECURSO DIAGNOSTICO
Comment by AZHAR MAHMOOD JAVED on November 13, 2009 at 1:12am
Target sign with MICRO LESIONS EXCELENT WORK.THANKS
Comment by Wael Nemattalla on October 16, 2009 at 8:51am
Nice case.
80% of CP angle masses.
Target sign pattern of enhancement is pathognomonic.
Usually moderate enhancement and not intense.
75% of schwannomas are in vestibulocochlear nerve; 20% at trigeminal nerve and 5% at remainder of cranial nerves except optic nerve where no schwannomas arising from this nerve.
Nice work.
Comment by Alessandro Lemos,MD on October 16, 2009 at 8:27am
Nice case!!!
Comment by radRounds Radiology Network on October 15, 2009 at 3:28pm
Thanks for the case Dr. Casey!

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