A 45-year-old woman consulted for a two-year history of gradual progressive hearing loss in the left ear, as well as dizziness and loss of balance in the past few months. On examination, she was awake, but had double vision, droopiness (“ngiwi”) on the left side of the face, decreased hearing on the left, and some difficulty in swallowing and talking. She also had difficulty walking because of poor balance, and had to be assisted by her daughter. 

Brain MRI showed a non-enhancing tumor in the left cerebello-pontine angle, most likely an epidermoid cyst. This is a slow-growing, benign tumor that is present since birth, but usually does not cause symptoms until adulthood, when the tumor has already gotten bigger. 

The patient underwent surgery to remove the tumor. The tumor was found to have pearly white flakes, similar to the description of an epidermoid cyst. This was confirmed by the biopsy result. The patient improved after the surgery, and could walk on her own, without support, after a month. She did not require additional treatment because it is a benign condition.