BMJ Case Reports 2012; doi:10.1136/bcr.12.2011.5356
  • Rare disease

Middle cranial fossa cystic schwannoma

  1. Peter C Whitfield2
  1. 1Department of General Medicine, Luton and Dunstable Hospital NHS Trust, Luton, UK
  2. 2Department of Neurosurgery, Derriford Hospital, Plymouth, UK
  3. 3Department of Clinical Radiology, Derriford Hospital, Plymouth, UK
  4. 4Department of Cellular and Anatomical Pathology, Derriford Hospital, Plymouth, UK
  1. Correspondence to Dr Vikas Acharya, vikas.acharya{at}


The authors present the unusual case of a 37-year-old man, with a history of hepatitis C, presenting with a 3 year history of progressive trigeminal, facial and vestibular nerve defects. Intracranial imaging demonstrated a cystic middle and posterior fossa lesion, that was ultimately diagnosed as a cystic trigeminal schwannoma. Due to the uncertainties of diagnosis he was managed in two stages with an open biopsy and then a subsequent partial resection. Surveillance of the tumour remnant is planned. The rare nature of this diagnosis is discussed, along with the more common findings in intracranial schwannoma, and the wide differential to be considered. Briefly, the authors describe the surgical option for a complex multi-fossa schwannoma and the importance of the multi-disciplinary team in the diagnosis and management of such patients.


  • Competing interests None.

  • Patient consent Obtained.

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