The answer is B. Vestibular schwannoma
The clinical presentation of unilateral sensorineural hearing loss and tinnitus, along with the characteristic MRI finding of an enhancing, nodular tumor along the eighth cranial nerve, is highly suggestive of a vestibular schwannoma.
Vestibular schwannomas, also known as acoustic neuromas, are benign, slow-growing tumors that develop from the Schwann cells covering the vestibulocochlear nerve (eighth cranial nerve). This nerve is responsible for balance and hearing, which explains the patient’s symptoms of unilateral sensorineural hearing loss and tinnitus. The pathophysiology involves the tumor compressing and damaging the nerve, leading to these auditory symptoms.
Diagnosis is typically made through imaging, with MRI being the gold standard. On an MRI with contrast, vestibular schwannomas appear as enhancing, nodular tumors along the course of the eighth cranial nerve, often at the internal auditory canal or cerebellopontine angle. This imaging characteristic is key in distinguishing vestibular schwannomas from other potential diagnoses.
Treatment options vary based on the size of the tumor, symptoms, and overall health of the patient. Small, asymptomatic tumors may be monitored with regular hearing tests and MRIs. For symptomatic or growing tumors, treatment options include surgical removal and radiotherapy. The goal is to preserve neurological function, especially hearing, while controlling tumor growth.
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