Classic Case

A facial schwannoma, though an uncommon lesion, has the propensity to involve the geniculate ganglion. The typical symptoms of geniculate ganglion schwannoma include facial weakness and sensorineural or conductive hearing loss. Other less common symptoms include tinnitus, hemifacial spasm, and loss of lacrimation. On MRI, the tumor is typically homogenously enhanced and can cause widening of the geniculate fossa  (A and B, white arrows) and thickening of the adjacent labyrinthine segment of the facial nerve  (A and B, yellow arrows). CT can demonstrate smooth bone scalloping and remodeling (C, arrow).