A 46 year-old female presented with progressively worsening hearing on the right side, intermittent headaches and diplopia for the past 3 years and imbalance while walking for the past 5-6 months. She was bedridden since 15 days. She was unable to walk and requires support. There was no history of unconsciousness, convulsions or sphincteric complaints. There was no trauma or fever. There were no clinical features suggestive of neurofibromatosis. She had abdominal tuberculosis 10 years ago for which took full course of recommended antitubercular therapy. On examination, she was conscious, disoriented but obeyed all commands. Vision was apparently normal. She has bilateral sixth nerve paresis and right sensorineural deafness. Gag was normal. There was no motor deficit. She had right cerebellar signs. MR imaging of the brain showed a large right heterogeneously enhancing CP angle tumor, iso to hypo intense T1 and mildly iso to hyper intense on T2-weighted images suggestive of a vestibular schwannoma. The internal acoustic meatus (IAM) was not significantly widened and there was mild to moderate brainstem compression and moderate supratentorial hydrocephalus. A second lesion was seen in the right cerebellum in close proximity to the middle cerebellar peduncle. It was hypo intense on T2 MR imaging, peripherally enhancing with central area of necrosis and associated with extensive perifocal cerebellar edema suggestive of tuberculoma. There was similar small peripherally enhancing lesion in the pons as well. (Fig. 1A and B) She underwent a right retro sigmoid craniectomy. The cerebellum was bulging and slackened after CSF drainage from the cisterna magna. The caudal vestibular schwannoma was excised primarily. It was entirely solid, yellowish-gray, firm and vascular. The cranial nerves including seventh-eighth complex were preserved by intraarachnoidal microsurgical dissection. The tumor had not significantly widened the IAM. There were extensive arachnoidal adhesions of the tumor with the brainstem, cerebellum and nerves. Radical excision of the lesion was performed. Subsequently the intraaxial lesion was approached. A small corticectomy was performed over the right cerebellum and the lesion was encountered at depth of 2 cm. It was hard, gritty, avascular and well capsulated. The lesion appeared to be a tuberculoma and it was meticulously separated from the surrounding gliotic cerebellar tissue. A thin rim of gliosis separated this lesion from the lesion in right cerebello-pontine angle. The lesion was seen to extend into the middle cerebellar peduncle. A safe maximal excision was performed. Histological examination of the caudal and rostral lesions revealed a vestibular schwannoma and tuberculoma respectively. The patient received antitubercular chemotherapy and was serially monitored using MR imaging at 3-6 months interval. At follow-up after 3 years, the patient is well and has no neurological deficit. She is leading an active and independent life. At follow-up MR imaging after 3 years showed minimal stable residue in the right middle cerebellar peduncle. The lesion in the pons has considerably reduced in size. There is no mass effect. The vestibular schwannoma has been completely resected (Fig. 1C and D).