gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Inflammatory pseudotumor of the posterior fossa mimicking vestibular schwannoma – A case report

Meeting Abstract

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  • G. Maier - Department of Neurosurgery, University Hospital Tuebingen, Germany
  • F. Roser - Department of Neurosurgery, University Hospital Tuebingen, Germany
  • M. Tatagiba - Department of Neurosurgery, University Hospital Tuebingen, Germany

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 068

DOI: 10.3205/11dgnc289, URN: urn:nbn:de:0183-11dgnc2892

Published: April 28, 2011

© 2011 Maier et al.
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Outline

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Objective: Inflammatory pseudotumours located within the brain are rare. The pathology is associated with immunosuppressive decease or prior EBV infection. With only two cases reported in the literature to date, we report the third case of an inflammatory pseudotumour in the cerebello-pontine angle (CPA). A 50-year-old woman received open resection of a tumor-like lesion in the CPA after hearing loss and tumor growth was detected within 18 months.

Methods: The tumor was microsurgically resected via a retrosigmoid approach under continuous intraoperative neuromonitoring (AEPs, SSEP, EMG of the VI-, VII- and caudal cranial nerves). Histopathological and immunophenotypical analysis were performed for tumor classification. Staging examination with whole body CT and MRI as well as extensive blood samples and a serotest were done.

Results: Histopathological analysis revealed atypically located hyperplastic lymphatic tissue conforming inflammatory pseudotumor. Non-Hodgkin lymphoma or especially a T-cell lymphoma could be ruled out by immunophenotypical analysis. Further staging examinations showed no other pathologies. Blood samples screening and serotest were positive for CMV and EBV (IgG) and negative for HIV, HBV and HCV. A 2-year follow-up with MRI and re-staging was inconspicuous, without evidence for recurrent tumor growth.

Conclusions: As only few cases of inflammatory pseudotumor are reported in literature, this case of a CPA pseudotumor is exceptionally rare. The pathogenetic mechanism of this tumor is believed to be chronic reactive EBV infection. Other cases were also treated by surgery and radiotherapy without recurrent growth.