A 55-year-old female presents with tinnitus, dizziness and history of progressive deafness. Differential diagnosis includes all except:: (A) Acoustic neuroma, (B) Endolymphatic hydrops, (C) Meningioma, (D) Histiocytosis X
Answer is D. Acoustic neuroma and endolymphic hydrops (Meniere's syndrome) present with tinnitus, dizziness and progressive hearing loss. This also holds true for meningiomas which involve cerebellopontine (CP) angle. Nearly 10% of tumors of CP angle are meningiomas.Histiocytosis X. presently called Langerhans cell histiocytosis, is a rare disease which may involve temporal bone (as eosinophilic granuloma) or multiorgan disorder involving skull, long bones, ribs, vertebrae, pelvis, maxilla and mandible, and other non-osseous organs. Langerhans cells are involved in cell-mediated immunity, cause osteolytic lesions in bones and recruit eosinophils. Eosinophilic granuloma is a milder form of Langerhans cell histiocytosis which can involve temporal bone.