A 58 year old male presents with left-sided hearing loss for the past 4 months. Axial and sagittal T1, axial T2, axial fluid-attenuated inversion-recovery (FLAIR), axial diffusion, and pre- and postcontrast axial T1 MR images are shown below. Discuss the diagnosis and possible treatment.

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MRI demonstrates a lesion in the left petrous posterior to the petrous internal carotid artery, with superior extension into the floor of the medial left internal auditory canal.

There are multiple areas of carotid canal wall thinning, including posteriorly and inferiorly. There is minimal partial opacification of the left mastoid air cells.
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CT of the temporal bone was obtained. Axial and coronal CT images with bone reconstruction are shown below.

? Acoustic neuroma ? Cerebellopontine angle tumour

CPANGLE TUMOR

It represents the Benign lesion.

Most probably diagnosis is Petrous apex cholesterol granuloma.
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Lesion is located in Petrous apex.

Vestibular schwanoma... Need to be operated

Vestibular schwanoma audiometry and plan for surgery

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