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Clinical Problem Solving | Radiology

Complex Cerebellopontine Angle Mass in a Patient With a History of Falls QUIZ

Aparna Singhal, MD1; Daniel J. Dauer, MD, MPH1; Philip R. Chapman, MD1
[+] Author Affiliations
1Section of Neuroradiology, Department of Radiology, University of Alabama at Birmingham, Birmingham
JAMA Otolaryngol Head Neck Surg. 2015;141(2):183-184. doi:10.1001/jamaoto.2014.3178.
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In this case report a woman in her 50s presented to the emergency department after a fall. She reported being clumsy her entire life, though with worsening difficulty with balance over the past few years. She occasionally had falls, which were sometimes preceded by vertigo and “shaking” episodes. The lateral soft-tissue density component of the mass extended through a widened porus acusticus and into the internal auditory canal. What is the diagnosis?

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Axial views of the head. A, Contrast-enhanced, temporal bone computed tomographic image showing mixed-density mass within the right cerebellopontine angle. B, T1-weighted magnetic resonance imaging (MRI) scan showing lateral soft-tissue density component of the mass. C, T2-weighted MRI scan demonstrating additional complexity of signal with inhomogeneous signal in the fat and soft-tissue components. D, Postcontrast fat-saturated T1-weighted MRI demonstrating nodular enhancement of soft-tissue component and fat saturation of medial component.

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