The central nervous system (CNS) is the most common site of extramedullary relapse in acute lymphoblastic leukemia (ALL). However, the diagnosis may be challenging due to its protean manifestations. A 64-year-old male reported right-sided hearing loss with intermittent bilateral occipitotemporal headaches during a clinic follow-up for Ph + B-ALL....
Audiologists and ENT clinicians should maintain a high index of suspicion for non-schwannoma diagnoses when audiovestibular presentations are atypical or when the patient has a relevant cancer history — imaging alone may be insufficient for differentiation.
This case underscores that mass lesions of the cerebellopontine angle are not always vestibular schwannomas, and missed or delayed diagnosis of CNS malignancy in this region can be life-threatening.
- 01A CNS relapse of B-lymphoblastic leukemia radiologically mimicked a vestibular schwannoma.
- 02The case highlights the diagnostic pitfall of assuming audiovestibular mass lesions are benign schwannomas.
- 03Highlights the importance of clinical history (e.g., prior malignancy) in differential diagnosis of inner-ear/nerve tumors.
- 04Published in Clinical Case Reports; evidence is inherently limited to a single patient.
- 05Relevant to audiologists, ENT surgeons, and neurologists involved in tumor workups.
B-lymphoblastic leukemia CNS relapse can radiologically mimic a vestibular schwannoma, posing a diagnostic challenge.
studysupported- PMID
- 42125164
- DOI
- 10.1002/ccr3.72670.
- Journal
- Clinical Case Reports
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient with B-lymphoblastic leukemia presenting with CNS relapse mimicking vestibular schwannoma
- Intervention
- Diagnostic workup of suspected vestibular schwannoma
Primary outcomes
Correct identification of CNS malignancy vs. vestibular schwannoma; Clinical and radiological features distinguishing the two diagnoses