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Sample records for benign ancient schwannoma

  1. Retroperitoneal Ancient Schwannoma: A Case Report.

    Science.gov (United States)

    Çalişkan, Selahattin; Gümrükçü, Gülistan; Kaya, Cevdet

    2015-01-01

    Schwannomas are extremely rare tumors that are composed of Schwann cells. Retroperitoneal localization comprises 0.7% to 2.6% of all schwannomas. Patients usually present with nonspecific symptoms. There are no pathognomonic features on radiologic evaluation. Preoperative biopsy is not recommended because of complication risks; however, surgery is necessary for diagnosis and treatment. Although most schwannomas are benign tumors, those that are associated with von Recklinghausen disease are malignant. Schwannomas exhibit regions of high and low cellularity, termed Antoni A and Antoni B areas, with a diffuse positivity of S100 protein on pathologic evaluation. If there are degenerative changes, such as cyst formation, hemorrhage, calcification, and hyalinization, these tumors are termed ancient schwannomas. We present a case of retroperitoneal ancient schwannoma.

  2. CASE REPORT: Giant Retroperitoneal Presacral Ancient Schwannoma

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    Al-Jiffry, B.O1, 2; Othman,B.S2; Hatem, M1

    2013-01-01

    Full Text Available Summary: Ancient schwannoma, is a rare variant of schwannoma with characterization of degenerative changes and diffuse hypercellularity. Retroperitoneal presacral form is often found incidentally, because they present with vague symptoms or symptomless. Schwannoma occurring in this area occasionally presents with enormous dimensions, known as a giant schwannoma. The tumor removal is a surgical challenge due to the difficult approach and abundant vascularity. In this report we describe a 61 –year old female presented to ER with vaginal bleeding and lower abdominal pain. The case diagnosed on clinical, CT and MRI findings to be a fibroma of the left ovary. Exploration by the gynecology team revealed a huge retroperitoneal presacral tumor compressing the left external iliac vessels and displacing the left ureter; they took a biopsy and closed the abdomen. Histopathological result was benign schwannoma. The patient were referred to our hospital (Al Hada Armed Forces Hospital, Taif, Saudi Arabia to be managed from postoperative DVT when her family asked our department of surgery for further management and signed a high risk consent. We explored the case after insertion of IVC filter and ureteric catheter. A 20x20 cm mass was thoroughly dissected and resected with part of sacrum. The final histopathological result was benign nerve sheath tumor with features consistent with degenerated (ancient schwannoma and the tumor was completely resected. The patient was discharged from the hospital without complications and follow up for three years revealed no recurrence. The clinical, radiological, and pathological features of this disease are discussed in this report. To conclude, retroperitoneal giant ancient schwannomas are a rare variant of the benign schwannoma and often present as unrecognized slow growing masses. Keep in mind potentially severe bleeding and neurological deficit risk of surgical intervention without away from oncologic principle

  3. Case report: Benign porta hepatic schwannoma

    International Nuclear Information System (INIS)

    Schwannoma is a myelin sheath tumor that can occur almost anywhere in the body. The most common locations are the central nervous system, extremities, neck, mediastinum and retroperitoneum. Benign schwannomas in the porta hepatis are extremely rare and radiologically are diagnosed as either enlarged lymph nodes or bowel masses, such as gastrointestinal stromal tumors. In this location they usually produce symptoms by compressing adjacent structures and often present with obstructive jaundice. The preoperative diagnosis can be extremely difficult

  4. Ancient schwannoma at the olfactory groove mimicking meningioma: A case report

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    Heo, Young Jin; Jeong, Hae Woong [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2015-12-15

    Schwannomas are benign slow-growing nerve sheath tumors, which can develop in any peripheral or central nerve that contains Schwann cells. Schwannomas located near the olfactory groove are extremely rare and radiological diagnosis can be difficult. Moreover, ancient schwannoma is an uncommon variant, and radiologic findings are rarely reported. Herein, we reported a surgically confirmed case of ancient schwannoma at the olfactory groove in a 44-year-old woman presenting with headache and visual disturbance. Brain magnetic resonance imaging (MRI) showed a solid and cystic extra-axial mass located in the subfrontal area mimicking an olfactory groove meningioma. Histopathologic diagnosis of ancient schwannoma was confirmed by immunohistochemical staining for S100, CD56, vimentin, and other markers. Furthermore, we described the clinical manifestations, MRI characteristics, and histopathologic findings of the case, and presented a review of related literature.

  5. Ancient schwannoma arising from mental nerve. A case report and review.

    Science.gov (United States)

    Subhashraj, Krishnaraj; Balanand, Subramanian; Pajaniammalle, Subhashraj

    2009-01-01

    Schwannoma is an intraoral rare, benign neoplasm derived from the nerve sheath of peripheral nerves. "Ancient schwannoma" shows histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. Ancient schwannoma of the head and neck region is relatively uncommon and very few cases had been reported in the oral cavity. We present a case of ancient schwannoma arising from the mental nerve in a 19 year old male which was of eight months duration. Examination revealed a 30 x 25 mm firm, strawberry-like mass in the periapical region of the left lower first premolar, extending anteriorly to the canine and posteriorly to the first molar, obliterating the buccal vestibule, with an intact overlying mucosa. Ultrasonography showed that the tumor was closely associated with the mental nerve on the left side, suggestive of a peripheral neural sheath tumor. Complete excision of the lesion was done under local anesthesia, preserving the mental nerve. The histological picture was strongly suggestive of ancient schwannoma (Antoni A type). There was no evidence of recurrence 18 months after excision. The clinicopathological aspects of this special case are discussed, and the literature regarding this entity is reviewed. PMID:19114949

  6. Benign retroperitoneal schwannoma presenting as colitis: A case report

    OpenAIRE

    Fass, Gary; Hossey, Didier; Nyst, Michel; Smets, Dirk; Saligheh, Esmail Najar; Duttmann, Ruth; Claes, Kathleen; da Costa, Pierre Mendes

    2007-01-01

    We report a case of a patient presenting with clinical , radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a ...

  7. Cellular schwannoma: a benign neoplasm sometimes overdiagnosed as sarcoma

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    Alberghini, M. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy); Anatomia Patologica, Istituto Rizzoli, Bologna (Italy); Zanella, L.; Bacchini, P.; Bertoni, F. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy)

    2001-06-01

    A case of cellular schwannoma originating in the left lumbar paraspinal region is described. The diagnosis was originally made on needle biopsy material. The histological examination is usually not sufficient to correctly diagnose this benign neoplasm. Bone erosion, neurological symptoms, caused by compression of the spinal roots, together with hypercellularity, pleomorphism and an occasional increase in mitotic activity, may lead to an erroneous diagnosis of malignancy. Immunohistochemistry and ultrastructural analysis are helpful in confirming the diagnosis. The recognition of this entity avoids unnecessary overtreatment of these patients. (orig.)

