Glioblastoma of the cerebellopontine angle and internal auditory canal mimicking a peripheral nerve sheath tumor: Case report

Hirokazu Takami, Christoph M. Prummer, Christopher S. Graffeo, Maria Peris-Celda, Caterina Giannini, Colin L. Driscoll, Michael Link

Research output: Contribution to journalArticle

Abstract

Glioblastoma (GBM) of the internal auditory canal (IAC) is exceedingly rare, with only 3 prior cases reported in the literature. The authors present the fourth case of cerebellopontine angle (CPA) and IAC GBM, and the first in which the lesion mimicked a vestibular schwannoma (VS) early in its natural history. A 55-year-old man presented with tinnitus, hearing loss, and imbalance. MRI identified a left IAC/CPA lesion measuring 8 mm, most consistent with a benign VS. Over the subsequent 4 months he developed facial weakness. The tumor grew remarkably to 24 mm and surgery was recommended; the main preoperative diagnosis was malignant peripheral nerve sheath tumor (MPNST). Resection proceeded via a translabyrinthine approach with resection of cranial nerves VII and VIII, followed by facial-hypoglossal nerve anastomosis. Intraoperative frozen section suggested malignant spindle cell neoplasm, but final histopathological and molecular testing confirmed the lesion to be a GBM. The authors report the first case in which absence of any brainstem interface effectively excluded a primary parenchymal tumor, in particular GBM, from the differential diagnosis. Given the dramatic differences in treatment and prognoses between malignant glioma and MPNST, this case emphasizes the importance of surgical intervention on an aggressively growing lesion, which provides both the best probability of local control and the critical tissue diagnosis.

Original languageEnglish (US)
Pages (from-to)1835-1839
Number of pages5
JournalJournal of neurosurgery
Volume131
Issue number6
DOIs
StatePublished - Jan 1 2019

Keywords

  • Cerebellopontine angle
  • Glioblastoma
  • Glioma
  • Internal auditory canal
  • Oncology

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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