• Hui-Min Xie, Seidu A Richard, and Zhigang Lan.
• Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang Road, Chengdu, Sichuan, PR China.
• Medicine (Baltimore). 2021 Nov 19; 100 (46): e27792e27792.

RationaleGlioma in the petroclival region is very rare. Also, very few cases of primary gliomas have been reported to have radiographic as well as intraoperative features of extra-axial lesions resulting in diagnostic dilemma in the literature. We present a rare case of petroclival glioma mimicking trigeminal schwannoma in a young female.Patient ConcernsWe present a 21-years old female with a 3-month history of pain in the right eye with no visual impairment. Cranial nerves examination revealed mild deficits in the trigeminal nerve, facial nerve, auditory nerve, oculomotor as well as the trochlear nerve.DiagnosesMagnetic resonance imaging detected an extra-axial mass with mixed signal intensities in the right petroclivus area. Immunohistochemical established glioma with world health organization (WHO) grade II.InterventionsThe lesion was resected via 2 successive operations in 6 months interval. The patient was further treated with radiotherapy and post-radiotherapy temozolamide.OutcomesTwo years follow-up revealed no recurrence of the lesions and she is well. Nevertheless, he is still being followed diligently to uncover any recurrence.LessonsThe extra-axial nature as well as petroclival location of the glioma makes our case very unique and very rare. The imaging characteristics were very extraordinary for a glioma which resulted in diagnostic dilemma. Thus, the definitive diagnosis was based on the histopathological evaluation of the excised tumor.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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