Extra-Axial Cerebellopontine Angle Low Grade Glioma – Unusual Occurrence in a 43-year-old Woman

Abstract

Cerebellopontine angle (CPA) is an anatomical space of posterior cranial fossa bounded by tentorium superiorly, pons and cerebellum posteriorly and temporal bone anterolaterally. Glial cell tumors are located frequently in the cerebral hemispheres, while vestibular Schwannoma, meningioma and epidermoid cysts frequently affect the CPA. Low-grade gliomas (LGGs) presenting as a space occupying lesion (SOL) in cerebellopontine angle (CPA) is an extremely rare occurrence. This study reports a 43-year-old female, with no comorbidities, who presented with the chief complaints of headache and walking difficulty for six weeks, associated with left-sided facial numbness and hearing impairment. Neuro-imaging revealed left CPA SOL, which was excised via retrosigmoid craniectomy. Pathological work up was suggestive of diffuse low-grade glioma. The development of atypical SOLs, like glioma in this case, should be considered in the differential diagnosis of cerebellopontine angle tumors. The standard treatment is maximum safe resection in case of LGGs with serial neuroimaging and adjuvant management.