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Show Poster 78 Hearing loss, facial paresthesia, and diplopia: an unusual suspect Aishwarya Sriram1, Cassidy Anderson1, Abigail Funari1, Raquel Yokoda1, Nadeem Akbar1, Patrick Colley1, Vijay Agarwal1, Howard Moskowitz1, Kevin Hsu1, Geoffrey Basson1 1 Albert Einstein College of Medicine, Bronx, USA Introduction: Cerebellopontine angle (CPA) tumors account for 5-10% of intracranial tumors. Etiologies include CN VIII acoustic neuromas, meningiomas, epidermoid/dermoid cysts, and non-acoustic schwannomas. We present a case of a CPA ectopic pituitary neuroendocrine tumor (PiNET), which to our knowledge is the first reported case of a CPA tumor of neuroendocrine origin. Description of Case(s): A 32-year-old female presented with right-sided facial weakness, paraesthesias, and sensorineural hearing loss, with headaches, dizziness, and altered taste and smell. She also had horizontal and vertical binocular diplopia on right and up gaze. Her vision was 20/100 and 20/25. Her right pupil was 5mm and sluggish, and left pupil was 3mm and briskly reactive, without rAPD. She had right-sided lagophthalmos and decreased facial sensation. The right eye had -0.5 limitation in all gazes and -1 limitation in supraduction. MRI head revealed a 3.7 x 1.8 x 2.6 cm mildly enhancing mass in the right CPA cistern and internal acoustic meatus, involving right cranial nerves V, VI, VII, VIII, IX, X, and XI. It was isointense to gray matter with internal vascularity. It exerted mass effect upon the cerebellum, pons, and medulla. Histopathological examination revealed a neuroendocrine tumor, WHO grade II, with a high Ki-67 index of 8%. The cells had round to irregularly shaped nuclei, little cytoplasm, and stained positively for synaptophysin, chromogranin, and CD56. Conclusions, including unique features of the case(s): PiNETs are the most common sellar tumor. Ectopic PiNETs are likely functional, located in the sphenoid sinus, clivus, or suprasellar space, and have more invasive characteristics. Ectopic PiNETs rarely involve the CPA, and to our knowledge a case of a CPA tumor of neuroendocrine origin has not been previously described. In addition to its ectopic location, this tumor is noteworthy in its high Ki-67 index and aggressive nature, and such cases require imaging to assess for metastasis. References: None. Keywords: neuroimaging, orbit/ocular pathology, tumors Financial Disclosures: The authors had no disclosures. Grant Support: None. Contact Information: Aishwarya Sriram, asriram@montefiore.org 142 | North American Neuro-Ophthalmology Society |
