Metastasis to Cerebellopontine Angle: A Case Report

Introduction: Cerebellopontine angle tumours accounts for 5-10 % of intracranial tumours. Most CPA tumours are benign, with 85 % being vestibular schwanomma, meningiomas, epidermoid cyst. Primary malignancies or metastasis to CPA are rare accounting for less than 2 % of neoplasm in CPA. Most common metastasis is from breast, lungs, nasopharynx, melanoma. Case report: A 35yr old female presented with headache for 1yr, diplopia, deviation of right angle of mouth. MRI finding was suggestive of tuberculoma. Patient took ATT for 1 month, but didnt show any improvement. Excision of tumour was done via right fronto temporal craniotomy. Operative D/D- trigeminal schwanomma, temporal glioma, meningioma was made. Tissue was sent for histopathology study. Histopathology findings sheets of malignant epithelial cells with high N: C ratio, hyperchromasia, with prominent nucleoli, mitosis- 10/10hpf. Focal areas of glial tissue and necrosis seen. Provisional diagnosis of squamous cell carcinoma / GBM made. Immunohistochemistry (panCK, GFAP, Ki67, HMB-45) done. panCK diffusely positive in tumour cells, Ki67 index -40 %, GFAP, HMB 45 negative in tumour cells. So final diagnosis of metastastic squamous cell carcinoma to CPangle made. Conclusion: Therefore it is highly advisable to do intraoperative squash cytology or frozen section biopsy for early detection and proper patient management.