Introduction: Report a case of a extra-axial cavernous malformation mimicking a pontocerebellar angle tumor involving the VII-VIII cranial nerve complex with a cystic hemorrhage component.

Case report: A 50 years old women with trigeminal neuralgia and progressive hearing loss was diagnosed of cerebellopontine angle tumor. The MRI showed a hemorrhagic lesion with a homogeneous contrast enhancement. The brain angiogram did not show vascular malformation. Before the treatment a rapid growing of the lesion was advised and then surgery was proposed. A suboccipital retromastoid craniotomy was performed. The lesion had different parts of a cystic, hemorrhagic and solid component. The solid component was adherent to the VIII nerve. The cystic components were in the cerebellopontine cistern compressing the fith and lower cranial nerves and the cerebellar lobe. The cystic component consisted of blood degradation products at different stages. Pathological examination of the solid component was compatible with sinusoidal vessels and cavernous angioma was diagnosed. Total excision of the lesion was accomplished.

Discussion: The cavernous angioma is a rare cause of pontocerebellar angle mass with only a few cases reported. In this location are adherent to the cranial nerves and they can grow rapidly by bleeding forming hemorrhagic cysts that comprises the cerebellar lobule and cranial nerves.