  8. Benign retroperitoneal schwannoma presenting as colitis: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a case of a patient presenting with clinical, radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a wide spectrum of nonspecific symptoms, including lumbar pain, headache, secondary hypertension, abdominal pain and renal colicky pain. CT and MR findings show characteristic features, but none are specific. Schwannoma can be isolated sporadic lesions, or associated with schwannomatosis or neurofibromatosis type Ⅱ (NF2). Although they vary in biological and clinical behavior, their presence is, in nearly every case, due to alterations or absence of the NF2 gene, which is involved in the growth regulation of Schwann cells. Both conditions were excluded by thorough mutation analysis. Diagnosis is based on histopathological examination and immunohistochemistry. Total excision is therapeutic and has a good prognosis. Schwannomatosis and NF2 should be excluded through clinical diagnostic criteria. Genetic testing of NF2 is probably not justified in the presence of a solitary retroperitoneal schwannoma.

  9. Giant solitary ancient schwannoma of the pleura masquerading as bronchopneumonia

    Science.gov (United States)

    Gilbert, Shegu; Singh, Devender; Kaliappan, Sivakumar Manjanaikkanpatti; Mehta, Sangita Sharma

    2016-01-01

    We report a 53-year-old female who presented with complaints of sudden onset breathlessness, cough with expectoration for 6 months, and a right lung base lesion in the chest X-ray, which was diagnosed and treated as bronchopneumonia by the family physician. High-resolution computed tomography of the chest was done which revealed a large heterogeneously enhancing mass in the right thoracic cavity. She underwent thoracotomy and was found to have a giant encapsulated and well-circumscribed mass arising from the pleura. Excision biopsy of the mass revealed it to be an ancient schwannoma. Ancient schwannoma of the pleura is a very rare entity. Complete surgical resection is curative.

  10. Benign giant mediastinal schwannoma presenting as cardiac tamponade in a woman: a case report

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    Sekiya Mitsuaki

    2011-02-01

    Full Text Available Abstract Introduction Mediastinal schwannomas are typically benign and asymptomatic, and generally present no immediate risks. We encountered a rare case of a giant benign posterior mediastinal schwannoma, complicated by life-threatening cardiac tamponade. Case presentation We report the case of a 72-year-old Japanese woman, who presented with cardiogenic shock. Computed tomography of the chest revealed a posterior mediastinal mass 150 cm in diameter, with pericardial effusion. The cardiac tamponade was treated with prompt pericardial fluid drainage. A biopsy was taken from the mass, and after histological examination, it was diagnosed as a benign schwannoma, a well-encapsulated non-infiltrating tumor, originating from the intrathoracic vagus nerve. It was successfully excised, restoring normal cardiac function. Conclusion Our case suggests that giant mediastinal schwannomas, although generally benign and asymptomatic, should be excised upon discovery to prevent the development of life-threatening cardiopulmonary complications.

  11. Cellular schwannoma: a rare spinal benign nerve-sheath tumor with a pseudosarcomatous appearance: case report

    OpenAIRE

    Landeiro José Alberto; Ribeiro Carlos Henrique; Galdino Alexandre C.; Taubman Elizabeth; Guarisch Alfredo J.

    2003-01-01

    We report a case of cellular schwannoma, a rare benign nerve-sheath tumor in a 27 year-old woman. It was presented as a voluminous lesion in the paraspinal region that caused lumbar vertebral body destruction. These features, in association to the microscopic aspects of a hypercellular, pleomorphic neoplasm may lead to a false impression of a malignant tumor. Therefore, it is important to have an accurate examination to confirm the benign nature of this tumor thus avoiding unnecessary therapy.

  12. SCHWANNOMA OF THE CERVICAL VAGUS NERVE: A RARE BENIGN NEUROGENIC TUMOR

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    Gokce SIMSEK

    2013-06-01

    Full Text Available A schwannoma, also known as an acoustic neuroma, is a benign nerve sheath tumor composed of schwann cells, which normally produce the insulating myelin sheath covering the peripheral nerves. Schwannoma, originating from the cervical vagus nerve, is an extremely rare neoplasm that usually occurs in men between the 3rd and 6th decades of life. The most common presentation is a painless, slow-growing, lateral neck mass;this appears in a large proportion of cases. Complete surgical resection with care to protect the nerve of origin is the recommended treatment of choice. Here, we report a case of cervical vagal schwannoma in a 55-year-old male who admitted with the complaint of a firm and painless mass lesion on the right side of the neck. The management of the case is discussed along with the relevant literature.

  13. Gastric schwannoma: a benign tumor often misdiagnosed as gastrointestinal stromal tumor

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    Apurva S. Shah

    2015-10-01

    Full Text Available Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma.

  14. Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas.

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    Lau, Ryan P; Melamed, Jonathan; Yee-Chang, Melissa; Marcus, Sonya; Givi, Babak; Zamuco, Ronaldo

    2016-09-01

    Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract, rarely involving the head/neck region. This is the first reported case involving the submandibular gland. We present a case in a 34 year old man with 4.5 cm submandibular mass. Fine needle aspiration suggested a spindle cell lesion. Frozen section evaluation raised the possibility of mucoepidermoid carcinoma. Resection showed a well circumscribed mass with a mucoid appearance. Histologic findings include a lobular architecture with fibrous septa, a lympho-plasmacytic infiltrate, and scattered lymphoid aggregates at the periphery. There are two distinct histologic patterns with solid areas of spindle cells and areas of spindle/ovoid cells with a microcystic pattern in a myxoid background. The tumor has a pushing border, with extension into adipose and adjacent parenchyma, without cytologic atypia or necrosis. Immunohistochemical stains are positive for S-100 and CD34, and negative for calponin, mammoglobin, ALK1, p63, ER, GFAP, SMA, desmin, cytokeratin 7, cytokeratin AE1/AE3, and C-Kit. Mucicarmine stain is negative. Recognition of this benign unusual variant of schwannoma is paramount for appropriate conservative treatment due to the morphologic and immunohistochemical overlap with primary salivary gland carcinomas. PMID:26621673

  15. Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas.

