Commentary

This is an interesting case report of two patients with intracanalicular meningiomas. The internal auditory canal is a rare location for meningiomas: only 10 cases have been documented in the English surgical literature. Certainly by viewing preoperative magnetic resonance images alone, clicians would presume that these patients had acoustic neuromas primarily because of the intracanalicular location of the lesions and the characteristic symptoms of hearing loss and tinnitus. As the authors note, the clinical significance of histologic identification is quire important because the meningiomas do not invade the nerve but have a higher recurence rate than neuromas because they may involve the adjacent dura or even bone. The authors note the importance of obtaining intraoperative samples for frozen-section specimens. Simply noting a spindle cell tumor on frozen section may be insufficient. This report serves to remind us of the importance of obtaining a clear differential diagnosis of cerebellopontine masses.