Phosphaturic mesenchymal tumor (PMT) is a rare entity that can result in osteomalacia and electrolyte abnormalities. Typically, PMT is found in either bony or soft tissue sites along the axial or appendicular skeleton.1 Phosphaturic mesenchymal tumors have also been identified intracranially and in the temporal bone, masquerading as glomus jugulare, glomus tympanicum, or destructive lesion of the bony temporal bone.2-4 These tumors, even when small, can cause characteristic derangements in metabolism. Mediated by increased tumor-expressed fibroblast growth factor 23 (FGF 23), these tumors result in increased urinary excretion of phosphorus, decreased serum phosphorus, decreased 1,25-dihydroxyvitamin D, and normal serum calcium. These changes in phosphorus metabolism can result in osetomalacia.5 Herein, we present the first case to our knowledge describing a PMT of the cerebellopontine angle (CPA) masquerading as an acoustic neuroma.