Acoustic neuroma staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Acoustic neuroma may be classified into three subtypes based on tumor size and into six subtypes based on tumor location.

Staging

Acoustic neuroma may be classified into three subtypes based on tumor size and into six subtypes based on tumor location.

WIGAND has defined a trinomial classification:

Tumour size stage A: The tumor is limited to the inner auditory passage and is 1-8 mm (average diameter) in size.

Tumour size stage B: The tumor has spread up to the cerebellopontine angle and is 9-25 mm in size.

Tumour size stage C: The tumor has spread to the brainstem and is bigger than 25 mm.

Stage	Tumor size	Tumor location
Stage A	1-8 mm in size	The tumor is limited to the inner auditory passage
Stage B	9-25 mm in size	The tumor has spread up to the cerebellopontine angle
Stage C	Greater than 25 mm in size	The tumor has spread to the brainstem

SAMII defines six tumour classes:

T1: clear intrameatal tumour (in the bony ear canal)

T2: intra and extrameatal tumour part (within and outside of the bony ear canal)

T3a: Tumour fills the cerebellopontine cistern (between the cerebellum and brainstem)

T3b: Tumour reaches the brainstem

T4: Tumour compromises the brainstem

T4b: Tumour compromises the brainstem and displaces the four ventricles (cerebral ventricle)

Stage	Tumor location
T1	Clear intrameatal tumour (in the bony ear canal)
T2	Intra and extrameatal tumour part (within and outside of the bony ear canal)
T3a	Tumor fills the cerebellopontine cistern (between the cerebellum and brainstem)
T3b	Tumor reaches the brainstem
T4a	Tumor compromises the brainstem
T4b	Tumor compromises the brainstem and displaces the four ventricles (cerebral ventricle)