Acoustic neuroma differential diagnosis: Difference between revisions
Simrat Sarai (talk | contribs) No edit summary |
Simrat Sarai (talk | contribs) No edit summary |
||
| Line 3: | Line 3: | ||
{{CMG}}{{AE}}{{Simrat}} | {{CMG}}{{AE}}{{Simrat}} | ||
==Overview== | ==Overview== | ||
Acoustic neuroma must be differentiated from [[meningioma]], epidermoid, [[facial nerve]] [[schwannoma]], [[trigeminal]] [[schwannoma]], [[ependymoma]], leiomyoma, intranodal palisaded myofibroblastoma, [[malignant]] peripheral nerve sheath tumour(MPNST), [[gastrointestinal]] stromal tumor, [[neurofibroma]], [[ | Acoustic neuroma must be differentiated from [[meningioma]], intracranial epidermoid cyst, [[facial nerve]] [[schwannoma]], [[trigeminal]] [[schwannoma]], [[ependymoma]], leiomyoma, intranodal palisaded myofibroblastoma, [[malignant]] peripheral nerve sheath tumour (MPNST), [[gastrointestinal]] stromal tumor, [[neurofibroma]], [[Meniere's]] disease, and [[Bell's palsy]].<ref>{{Cite web | title =Radiopedia Differential diagnosis of Acoustic Neuroma| url =http://radiopaedia.org/articles/acoustic-schwannoma }}</ref> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
The most frequent differential to be considered are:<ref>{{Cite web | title =Radiopedia Differential diagnosis of Acoustic Neuroma| url =http://radiopaedia.org/articles/acoustic-schwannoma }}</ref> | The most frequent differential to be considered are:<ref>{{Cite web | title =Radiopedia Differential diagnosis of Acoustic Neuroma| url =http://radiopaedia.org/articles/acoustic-schwannoma }}</ref> | ||
| Line 22: | Line 22: | ||
calcification more common | calcification more common | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Intracranial epidermoid cyst | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Hearing loss is a less prominent | | style="padding: 5px 5px; background: #F5F5F5;" |Hearing loss is a less prominent | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No enhancing component | | style="padding: 5px 5px; background: #F5F5F5;" |No enhancing component | ||
Very high signal on DWI | Very high signal on [[DWI]] | ||
does not widen the IAC (Internal Auditory Canal) | does not widen the IAC (Internal Auditory Canal) | ||
|- | |- | ||
Revision as of 04:26, 2 October 2015
|
Acoustic neuroma Microchapters | |
|
Diagnosis | |
|---|---|
|
Treatment | |
|
Case Studies | |
|
Acoustic neuroma differential diagnosis On the Web | |
|
American Roentgen Ray Society Images of Acoustic neuroma differential diagnosis | |
|
Risk calculators and risk factors for Acoustic neuroma differential diagnosis | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Acoustic neuroma must be differentiated from meningioma, intracranial epidermoid cyst, facial nerve schwannoma, trigeminal schwannoma, ependymoma, leiomyoma, intranodal palisaded myofibroblastoma, malignant peripheral nerve sheath tumour (MPNST), gastrointestinal stromal tumor, neurofibroma, Meniere's disease, and Bell's palsy.[1]
Differential Diagnosis
The most frequent differential to be considered are:[2]
| Disease/Condition | Differentiating Signs/Symptoms | Findings on CT or MRI |
|---|---|---|
| Meningioma | Hearing loss is a less prominent | Usually more homogeneous in appearance: significant signal heterogeneity with cystic or haemorrhagic areas is more typical of vestibular schwannoma than meningiomas (although cystic meningiomas do occur)
Meningiomas tend to have a broad dural base usually lack trumpet IAM sign calcification more common |
| Intracranial epidermoid cyst | Hearing loss is a less prominent | No enhancing component
Very high signal on DWI does not widen the IAC (Internal Auditory Canal) |
| Facial nerve Schwannoma | Facial weakness is prominent and occurs early
Sometimes associated with neurofibromatosis |
CT and MRI imaging results are similar to acoustic neuroma but enhancement extends into the geniculate ganglion of the facial nerve and facial canal |
| Trigeminal Schwannoma | Clinically associated with more prominent facial numbness
Hearing loss is also less prominent |
CT and MRI imaging displays a dumbbell-shaped mass over the petrous apex affecting Meckel cave.
The trigeminal nerve enhancement extends proximal to the tumor and does not extend into the IAM (internal acoustic meatus) |
Other Differential diagnosis and their findings include:[3]
- Ependymoma
- Metastasis
- Leiomyoma
- Intranodal palisaded myofibroblastoma
- Gastrointestinal stromal tumor
- MPNST - schwannoma with ancient change has no significant mitotic activity[4]
- Neurofibroma
- Meniere's disease
- Bell's palsy
References
- ↑ "Radiopedia Differential diagnosis of Acoustic Neuroma".
- ↑ "Radiopedia Differential diagnosis of Acoustic Neuroma".
- ↑ "Libre Pathology Differential diagnosis of Acoustic Neuroma".
- ↑ Chan PT, Tripathi S, Low SE, Robinson LQ (2007). "Case report--ancient schwannoma of the scrotum". BMC Urol. 7: 1. doi:10.1186/1471-2490-7-1. PMC 1783662. PMID 17244372.