Vestibular Schwannoma (VS)

Figure 1: The most common intracranial location of schwannoma is in the cerebellopontine angle, as in this patient. Cystic change is quite common in larger schwannomas on T2WI (left). Schwannomas are also typically avidly enhancing on postcontrast T1WI (right). This schwannoma can be differentiated from meningioma based on this cystic change and on the clearly delineated extention into the internal auditory canal. IAC remodeling and widening may also be present. The lack of a  meningioma's "dural tail" is also helpful. Basic Description Benign peripheral nerve sheath tumor arising from Schwann cells of CN 8 (vestibular portion) within the CPA-IAC Pathology WHO grade 1 Originates from Schwann cells surrounding CN 8 vestibular segment CN 8 superior vestibular branch > inferior branch CN 5 and CN 7 schwannomas not uncommon Origin in CN 8 cochlear portion is rare Bilateral VS hallmark of Neurofibromatosis type 2 (NF-2) Mutations in NF2 tumor suppressor gene in maj...

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