    Science.gov (United States)

    Lau, Ryan P; Melamed, Jonathan; Yee-Chang, Melissa; Marcus, Sonya; Givi, Babak; Zamuco, Ronaldo

    2016-09-01

    Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract, rarely involving the head/neck region. This is the first reported case involving the submandibular gland. We present a case in a 34 year old man with 4.5 cm submandibular mass. Fine needle aspiration suggested a spindle cell lesion. Frozen section evaluation raised the possibility of mucoepidermoid carcinoma. Resection showed a well circumscribed mass with a mucoid appearance. Histologic findings include a lobular architecture with fibrous septa, a lympho-plasmacytic infiltrate, and scattered lymphoid aggregates at the periphery. There are two distinct histologic patterns with solid areas of spindle cells and areas of spindle/ovoid cells with a microcystic pattern in a myxoid background. The tumor has a pushing border, with extension into adipose and adjacent parenchyma, without cytologic atypia or necrosis. Immunohistochemical stains are positive for S-100 and CD34, and negative for calponin, mammoglobin, ALK1, p63, ER, GFAP, SMA, desmin, cytokeratin 7, cytokeratin AE1/AE3, and C-Kit. Mucicarmine stain is negative. Recognition of this benign unusual variant of schwannoma is paramount for appropriate conservative treatment due to the morphologic and immunohistochemical overlap with primary salivary gland carcinomas.

  16. Clinical Analysis of 81 Cases of Benign Retroperitoneal Schwannoma%81例良性腹膜后神经鞘瘤临床分析

    Institute of Scientific and Technical Information of China (English)

    李强; 高春涛

    2006-01-01

    Objective: To analyze the clinical manifestations of retroperitoneal schwannoma in order to improve the diagnosis and treatment of this rare disease. Methods: Between January 1951 and September 2004, 81 patients with retroperitoneal schwannoma were retrospectively analyzed. Results: All cases received operative therapy. Sixty cases (74.1%) received a total resection; 12 cases (14.9%) subtotal resection, and 9 cases (11.1%) exploration. During the surgical operation, a single tumor was found in 77 cases (95.1%), and multiple tumors in 4 cases (4.9%). Most of the retroperitoneal schwannomas located beside the spine. The tumor was a fusiform, round or oval mass that was sharply circumscribed and encapsulated. Pathologic results showed all 81 cases were benign schwannoma. In the 4 cases of multiple tumors,2 (2.5%) were diagnosed as double-primary tumors associated with ascending colon adenocarcinoma and lung squamous-cell cancer. One case recurred postoperatively. Conclusion: Retroperitoneal schwannoma was rare and preoperative diagnosis was difficult. Most of retroperitoneal schwannoma were benign and the surgical treatment was the first choice.

  17. Intracochlear Schwannoma: A Rare Lesion

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    Nazim Sangram

    2016-01-01

    Full Text Available Intralabyrinthine schwannoma is a rare cause of sensorineural hearing loss and intractable vertigo. Schwannoma is a benign neoplasm of the nerve sheath. Acoustic schwannomas can arise anywhere along the entire course of the eighth cranial nerve, usually from intracanalicular portion of either the inferior or superior division of vestibular nerve. Intralabyrinthine schwannoma arises primarily from intralabyrinthine branches of the eight cranial nerve and initially have no component in the internal auditory canal (IAC. We report a case of a young lady with left sided progressive hearing loss. Magnetic resonance imaging of cochlea documented intralabyrinthine schwannoma (intracochlear type. She underwent surgery and histopathology confirmed the diagnosis of schwannoma.

  18. Intraosseous schwannoma in schwannomatosis

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    Kashima, T.G.; Gibbons, M.R.J.P.; Whitwell, D.; Gibbons, C.L.M.H.; Bradley, K.M.; Ostlere, S.J.; Athanasou, N.A. [University of Oxford, Nuffield Orthopaedic Centre, Department of Pathology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford (United Kingdom)

    2013-12-15

    This study investigates the clinical, radiological, and pathological features of two cases of intraosseous schwannoma that arose in patients with multiple soft tissue schwannomas. In both cases, the patients were adult females and the tibial bone was affected. Vestibular schwannomas were not identified, indicating that these were not cases of neurofibromatosis 2 (NF2). Radiographs showed a well-defined lytic lesion in the proximal tibia; in one case, this was associated with a pathological fracture. Histologically, both cases showed typical features of benign schwannoma. Molecular analysis of one of the excised tumors showed different alterations in the NF2 gene in keeping with a diagnosis of schwannomatosis. Our findings show for the first time that intraosseous schwannomas can occur in schwannomatosis. (orig.)

  19. Intraosseous schwannoma in schwannomatosis.

    Science.gov (United States)

    Kashima, T G; Gibbons, M R J P; Whitwell, D; Gibbons, C L M H; Bradley, K M; Ostlere, S J; Athanasou, N A

    2013-12-01

    This study investigates the clinical, radiological, and pathological features of two cases of intraosseous schwannoma that arose in patients with multiple soft tissue schwannomas. In both cases, the patients were adult females and the tibial bone was affected. Vestibular schwannomas were not identified, indicating that these were not cases of neurofibromatosis 2 (NF2). Radiographs showed a well-defined lytic lesion in the proximal tibia; in one case, this was associated with a pathological fracture. Histologically, both cases showed typical features of benign schwannoma. Molecular analysis of one of the excised tumors showed different alterations in the NF2 gene in keeping with a diagnosis of schwannomatosis. Our findings show for the first time that intraosseous schwannomas can occur in schwannomatosis. PMID:23995262

  20. LINGUAL SCHWANNOMA: OUR EXPERIENCE

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    Aneesa A Mirza

    2012-08-01

    Full Text Available Schwannomas are benign tumors of nerve sheath and quite uncommon in oral cavity. The case of a 15 yr old male is presented who had a 4 months history of swelling on right lateral border of tongue associated with disturbance in mastication. Examination revealed a 2x2 cm globular and smooth swelling on right lateral border of tongue. Complete excision with primary closure was carried out. Histopathological examination of the surgical specimen was consistent with schwannoma.

  1. Cellular schwannoma: a rare spinal benign nerve-sheath tumor with a pseudosarcomatous appearance: case report Schwanoma celular: um tumor benigno com características malignas: relato de caso

    OpenAIRE

    José Alberto Landeiro; Carlos Henrique Ribeiro; Alexandre C. Galdino; Elizabeth Taubman; Alfredo J. Guarisch

    2003-01-01

    We report a case of cellular schwannoma, a rare benign nerve-sheath tumor in a 27 year-old woman. It was presented as a voluminous lesion in the paraspinal region that caused lumbar vertebral body destruction. These features, in association to the microscopic aspects of a hypercellular, pleomorphic neoplasm may lead to a false impression of a malignant tumor. Therefore, it is important to have an accurate examination to confirm the benign nature of this tumor thus avoiding unnecessary therapy...

