Cystic Non-enhancing Vestibular Schwannoma with Unusual Clinical Presentation

ABSTRACT

We present a case of large cystic vestibular schwannoma in a 60-year-old woman who complained of facial palsy and tinnitus. Magnetic resonance images revealed signals of long T1 and T2, suggesting its cystic architectures. Enhanced images showed marginal enhancement at the peripheral wall and multiple internal septa, but not at the intracanalicular portion. An epidermoid cyst was presumed owing to its insinuating growth and lack of enhancement, but cystic degeneration of vestibular schwannoma was confirmed histopathologically. She had an unremarkable postoperative course. After thorough review of our case together with pertinent literatures, we emphasise the importance of differential diagnosis of cystic lesions in the cerebellopontine angle.