• Daibo Ke, Xueyun Deng, Xiang Li, Jiuhong Li, and Xuhui Hui.
• Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan.
• Medicine (Baltimore). 2021 Feb 5; 100 (5): e24566e24566.

RationaleExtra-axial cavernous malformations (ECMs) arising from cranial nerves (CNs) are rare. Complete "en bloc" lesion resection and hemosiderin-stained tissue preservation remain the standard treatment, while a different strategy may be needed when the lesion is highly calcified . We report the 3rd calcified ECM-CN and review the clinical features and surgical strategy for this rare condition considering previous literature.Patient ConcernsWe present a 52-year-old woman with a calcified lesion located in the right lower 1/3 of the cerebellopontine angle.DiagnosisThe diagnosis was calcified ECM-CNs according to the pathological and radiological features.InterventionsA posterior midline craniotomy was performed, and piecemeal resection of the lesion was carried out. Subtotal resection of the lesion was achieved with a small piece left in situ.OutcomesNo symptom or lesion-related recurrence was found during 28 months of follow-up.LessonsCalcified ECM-CNs are unique cavernous malformations arising from CNs. Piecemeal resection and subtotal or near-total excision are 2 major aspects that differ from the surgical strategy for general ECM-CNs.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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