J Neurol Surg B Skull Base 2019; 80(S 01): S1-S244
DOI: 10.1055/s-0039-1679739
Poster Presentations
Georg Thieme Verlag KG Stuttgart · New York

Primary Central Nervous System Lymphoma of the Internal Auditory Canal Mimicking Facial Nerve Schwannoma

Garrett M Rogers
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Noga Lipschitz
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Gavriel D. Kohlberg
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Mario Zuccarello
2   Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Ravi N. Sami
1   Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2019 (online)

 

Background: Primary central nervous system lymphoma (PCNSL) is a rare non-Hodgkin’s lymphoma and a rare primary brain tumor. When arising within the internal auditory canal (IAC), it can mimic more common tumors of the region. We report a rare case of PCNSL presenting as an IAC mass mimicking a facial nerve schwannoma.

Methods: Case report and literature review.

Results: A 66-year-old male presented with left-sided peripheral facial nerve palsy, tinnitus, and sensorineural hearing loss. Magnetic resonance imaging (MRI) demonstrated a left enhancing IAC lesion as well as enhancement and thickening of cranial nerves VII and VIII. Rapid progression of symptoms prompted further workup. Fludeoxyglucose positron emission tomography (FDG-PET) demonstrated an isolated hypermetabolic IAC mass. Cerebrospinal fluid (CSF) analysis showed atypical cells. The patient underwent a translabyrinthine approach for resection of the mass, and the histopathologic diagnosis was confirmed as diffuse large B cell lymphoma consistent with PCNSL.

Conclusion: PCNSL is an extremely rare clinical entity. PCNSL should be included in the differential for skull base lesions, especially in atypical or rapidly progressive clinical presentations.