• Komal Preet, Methma Udawatta, Prasanth Romiyo, Quinton Gopen, and Isaac Yang.
• Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA.
• World Neurosurg. 2019 Apr 1; 124: 358360358-360.

BackgroundCystic acoustic neuromas typically present with more rapid growth and shorter symptomatic periods when compared with solid tumors.Case PresentationWe present the case of a 70-year-old man unilateral sensorineural hearing loss, frequent falls, and worsening ataxia. Magnetic resonance imaging (MRI) confirmed a 33.9-cm3 cystic acoustic neuroma with mass effect on the brainstem and cerebellum. Subsequent MRI scans revealed tumor measurements of 38.2 cm3, 37.6 cm3, 23.8 cm3, and 14.3 cm3 at 3, 6, 9, and 15 months after initial presentation, respectively.ConclusionsSpontaneous tumor regression was accompanied with reduced mass effect on neighboring structures and improved symptoms. Owing to their unpredictable growth patterns, early surgical resection has been recommended for cystic acoustic neuromas. However, this patient experienced spontaneous tumor involution after conservative management. Further research on the growth patterns of cystic schwannomas is imperative for them proper counseling of patients and improvement of treatment strategies.Copyright © 2019 Elsevier Inc. All rights reserved.

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