Diagnostic and surgical challenges in resection of cerebellar angle tumors and acoustic neuromas

BACKGROUND: Cerebellopontine angle (CPA) lesions can mimic more common tumors through nonspecific symptoms and radiologic findings. METHODS: To increase the preoperative diagnostic accuracy for CPA pathologies, the authors review the full spectrum of reported CPA lesions. RESULTS: A wide spectrum of lesions mimics vestibular schwannoma (VS) in the space of the CPA. CONCLUSION: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list. Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion. This knowledge will allow improved operative execution and outcomes.