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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2021; 82(01): e1-e5
DOI: 10.1055/s-0040-1722343
Case Report

Primary Lymphoma of Internal Acoustic Meatus Mimicking Vestibular Schwannoma—A Rare Diagnostic Dilemma

Narayan Jayashankar
1   Department of Otorhinolaryngology, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India
,
Swati Kodur 
1   Department of Otorhinolaryngology, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India
,
Deepak Patkar
2   Department of Radiology, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India
,
Mitusha Verma
2   Department of Radiology, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India
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Abstract

Background/Setting A subject presenting with a unilateral sensorineural hearing loss and with vertigo/imbalance and a lesion of internal acoustic meatus (IAM) most often represents a vestibular schwannoma. Several alternative pathologies involving the region, with clinical and neuroradiological similarities, could lead to an error in judgement and management. Rare tumors of the IAM pose unique diagnostic difficulty. A rare case that we present here had a typical history and imaging findings suggestive of vestibular schwannoma. A primary central nervous system (CNS) lymphoma was diagnosed in later stages of brain involvement warranting a retrospective analysis of the entity.

Case Summary An 80-year-old male presented with unilateral sensorineural hearing loss, vertigo, and imbalance. On imaging, he was found to have a lesion in the left internal auditory meatus, reported as a vestibular schwannoma and operated upon. Subject's condition worsened with time and a repeat imaging was suggestive of a CNS lymphoma with lesions involving bilateral cerebellum and subcortical white matrix.

Conclusion To conclude, primary CNS lymphoma presenting an isolated lesion in the IAM with no other parenchymal lesions at presentation is a rare incidence; to our knowledge this is the first case of such unique presentation.

Keywords

vestibular schwannoma - internal acoustic meatus - CNS lymphoma - imaging of internal acoustic meatus lesions

Author Contributions

1. Operating surgeon, rafting the work or revising it critically for important intellectual content. Involved in final approval.


2. Substantial contributions to the conception or design of the work.


3. Radiology team involved in the process.


4. Radiology team involved in the process.




Publication History

Received: 26 March 2019

Accepted: 25 February 2020

Article published online:
23 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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