Neurofibromatosis, type 2 [Q85.02] / Benign neoplasm of cranial nerves [D33.3] There are postoperative findings seen in the right mastoid temporal bone. There are enhancing lesions within the bilateral internal auditory canals. The left lesion measures 6.6 x 9.5 cm, which is similar to the prior examination, while the right lesion appears to have enlarged compared to prior examination, now measuring 8.3 x 5.7 mm, previously 6.1 x 6 x 1 mm. There is a plaque-like enhancing mass along the right parietal convexity that measures up to 9 mm in thickness with minimal mass effect upon the brain. There is redemonstration of an expansile, heterogeneously enhancing lesion involving the medulla. In addition, punctate areas of gradient susceptibility involving the lesion likely relating to microhemorrhage appears slightly increased since prior examination. The lesion appears to have slightly increased in size, now measuring 2.3 x 1.8 x 2.7 cm, previously 2.2 x 1.7 x 2.4 cm. Additional small upper cervical spinal cord lesions are incompletely characterized. There is no evidence for hydrocephalus. There is no evidence of acute ischemia. There is no midline shift. There is no significant interval change in the lobulated, enhancing mass at the left C1-2 level with mild intraspinal and paraspinal extension, but no mass effect upon the spinal cord. There may also be an additional punctate enhancing nodule in the right aspect of the thecal sac at the C4 level.
1. Interval increase in size of right vestibular schwannoma, but stable left vestibular schwannoma.2. The medullary ependymoma has increased in size. Small upper cervical spinal cord lesions are incompletely characterized. 3. Stable appearance of schwannoma at left C1-2 level with paraspinal extension and possible additional punctate schwannoma at the right C4 level. Dedicated cervical spine imaging may be useful for further evaluation.4. Small right parietal convexity meningioma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.