Question: A 38 year old woman is referred for management of a newly discovered cerebellopontine angle mass. She has ipsilateral hearing loss, headache, and vague dizziness. Examination is normal. MRI reveals a right sided CPA tumor measuring 3 cm in posterior fossa dimension. A portion of the tumor extends nearly to the fundus of the IAC. The center of the tumor is positioned eccentric to the IAC in a posterior direction. Which element of this patient’s history or imaging findings is most suggestive of meningioma compared to vestibular schwannoma?

a) Headache

b) Position eccentric to IAC

c) Size of tumor

d) Extension nearly to fundus of IAC

[Answer will be posted with next week's new question]

Answer to last week's question, “Look A Little Closer" (March 18, 2019)

D - Charcot Leyden crystals.