Acoustic neuroma differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
| Line 143: | Line 143: | ||
|} | |} | ||
=== Differentiating Acoustic Neuroma from Meningioma | === Differentiating Acoustic Neuroma from Meningioma based on CT Findings === | ||
The most important [[differential diagnosis]] of acoustic neuroma is [[meningioma]] of the [[Pons|pontine angle]]. Below given diagram demonstrates the difference between acoustic neuroma and [[meningioma]] of the [[Pons|pontine angle]] based on [[Computed tomography|CT scan]] findings:<ref>{{Cite journal|last=A. M611er, A. Hatam and H. Olivecrona|first=|date=1978|title=The Differential Diagnosis of Pontine Angle Meningioma and Acoustic Neuroma with Computed Tomography|url=|journal=Neuroradilogy|volume=|pages=|via=}}</ref>{{familytree/start}} | The most important [[differential diagnosis]] of acoustic neuroma is [[meningioma]] of the [[Pons|pontine angle]]. Below given diagram demonstrates the difference between acoustic neuroma and [[meningioma]] of the [[Pons|pontine angle]] based on [[Computed tomography|CT scan]] findings:<ref>{{Cite journal|last=A. M611er, A. Hatam and H. Olivecrona|first=|date=1978|title=The Differential Diagnosis of Pontine Angle Meningioma and Acoustic Neuroma with Computed Tomography|url=|journal=Neuroradilogy|volume=|pages=|via=}}</ref>{{familytree/start}} | ||
{{familytree | | | | | | | | | |,|-| A01 |~|~| A02 |~|~| A03 |-|.| | |A01= <13cm3 |A02= Volume |A03= >35cm3 }} | {{familytree | | | | | | | | | |,|-| A01 |~|~| A02 |~|~| A03 |-|.| | |A01= <13cm3 |A02= Volume |A03= >35cm3 }} | ||
Revision as of 18:26, 26 April 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2], Arash Azhideh,
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
Acoustic neuroma must be differentiated from:[2]
- Meningioma
- Intracranial epidermoid cyst
- Facial nerve schwannoma
- Trigeminal schwannoma
- Ependymoma
- Metastasis
- Leiomyoma
- Intranodal palisaded myofibroblastoma
- Gastrointestinal stromal tumor
- MPNST - schwannoma with ancient change has no significant mitotic activity[3]
- Neurofibroma
- Meniere's disease
- Bell's palsy
Differentiating features of common differential diagnoses are:[1]
| Differentiating features of common differential diagnosis | ||
|---|---|---|
| Disease/Condition | Differentiating Signs/Symptoms | Findings on CT or MRI |
| Meningioma |
|
|
| Intracranial epidermoid cyst |
|
|
| Facial nerve schwannoma |
|
|
| Trigeminal schwannoma |
|
|
Differential diagnosis for SSNHL:
Since the most common outcome of acoustic aeuroma is hearing loss, the differential diagnoses for SSNHL (Sudden Sensorineural Hearing Loss ) are listed below.[4]
| Identifiable Causes of Sudden Sensorineural Hearing Loss | |||
|---|---|---|---|
| Autoimmune | Autoimmune inner ear disease | Neurologic | Migraine |
| Behcet’s disease | Multiple sclerosis | ||
| Cogan syndrome | Pontine ischemia | ||
| Systemic lupus erythematosis | Otologic | Fluctuating hearing loss | |
| Infectious | Bacterial Meningitis | Meniere’s disease | |
| Cryptococcal meningitis | Otosclerosis | ||
| HIV AIDS | Enlarged vestibular aqueduct | ||
| Lassa fever | Toxic | Aminoglycosides | |
| Lyme disease | Chemotherapeutic agents | ||
| Mumps | Non-steroidal anti-inflammatory drugs | ||
| Mycoplasma infection | Salicylates | ||
| Syphilis | Traumatic | Inner ear concussion | |
| Toxoplasmosis | Iatrogenic trauma/surgery | ||
| Vascular | Cardiovascular bypass | Perilymphatic fistula | |
| Temporal bone fracture | Cerebrovascular accident/stroke | ||
| Sickle cell disease | Metabolic | Diabetes mellitus | |
| Neoplastic | Acoustic neuroma | Hypothyroidism | |
| Cerebellopontine angle or petrous meningiomas | Functional | Conversion disorder | |
| Cerebellopontine angle or petrous apex metastases | Malingering | ||
| Cerebellopontine angle myeloma | |||
Differentiating Acoustic Neuroma from Meningioma based on CT Findings
The most important differential diagnosis of acoustic neuroma is meningioma of the pontine angle. Below given diagram demonstrates the difference between acoustic neuroma and meningioma of the pontine angle based on CT scan findings:[5]
| <13cm3 | Volume | >35cm3 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Increased attenuation | Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Marked calcification | Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Oval shape | Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | Round shape | Mostly No | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acoustic Neuroma | No | Tumor reaches dorsum sellae anteriorly | Yes | Meningioma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mostly No | Apparently broad attachment to bone | Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Center of tumor anterior to porus | Sometimes Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Tumor reaches > 2 cm above dorsum | Mostly Yes | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Sometimes | Peripheral edema | No | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mostly Yes | Widening of porus or other bone changes | No | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ 1.0 1.1 Acoustic Schwannoma. Radiopedia(2015) http://radiopaedia.org/articles/acoustic-schwannoma Accessed on October 2 2015
- ↑ Schwannoma. Librepathology(2015) http://librepathology.org/wiki/index.php/Schwannoma Accessed on October 2 2015
- ↑ 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.
- ↑ Maggie Kuhn, MD, Selena E. Heman-Ackah, MD, MBA, Jamil A. Shaikh, BA, and Pamela C. Roehm, MD, PhD (2011). "Sudden Sensorineural Hearing Loss: A Review of Diagnosis, Treatment, and Prognosis". Sagepub.
- ↑ A. M611er, A. Hatam and H. Olivecrona (1978). "The Differential Diagnosis of Pontine Angle Meningioma and Acoustic Neuroma with Computed Tomography". Neuroradilogy.