  2. Intraosseous schwannoma of the humerus

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    Mutema, George K. [Department of Pathology, University of Cincinnati, OH (United States); Sorger, Joel [Department of Orthopedic Surgery, University of Cincinnati, OH (United States)

    2002-07-01

    Intraosseous schwannomas are rare benign neoplasms of the bone, of which fewer than 200 cases have been described in the world literature. These tumors are well-defined, lytic lesions, rarely associated with pathologic fracture. The mandible is the most frequently involved bone. We present only the third case of an intraosseous schwannoma involving the humerus. (orig.)

  3. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno;

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...

  4. Intrascrotal extratesticular schwannoma: A first pediatric case

    OpenAIRE

    Bergeron, Michelle; Bolduc, Stéphane; Labonté, Sébastien; Moore, Katherine

    2014-01-01

    Scrotal nerve sheath tumours unassociated with neurofibromatosis or schwannomatosis are extremely rare. Very few cases of benign intrascrotal and extratesticular schwannomas have been reported, but none of them occurred in childhood. This current report describes for the first time a case of benign intrascrotal extratesticular solitary schwannoma in a 16-year-old male.

  5. Intrascrotal extratesticular schwannoma: A first pediatric case.

    Science.gov (United States)

    Bergeron, Michelle; Bolduc, Stéphane; Labonté, Sébastien; Moore, Katherine

    2014-03-01

    Scrotal nerve sheath tumours unassociated with neurofibromatosis or schwannomatosis are extremely rare. Very few cases of benign intrascrotal and extratesticular schwannomas have been reported, but none of them occurred in childhood. This current report describes for the first time a case of benign intrascrotal extratesticular solitary schwannoma in a 16-year-old male. PMID:24839501

  6. Schwannomas of the head and neck

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    Anastasios Kanatas

    2011-12-01

    Full Text Available Schwannomas are benign encapsulated nerve sheath tumors composed of Schwann cells. Malignant change in head and neck schwannomas is rare, with the incidence varying between 8 and 13.9%. In this review, we discuss the presentation and the management of head and neck schwannomas. The issues and difficulties based on our own experience as well as the experience of published reports from the literature are presented.

  7. Gastric schwannoma coexists with peptic ulcer perforation

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    Volkan İnce

    2011-09-01

    Full Text Available Gastric schwannoma is a benign neoplasm that originates from sheet of nerve cell in stomach. Differential diagnosis of gastrointestinal stromal tumors, (GISTs which have malign potential, than these tumors, which definite diagnosis is determined by histopathological and immunohistochemical methods have clinical significance due to gastric schwannomas have excellent progress after surgical resection. We presented a case of gastric schwannoma coexists with peptic ulcer perforation with guide of literature in this study.

  8. Pancreatic schwannoma: A rare case and a brief literature review

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    Ercan, Metin; Aziret, Mehmet; Bal, Ali; Şentürk, Adem; Karaman, Kerem; Kahyaoğlu, Zeynep; Koçer, Havva Belma; Bostancı, Birol; Akoğlu, Musa

    2016-01-01

    Introduction Pancreatic schwannoma (PS) is an extremly rare benign tumor. Less than 50 cases of pancreatic schwannoma have been described in the English literature over the past thirty years. Presentation of case report A 63-year-old female underwent left modified radical mastectomy 2 years ago due to breast cancer. During her routine check-up, a 65 × 63 × 55 mm measured calcified, well-demarcated, cystic-mass having septations and calcifications that localized to the pancreatic head was detected by abdominal computerized tomography. She was asymptomatic and her tumor markers were in normal ranges. A standard Whipple procedure was performed, and the histo-pathological diagnosis of the resected specimen was reported as ancient schwannoma with clear surgical margins. Patient’s postoperative course was eventful. She had a biliary leakage after surgery which was managed conservatively. She is under follow-up. Discussion Pancreatic schwannoma also known as neurilemoma or neuroma is a slowly growing, encapsulated, mostly benign tumor with smooth well-delineated margins that originates from myelin producing schwann cells located on the nerve sheath of the peripheral epineurium of either the sympathetic or parasympathetic autonomic fibers. PS’s are extremly rare. The head of pancreas being involved in the vast majority of cases (40%), followed by its body (20%). Management of pancreatic schwannomas remains largely controversial. Both enucleation and radical surgical resections have revealed great therapeutic efficiency. with a well prognosis without recurrences. Conclusion Although rare, PS’s should be considered in the differential diagnosis of the other solid or cystic masses of the pancreas. PMID:27084984

  9. Accessory Nerve Schwannoma Containing Multiple Calcifed Foci: Unusual Presentation

    OpenAIRE

    Leila Aghaghazvini; Habib Mazaher; Hashem Sharifian; Shirin Aghaghazvini

    2009-01-01

    "nIntroduction: Schwannomas are benign neural tumors which arise from the nerve sheath. Schwannomas of the accessory nerve are rare lesions. The clinical presentation of cranial nerve XI schwannomas relates to their location and extent: intracranial, jugular foramen, upper neck, or cervical spine. The extra cranial form is the least common reported. Calcified accessory schwannoma is rare. These lesions most often occur in the third to sixth decades of life. These tumors are slightly more...

  10. Vestibular schwannoma treatment : patients’ perceptions and outcomes

    NARCIS (Netherlands)

    Godefroy, Willem Paul

    2010-01-01

    Vestibular schwannomas are benign intracranial tumors which generally arise from the Schwann cells of the superior part of the vestibular portion of the eight cranial nerve. The most common symptoms accompanying vestibular schwannoma (VS) are unilateral hearing loss, tinnitus, vertigo and unsteadine

  11. Isolated colonic schwannoma in the ascending colon: A case report and literature review of Schwannomas in the large intestine

    Energy Technology Data Exchange (ETDEWEB)

    Nam, In Chul; Lee, Ye Daum; Kim, Seung Ho; Yoon, Jung Hee; Baek, Hye Jin; Lee, Kwang Hwi; Nam, Kyung Han [Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2015-05-15

    Schwannomas are benign mesenchymal spindle cell tumors arising from the Schwann cells that form the peripheral neural sheath. Several recent studies indicate that although reports of gastrointestinal schwannomas have increased with advanced technological developments in immunohistochemical staining, isolated colonic schwannomas are extremely rare. Moreover, it is known to be somewhat difficult to diagnose colonic schwannoma before surgical operation. In this paper, we report a case of isolated schwannoma that was incidentally discovered in the ascending colon, along with a review of few recent literatures.

