CPA Schwannoma vs CPA Meningioma

Listed are the pathologies that closely resemble each other, and these pathologies are the favourite questions in final FRCR part A exam.

CEREBELLOPONTINE MASS

	Vestibular nerve schwannoma	Cerebellopontine angle meningioma
1	Lack dural tail	Has dural tail
2	Forms acute angle with petrous bone	Forms obtuse angle with petrous bone
3	Expands IAC / Erosion IAC (posterior edge of porus acousticus)	Seldom expand IAC
4	No calcification	Calcification present
5	Grow into IAC ‘Ice-cream cone’ appearance	+/- grow into IAC
6	No hyperostosis	Bony hyperostosis
7	Patchy enhancement	Avid enhancement
8	Isodense to brain Iso to bain T1 ; ↑ T2	Iso/↓ T2
9	Rarely with cystic degeneration	Cystic degeneration in 10%

Schwannoma from the left internal acoustic meatus, causing widening of the canal (Red arrow)
Forms sharp angle with the petrous bone (Blue arrow)
Demonstrates a CSF cleft with the adjacent cerebellum (Green arrow)