Calcified acoustic neurinoma.

An unusual case history of a patient with an acoustic neurinoma is reported. The patient had a two-year history of unilateral sensori-neural hearing impairment, normal radiological appearance of the internal acoustic meatus at tomography and on CT a grossly calcified tumour in the cerebello-pontine angle, indicating pathology other than an neurinoma. Vertebral angiography was normal, and at surgery a grossly calcified tumour was found, while microscopy revealed a typical neurinoma pattern. The tumour had to be removed in two stages, both via the translabyrinthine approach, with a satisfactory post-operative condition, including near-normal facial function. It is concluded that dense calcifications in tumours in the cerebello-pontine angle do not necessarily exclude a neurinoma, and vertebral angiography is therefore not indicated routinely. However, such findings do predict difficulties at surgery.