Cerebellopontine Angle Meningioma Mimicking Vestibular Schwannoma: A Diagnostic and Therapeutic Challenge

Introduction: Meningiomas of the cerebellopontine angle may occasionally mimic vestibular schwannomas, creating diagnostic ambiguity. We report such a presentation in a patient with long-standing audiovestibular symptoms.Case presentation: A 47-year-old woman developed progressive left sensorineural hearing loss with tinnitus and intermittent vertigo over three years. Clinical examination was normal. Audiometry and vestibular testing showed left-sided deficits, and MRI revealed an enhancing CPA mass suggestive of a vestibular schwannoma. Surgical exploration later identified the lesion as a meningioma.Discussion: This case shows how certain CPA meningiomas can reproduce the clinical and radiological profile of a schwannoma, particularly when the mass approaches the internal auditory canal. Such overlap may lead to misclassification and may influence the surgical approach.Conclusion: CPA meningioma should be considered when evaluating unilateral hearing loss with vestibular dysfunction, especially if imaging features are not fully typical of a schwannoma.