Solitary fibrous tumor of the cerebellopontine angle: A case report and literature review

Abstract

118revealed a normal higher mental function with a gaze-evoked nystagmus to the right and profound sensori-neural hearing loss on the same side. He had right-sided cerebellar signs, House-Brackmann (HB) grade 2 facial palsy and no neurocutaneous markers or enlarged lymph nodes.Magnetic resonance imaging (MRI) brain showed a T2 heterogeneously hyperintense extra-axial lesion, measuring 4.5 × 3.5 × 3 cm in the right CP angle with solid and cystic areas. The lesion showed intense enhancement on contrast administration and pressure effect on pons, with no extension to internal auditory canal [ Figure 1]. There was evidence of obstructive hydrocephalus. A preoperative diagnosis of CP angle meningioma was made, and preoperative embolization was planned. Digital subtraction angiography revealed dense tumor blush with predominant arterial feeders from vertebro-basilar system and small branches from right external carotid artery (ECA) [ Figure 2]. Embolization was not carried out as the predominant supply was from intracranial arteries, and the ECA feeders were too small to cannulate.Right suboccipital retrosigmoid craniectomy was done. The tumor was reddish in color and highly vascular. It was soft in consistency, with no definite plane with surrounding normal parenchyma; and was adherent to the petrous ridge and to the tentorium cerebelli. Facial nerve was found antero-superior to the tumor.