  12. Retroperitoneal Schwannoma: A Rare Case

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    Murat Kalaycı

    2011-01-01

    Case Presentation. A 38-year-old woman was admitted to the emergency service with the complaints of progressive abdominal pain and nausea for the last 24 hours. Abdominal examination was compatible with acute abdomen. Acute appendicitis was diagnosed by CT. During CT evaluation, a round shaped soft-tissue mass at the retroperitoneal area inferior to the right kidney was detected, The mass was resected and histology revealed schwannoma. Conclusion. Rare tumoral lesions with benign course such as schwannoma can be detected incidentally.

  13. Laryngeal schwannoma: a case report with emphasis on sonographic findings

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    Souza, Luis Ronan Marquez Ferreira de, E-mail: luisronan@gmail.com [Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG (Brazil); De Nicola, Harley; Yamasaki, Rosiane; Pedroso, Jose Eduardo; Brasil, Osiris de Oliveira Campones do; Yamashita, Helio [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina

    2014-05-15

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings. (author)

  14. A rare adrenal incidentaloma: adrenal schwannoma.

    Science.gov (United States)

    Adas, Mine; Ozulker, Filiz; Adas, Gokhan; Koc, Bora; Ozulker, Tamer; Sahin, Ilknur Mansuroglu

    2013-01-01

    Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [(18)F] fluorodeoxyglucose positron emission tomography (PET) were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging. PMID:24403879

  15. A Rare Adrenal Incidentaloma: Adrenal Schwannoma

    Directory of Open Access Journals (Sweden)

    Mine Adas

    2013-10-01

    Full Text Available Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT of the abdomen and [18F] fluorodeoxyglucose positron emission tomography (PET were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging.

  16. TONGUE BASE SCHWANNOMA : A RARE ENTITY

    Directory of Open Access Journals (Sweden)

    Vivek

    2015-03-01

    Full Text Available INTRODUCTION: Schwannomas are the benign tumours arising from the Schwann cells. Intraoral and pharyngeal schwannomas are rare and constitute less than 1%. CASE REPORT: We report a case of a 39 year old lady who presented with progressive dysphagia and dysphonia since three months. Intraoral examination showed a well - defined reddish lesion arising from the base of the tongue. She was referred to the department of radiodiagnosis for CT and MRI of the neck to know the extent of the lesion. Differential diagnosis of schwannoma and minor salivary gland tumor was given. Excision biopsy of the lesion was done and the histologic examination showed it as schwannoma. DISCUSSION: Schwannomas of the base of the tongue are rare and should be included in the differential diagnosis based on the imaging features and enhancem ent pattern. CONCLUSION: Imaging features, particularly MRI with contrast helps in differentiating benign from malignant lesions of the base of the tongue. Schwannomas are benign and have good prognosis as they can be excised when compared to the other intraoral malignant lesions.

  17. Tracheal schwannoma: Completely resected with therapeutic bronchoscopic techniques

    OpenAIRE

    Barney Thomas Jesudason Isaac; Devasahayam Jesudasan Christopher; Balamugesh Thangakunam; Mayank Gupta

    2015-01-01

    Tracheal schwannomas are rare benign tumors of the trachea. There are only a few reported cases in the literature. Surgeons have generally resected these tumors, whereas bronchoscopists have attempted to remove them bronchoscopically. We report a case of tracheal schwannoma which was completely resected using bronchoscopic techniques.

  18. Radiosurgery of Spinal Meningiomas and Schwannomas

    OpenAIRE

    Kufeld, M; Wowra, B.; Muacevic, A.; Zausinger, Stefan; Tonn, Jörg-Christian

    2012-01-01

    Purpose of this study is to analyze local control, clinical symptoms and toxicity after image-guided radiosurgery of spinal meningiomas and schwannomas. Standard treatment of benign spinal lesions is microsurgical resection. While a few publications have reported about radiosurgery for benign spinal lesions, this is the first study analyzing the outcome of robotic radiosurgery for benign spinal tumors, treated exclusively with a non-invasive, fiducial free, single-fraction setup. Thirty-six p...

  19. CT findings of esophageal schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Man Ho; Ryu, Dae Shick; Eom, Dae Woon; Shin, Dong Rock; Choi, Soo Jung; Ahn, Jae Hong; Park, Man Soo; Yoo, Dong Kon [Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung (Korea, Republic of)

    2015-03-15

    Esophageal schwannomas are a relative rare benign neoplasm that usually occurs in the upper esophagus, in the middle aged women. We report a case of a 67-year-old man with a lower esophageal schwannoma. This lesion was composed of homogenous density, iso-attenuating with the chest wall muscle on pre- and post-contrast chest computed tomography (CT). The CT findings of the esophageal schwannoma are similar to those of esophageal leiomyoma. Hense, esophageal schwannoma may be a differential diagnosis with esophageal leiomyoma.

  20. Laparoscopic Resection of an Adrenal Schwannoma

    Science.gov (United States)

    Konstantinos, Toutouzas G.; Panagiotis, Kekis B.; Nikolaos, Michalopoulos V.; Ioannis, Flessas; Andreas, Manouras; Geogrios, Zografos

    2012-01-01

    Background and Objectives: Schwannomas are tumors originating from Schwann cells of the peripheral nerve sheath (neurilemma) of the neuroectoderm. Rarely, schwannomas can arise from the retroperitoneum and adrenal medulla. We describe a case of a 71-y-old woman who presented with an incidentally discovered adrenal tumor. Methods: Ultrasound and computed tomography scans revealed a lesion with solid and cystic areas originating from the left adrenal gland. The patient underwent complete laparoscopic resection of the tumor and the left adrenal gland. Results: Histopathological examination and immunohistochemical staining of the excised specimen revealed a benign schwannoma measuring 5.5×5×3.7 cm. To our knowledge, few other cases of laparoscopic resection of adrenal schwannomas have been reported. Conclusion: Because preoperative diagnosis of adrenal tumors is inconclusive, complete laparoscopic excision allows for definitive diagnosis with histological evaluation and represents the treatment of choice. PMID:23484583

  1. Facial Schwannoma

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    Mohammadtaghi Khorsandi Ashtiani

    2005-06-01

    Full Text Available Background: Facial schwannoma is a rare tumor arising from any part of the nerve. Probable symptoms are partial or facial weakness, hearing loss, visible mass in the ear, otorrhea, loss of taste, rarely pain, and sometimes without any symptoms. Patients should undergo a complete neurotologic history, examination with documentation of facial and auditory function, specially C.T. scan or M.R.I. Surgery is the only treatment option although the decision of when to remove facial schwannoma in the presence of normal facial function is difficult. Case: A 19-year-old girl with all above symptoms in the right side except loss of taste is diagnosed having facial schwannoma with full examination, audiometric, and radiological tests. She underwent surgery. In follow-up facial function were mostly restored. Conclusion: The need for careful assessment of patients with Bell's palsy cannot be overemphasized. In spite of the negative results if still there is any suspicoin, total facial nerve exploration is necessary.

