Intracranial Giant Cell Tumour Causing Left-Sided Hearing Impairment and Tinnitus

I am not a doctor, therefore I don't know the medical flow charts or medical guidelines. I just wonder what were the hints that tell the doctors to test an extended CT and MRI (not just in the cerebellopontine angle to rule out Vestibular Schwannoma). Is it because the patient suffered left headaches during 2 years? Unless these tests are done, you just miss the diagnosis.

Intracranial giant cell tumour—a case report
Abstract

Background
Giant cell tumours (GCT) are rare benign bone tumours that typically occur in the appendicular skeleton. In typical locations, these tumours are relatively simple to diagnose by radiography. However, at atypical locations, these tumours can be confused with other disease pathologies. Here, we describe a patient with an intracranial GCT that was initially thought to be a cystic teratoma.

Case presentation
A 49-year-old man with no previous medical illness was investigated for left-sided hearing impairment and tinnitus associated with a left-sided headache of 2 years’ duration. He did not complain of fever, vertigo, nasal or constitutional symptoms. Examination confirmed a sensory neural hearing loss with no other neurological deficit. Imaging by CT and subsequent MRI revealed an extra axial, multiloculated, and septated mass at the left temporal area with a significant mass effect. A provisional diagnosis of cystic teratoma was made. However, histopathological examination of the resected mass indicated that the lesion was a GCT. The patient required a second excision of the tumour, which he refused. His latest follow-up MRI showed no further progression of the residual tumour. His headaches have resolved and there was no progression of other symptoms.

Conclusion
This case highlights that GCTs can occur at sites outside the appendicular skeleton and that these tumours may be confused with other diseases that have a similar appearance on imaging.

Full article: https://ejrnm.springeropen.com/articles/10.1186/s43055-020-00307-x

 

Wow. Potentially scary, but seems like a pretty rare event I would say.