Facial neuroma masquerading as acoustic neuroma.
Facial nerve neuromas are rare benign tumors that may be initially misdiagnosed as acoustic neuromas when situated near the auditory apparatus. We describe a patient with a large cystic tumor with associated trigeminal, facial, audiovestibular, and brainstem dysfunction, which was suspicious for acoustic neuroma on preoperative neuroimaging. Intraoperative investigation revealed a facial nerve neuroma located in the cerebellopontine angle and internal acoustic canal. Gross total resection of the tumor via retrosigmoid craniotomy was curative. Transection of the facial nerve necessitated facial reanimation 4 months later via hypoglossal-facial cross-anastomosis. Clinicians should recognize the natural history, diagnostic approach, and management of this unusual and mimetic lesion.
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611-2911, USA.
Eli T
ET
Sayegh
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611-2911, USA.
Gurvinder
G
Kaur
Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Michael E
ME
Ivan
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611-2911, USA.
Orin
O
Bloch
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, USA.
Steven W
SW
Cheung
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611-2911, USA. Electronic address: aparsa@nmff.org.
Andrew T
AT
Parsa
D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005154:Facial Nerve / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009463:Neuroma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009464:Neuroma, Acoustic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D055815:Young Adult
Acoustic neuroma; Cerebellopontine angle; Facial nerve neuroma; Facial neuroma; Internal acoustic canal