  2. MR findings in intralabyrinthine schwannomas

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    Montague, Mary-Louise; Kishore, Ameet; Hadley, Donald M.; O' Reilly, Brian

    2002-05-01

    AIM: Intralabyrinthine schwannomas (ILS) are rare benign tumours. They are not always recognized on routine magnetic resonance imaging (MRI). We aimed to study the clinical presentation and MRI findings in our patients with ILS. MATERIALS AND METHODS: Retrospective analysis of patients with vestibular schwannomas treated at this center. RESULTS: Of 144 vestibular schwannomas studied at this centre, three patients had an ILS. The most common presenting symptoms were unilateral hearing loss, tinnitus and vertigo. Two patients demonstrated a progressive sensorineural hearing loss (SNHL). The third patient had a severe SNHL at presentation. MRI enhanced with contrast medium was positive in the two patients with progressive SNHL and negative in the patient with the severe SNHL. CONCLUSION: This series demonstrates the ability of MRI to identify schwannomas filling the labyrinth, and also its inability to identify extremely small ILS. It underlines the importance of sending the cristae of patients undergoing labyrinthectomy for presumed Meniere's disease for histological examination. Montague, M.-L. et al. (2002)

  3. Atypical Manifestation of Vestibular Schwannoma

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    Webster, Guilherme

    2013-09-01

    Full Text Available Introduction: Vestibular schwannoma (also known as acoustic neuroma is a benign tumor whose cells are derived from Schwann sheaths, which commonly occurs from the vestibular portion of the eighth cranial nerve. Furthermore, vestibular schwannomas account for ∼8% of intracranial tumors in adults and 80 to 90% of tumors of the cerebellopontine angle. Its symptoms are varied, but what stands out most is a unilateral sensorineural hearing loss, with a low index of speech recognition. Objective: Describe an atypical manifestation of vestibular schwannoma. Case Report: The 46-year-old woman had vertigo and binaural hearing loss and fullness, with ear, nose, and throat examination suggestive of cochlear injury. After 6 months, the patient developed worsening of symptoms and onset of right unilateral tinnitus. In further exams the signs of cochlear damage remained, except for the vestibular test (hyporeflexia. Magnetic resonance imaging showed an expansive lesion in the right cerebellopontine angle. Discussion: This report warns about the atypical manifestations of vestibular schwannoma, which must always be remembered in investigating and diagnosing hearing loss.

  4. Nasal Schwannoma: a case report

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    Siu-Navarro YJ, Pérez-Carbajal AJ

    2013-10-01

    Full Text Available Introduction: Schwannomas are benign tumors that arise from Schwann cells peripheral nerves sheath. About 25-45% occur in the head and neck and only 4% of these tumors involve the sinunasal tract.Objective: To provide, through a clinic case and lecture review, the clinical and radiopatology findings of a bening and unusual tumors, as are the Nasal schwannomas. Case Report: We report a case of a young woman with nasal schwannoma, who complain of left nasal obstruction and rhinorrhea, which after subsequent imaging studies, surgical and pathology analisis, diagnosis was found. Sustained a favorable clinical evolution.Results and Discussion: The clinic and radiologic findings are nonspecific, depend upon the location or size of the tumor and subsequent involvement of surrounding structures, but generally present as a mass with less agressive behavior. The elective treatment is surgery, confirming this disease by microscopic and immunohistochemistry studies.Conclusion: Given these aspects must be considered nasal schwannomas within the differential diagnosis of a tumor with less aggressive behavior, clinical-radiological, because implies good results for the patient and unusual recurrence after surgery.

  5. Solid cystic trigeminal schwannoma with intraorbital extension causing proptosis and vision loss

    Science.gov (United States)

    Gupta, Pankaj; Sharma, Arvind; Singh, Jitendra

    2016-01-01

    Schwannomas are slowly growing, well capsulated, benign tumors. Involvement of vestibular nerve is most commonly followed by trigeminal nerve. Trigeminal schwannoma is rare entity, and cystic degeneration with intraorbital extension of trigeminal schwannoma is even rarer. These tumors occur in fourth and fifth decades of life and patients have variable presentation depending on which cranial compartment is involved. Orbital schwannoma usually presents with proptosis with or without vision loss. We are reporting such a rare case of solid cystic trigeminal schwannoma with intraorbital extension through superior orbital fissure that was removed surgically.

  6. Solid cystic trigeminal schwannoma with intraorbital extension causing proptosis and vision loss

    Science.gov (United States)

    Gupta, Pankaj; Sharma, Arvind; Singh, Jitendra

    2016-01-01

    Schwannomas are slowly growing, well capsulated, benign tumors. Involvement of vestibular nerve is most commonly followed by trigeminal nerve. Trigeminal schwannoma is rare entity, and cystic degeneration with intraorbital extension of trigeminal schwannoma is even rarer. These tumors occur in fourth and fifth decades of life and patients have variable presentation depending on which cranial compartment is involved. Orbital schwannoma usually presents with proptosis with or without vision loss. We are reporting such a rare case of solid cystic trigeminal schwannoma with intraorbital extension through superior orbital fissure that was removed surgically. PMID:27695572

  7. Intralabyrinthine schwannoma shown by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Saeed, S.R. (Univ. Dept. of Otolaryngology, Manchester Royal Infirmary (United Kingdom)); Birzgalis, A.R. (Univ. Dept. of Otolaryngology, Manchester Royal Infirmary (United Kingdom)); Ramsden, R.T. (Univ. Dept. of Otolaryngology, Manchester Royal Infirmary (United Kingdom))

    1994-01-01

    Intralabyrinthine schwannomas are rare benign tumours which present with progressive or fluctuant audiovestibular symptoms and may mimic Menieres disease. The size and position of these lesions make preoperative diagnosis unusual and most are discovered incidentally at labyrinthectomy. A case is reported which was diagnosed on magnetic resonance imaging and confirmed at surgery. (orig.)

