Vestibular schwannoma and tuberculoma occurring In collision in the posterior fossa: A case report

INTRODUCTION: Though acoustic schwannoma is the most common primary tumour in the cerebello-pontine angle, its occurrence with tuberculoma has never been reported. PRESENTATION OF CASE: A case of a vestibular schwannoma and tuberculoma occurring as collision tumors in the posterior fossa in a 46 years old female is reported. She presented with chronic raised intracranial pressure manifesting as headache, occasional diplopia, speech disturbance, and unsteady gait. Magnetic resonance imaging of the brain demonstrated a vestibular schwannoma and tuberculoma in the right cerebello-pontine angle. The lesions were resected through retro sigmoid route. The caudal mass was vestibular schwannoma while the rostral and medial portion was tuberculoma. DISCUSSION: The occurrence of a vestibular schwannoma and tuberculoma in collision has hitherto never been reported. The pathogenesis, surgical challenges and management of such a rare entity is discussed and the relevant literature is briefly reviewed. CONCLUSION: The association of vestibular schwannoma and tuberculoma is rare. Surgical excision of lesions occurring in collision can be formidable. They require careful planning and strategy.