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Unusual Lesions of the Cerebellopontine Angle: A Segmental Approach¹

¹ From the Department of Neuroradiology, Hôpital J. Minjoz, Boulevard Fleming, 25000 Besançon, France (F.B., J.F.B.); the Department of Radiology, Hôpital d’Instruction des Armées du Val-de-Grâce, Paris, France (J.L.S., Y.S.C.); the Department of Radiology, Hôpital Saint-Antoine, Paris, France (K.M.D.); and the Department of Neuroradiology, Hôpital de Bicêtre, Le Kremlin Bicêtre, France (C.I., D.D.). Presented as a scientific exhibit at the 1999 RSNA scientific assembly. Received April 3, 2000; revision requested May 8 and received July 25; accepted July 27. Address correspondence to F.B. (e-mail: fabbonne@club-internet.fr).

Tumors of the cerebellopontine angle (CPA) are frequent; acoustic neuromas and meningiomas represent the great majority of such tumors. However, a large variety of unusual lesions can also be encountered in the CPA. The site of origin is the main factor in making a preoperative diagnosis for an unusual lesion of the CPA. In addition, it is essential to analyze attenuation at computed tomography (CT), signal intensity at magnetic resonance (MR) imaging, enhancement, shape and margins, extent, mass effect, and adjacent bone reaction. CPA masses can primarily arise from the cerebellopontine cistern and other CPA structures (arachnoid cyst, nonacoustic schwannoma, aneurysm, melanoma, miscellaneous meningeal lesions) or from embryologic remnants (epidermoid cyst, dermoid cyst, lipoma). Tumors can also invade the CPA by extension from the petrous bone or skull base (cholesterol granuloma, paraganglioma, chondromatous tumors, chordoma, endolymphatic sac tumor, pituitary adenoma, apex petrositis). Finally, CPA lesions can be secondary to an exophytic brainstem or ventricular tumor (glioma, choroid plexus papilloma, lymphoma, hemangioblastoma, ependymoma, medulloblastoma, dysembryoplastic neuroepithelial tumor). A close association between CT and MR imaging findings is very helpful in establishing the preoperative diagnosis for unusual lesions of the CPA.

Index Terms: Brain neoplasms, 154.30 • Brain neoplasms, CT, 154.12112 • Brain neoplasms, diagnosis, 154.30 • Brain neoplasms, MR, 154.121411 Cerebellopontine angle, neoplasms, 154.30

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