  8. F 18 FDG PET/CT of a Gastric Schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Il Ki; Kim, Deog Yoon [Kyung Hee Univ. School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Schwannomas, also known as neurilemmomas, are tumors originating from nervous tissue; they have Schwann cell sheaths. According to a recent classification, about 80% of gastrointestinal mesenchymal tumors are gastrointestinal stromal tumors (GISTs). Gastrointestinal (GI) Schwannomas have been reported to represent only 3% of all GI mesenchymal tumors. These tumors make up only 0.2% of all gastric neoplasms. Schwannomas of the GI tract are distinctive from conventional Schwannomas that arise in soft tissue of the central nervous system. GI Schwannomas are hypothesized to arise from the myenteric plexus within the GI tract wall. These tumors are usually benign, slow growing and asymptomatic, and therefore most are discovered incidentally. The differentiation of Schwannomas from other submucosal tumors is very difficult. The main differential diagnosis for a mass arising in the wall of the gastointestinal tract is a GIST, which is a potentially malignant mesenchymal GI tumor that arises from the interstitial cells of Cajal, which help regulate peristalsis. The diagnostic determination of Schwannomas requires positive histological tests for S 100 protein and vimentin, but negative histological tests for smooth muscle actin and c KIT. In contrast, GISTs are C KIT positive and can be S 100 positive if they are located in small bowel. Because most patients with Schwannomas have excellent prognoses, surgical removal is sufficient for treatment. Gastric Schwannomas are normally benign, and malignant transformation is extremely rare. However, the current case illustrates that these tumors may exhibit avid F 18 FDG uptake. It remains unclear why high F 18 FDG uptake is found in benign tumors such as Schwannomas. F 18 FDG uptake in soft tissue and neural Schwannomas is variable but is frequently high, possibly due to over expression of the glucose transporter by tumor cells. In particular, glucose transporter type 3 is found in all human tissues and is the major glucose

  9. Schwannomas cervicales

    OpenAIRE

    Torres Morientes, Luis Miguel; Martín Pascual, María Consolación; Bauer, Michael; Hernández de los Santos, María; Casasola Girón, Sandra Marleny; Álvarez-Quiñones Sanz, María; Morais Pérez, Darío

    2015-01-01

    [ES] Introducción y objetivo: Los schwannomas son tumores benignos derivados de las células de Schwann. El síntoma más frecuente es una tumoración cervical aislada, palpable, de tamaño variable y habitualmente asintomática. El diagnóstico de sospecha es clínico-radiológico y el definitivo es el estudio histológico. El tratamiento electivo es la cirugía y en raras ocasiones se producen recidivas o malignización. Explicamos mediante la revisión del tema y la descripción de los casos la etiologí...

  10. Giant cystic schwannoma of the middle mediastinum with cervical extension

    Directory of Open Access Journals (Sweden)

    Majdi Gueldich

    2015-04-01

    Full Text Available Schwannomas (neurilemmomas are benign tumors arising from the Schwann cells of the neural sheath. They are typically, well-encapsulated lesions which rarely adhere to the adjacent structures. In the chest, schwannomas are often seen within the posterior mediastinum and commonly originating along intercostal nerves. Several operative approaches have previously been described for the resection of these tumors, including thoracoscopic techniques and posterolateral thoracotomy. We report in this case a giant cystic mediastinal schwannoma of the left recurrent laryngeal nerve with cervical extension, unresectable by the usual described approaches, which was completely removed through a cervical approach.

  11. Plexiform Schwannoma of the Stomach in Neurofibromatosis Type 2: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jung [Dept. of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Yeom, Dong Heon; Cho, Hyun Sun; Cho, Woo Ho [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Plexiform schwannoma is a relatively rare benign subepithelial tumor arising from the peripheral nerve sheath, and associated with Neurofibromatosis type 2 (NF2). There are a few reports of plexiform schwannomas arising from the gastrointestinal tract, and to our knowledge, there is no report of it arising from the stomach in a patient with NF2. Here we present the first case of a plexiform schwannoma of the stomach in an NF2 patient a submucosal tumor on radiologic finding.

  12. Multiple Schwannomas of the Spine: Review of the Schwannomatosis or Congenital Neurilemmomatosis: A Case Report

    OpenAIRE

    Lee, Sang-Hoon; Kim, Se-Hoon; Kim, Bum-Joon; Lim, Dong-Jun

    2015-01-01

    Schwannomas are the most common benign nerve sheath tumors originating in Schwann cells. With special conditions like neurofibromatosis type 2 or entity called schwannomatosis, patients develop multiple schwannomas. But in clinical setting, distinguishing schwannomatosis from neurofibromatosis type 2 is challengeable. We describe 58-year-old male who presented with severe neuropathic pain, from schwannomatosis featuring multiple schwannomas of spine and trunk, and underwent surgical treatment...

  13. P07.04PROMOTER METHYLATION OF THE LATS1 AND LATS2 GENES IN SCHWANNOMAS

    OpenAIRE

    Ohta, T.(Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan); Oh, J; Mittelbronn, M; Paulus, W; Ohgaki, H.

    2014-01-01

    Schwannoma is a benign nerve sheath tumor that is typically encapsulated and composed of well-differentiated Schwann cellswhich comprises 5-10% of all intracranial tumors in adults. Approximately 90% of schwannomas are solitary and sporadic, whereas ∼4% are considered to arise in the setting of neurofibromatosis type 2 (NF2) syndrome by NF2 germline mutations. The molecular basis of sporadic schwannomas is not fully understood, other than frequent NF2 mutations (∼60%). LATS1 and the related L...

  14. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report

    Science.gov (United States)

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun

    2016-01-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  15. Special problems encountering surgical management of large retroperitoneal schwannomas

    OpenAIRE

    Kondi-Pafitis Agathi; Marinis Athanasios; Yiallourou Anneza; Tsiantoula Paraskevi; Stafyla Vaia K; Theodosopoulos Theodosios; Chatziioannou Achilleas; Boviatsis Efstathios; Voros Dionysios

    2008-01-01

    Abstract Background Retroperitoneal schwannomas are rare, usually benign tumors that originate in the neural sheath and account for only a small percentage of retroperitoneal tumors. The aim of this clinical study is to present our experience in managing retroperitoneal schwannomas with a review of the current literature and to point out the surgical technical difficulties we faced, due to the tumor's strange behavior that eroded the vertebra in two cases without causing malignant invasion. M...

  16. Intraneural Hybrid Neurofibroma/Schwannoma In Scalp: A Case Report

    OpenAIRE

    Panda, Kishori Moni; Reena, Naik

    2015-01-01

    Benign Peripheral Nerve Sheath Tumours (BPNSTs) are traditionally classified into schwannoma, neurofibroma and perinurioma. Due to advances in molecular techniques, hybrid BPNSTs containing more than one histologic types have been documented. Recent studies have demonstrated their frequent association with inherited syndromes like schwannomatosis and neurofibromatosis. Intraneural variant of hybrid neurofibroma/schwannoma is yet to be described. Here we report such a case in a 30-year-old mal...

  17. Simultaneous Right Retroperitoneal Schwannoma and Left Renal Hydatid Cyst

    OpenAIRE

    Ali Kamalati; Hamid Tabrizchi

    2013-01-01

    Retroperitoneal schwannomas are quite rare tumors. Isolated renal hydatid cyst is also rare, and it forms 2–4% of hydatid disease. Because of their infrequent occurrence, nonspecific signs and symptoms, and lack of distinguishing radiologic features, we report herein a case of right retroperitoneal mass in a 26-year-old woman which was found to be benign schwannoma following a percutaneous core needle biopsy and a large cortical cyst in the lower pole of the left kidney which was diagnosed as...

  18. Intramammary schwannoma: a palpable breast mass.

    Science.gov (United States)

    Parikh, Yasha; Sharma, Kush J; Parikh, Samir J; Hall, Diane

    2016-09-01

    Schwannomas are benign tumors arising from the peripheral nerve sheath, commonly occurring in the head, neck, and extensor surfaces of the extremities. They can be associated with neurofibromatosis type II. Our case describes a 48-year-old woman with a 2-week history of a left-sided palpable breast mass. She was referred to radiology, where additional imaging revealed a 1.1-cm mass. A biopsy was performed; histology revealed an intramammary schwannoma. Mammography findings include a well-defined mass without calcification. Ultrasound images have shown hypoechoic, encapsulated, and well-defined lesions without calcification. Histologically, schwannomas reveal alternating Antoni A and Antoni B cellular areas. Schwannomas are also S100-positive on immunohistochemistry. This case is best categorized as a BI-RADS 4A lesions. This case report highlights the importance of both imaging and pathology in the diagnosis of breast neoplasms. Although breast schwannomas are not a common entity, they are an important consideration when evaluating a breast mass. PMID:27594933

  19. Pancreatic Tail Schwannoma: Case Report and Updated Review of the Literature

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    Helge Bruns

    2016-05-01

    Full Text Available Schwannoma is a well-defined benign tumor which arises from neural crest cells and surround the nerve sheath. Schwannoma of the pancreas is extremely rare, and only a limited number of cases have been reported in the literature as of today. Schwannomas of the pancreatic tail are extremely rare (4%. We hereby report a case of a patient undergoing distal pancreatectomy with en-bloc splenectomy for a cystic lesion of the pancreatic tail. The diagnosis of a pancreatic schwannoma was made upon histological examination.

  20. Intraneural Hybrid Neurofibroma/Schwannoma In Scalp: A Case Report.

    Science.gov (United States)

    Panda, Kishori Moni; Reena, Naik

    2015-10-01

    Benign Peripheral Nerve Sheath Tumours (BPNSTs) are traditionally classified into schwannoma, neurofibroma and perinurioma. Due to advances in molecular techniques, hybrid BPNSTs containing more than one histologic types have been documented. Recent studies have demonstrated their frequent association with inherited syndromes like schwannomatosis and neurofibromatosis. Intraneural variant of hybrid neurofibroma/schwannoma is yet to be described. Here we report such a case in a 30-year-old male, who presented with a scalp swelling and histology showed intraneural neurofibromatous tumour admixed with schwannoma-like nodules. IHC (immunohistochemistry) showed variable S100 staining in neurofibromatous areas, diffuse S100 staining in schwannoma-like areas and negative EMA staining in the tumour. PMID:26557528

  1. Rare presentation of pancreatic schwannoma: a case report

    Directory of Open Access Journals (Sweden)

    Tofigh Arash

    2008-08-01

    Full Text Available Abstract Introduction Schwannoma is a rare tumor among pancreatic neoplasms. Schwannomas vary in size, and most of them are cystic, mimicking pancreatic cystic lesions. Generally, a definitive diagnosis is made at the time of histological analysis. The mainstay treatment is surgical resection. Case presentation We report an unusual presentation of pancreatic schwannoma with abdominal pain and several episodes of cholangitis in a 54-year-old Caucasian (Iranian man. The condition was not diagnosed pre-operatively and Whipple's procedure was performed. Conclusion Pancreatic schwannoma is an important clinical entity to include in the differential diagnosis of pancreatic lesions. Pre-operative diagnosis is difficult but computed tomographic findings may be helpful. The tumor may also have atypical and rare presentations, such as cholangitis and weight loss. For benign tumors, simple enucleation is usually adequate, whereas malignant tumors require standard oncological resection.

  2. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Krishnan

    2015-01-01

    Full Text Available Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed.

  3. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    Science.gov (United States)

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis On this page: ... more information about vestibular schwannomas? What is a vestibular schwannoma (acoustic neuroma)? Inner ear with vestibular schwannoma ( ...

  4. MR imaging features of giant pre-sacral schwannomas: a report of four cases

    International Nuclear Information System (INIS)

    Benign giant sacral schwannoma is an uncommon cause of destruction of the sacrum. This report details four cases of a variant of this condition called giant presacral schwannoma (GPSS). On MR imaging the features are of a large, well-defined presacral soft tissue mass, arising just to one side of the midline with minor involvement of the bone. The typical MR features of a benign peripheral nerve sheath tumour are not seen. The tumours appear heterogeneous due to long-standing degeneration. Biopsy is advocated as the appearances of GPSS can be similar to a malignant peripheral nerve sheath tumour (malignant schwannoma). (orig.)

  5. Intracochlear Schwannoma: Diagnosis and Management

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    Bittencourt, Aline Gomes

    2014-01-01

    Full Text Available Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI. Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions.

  6. Pelvic schwannoma in the right parametrium

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    Machairiotis N

    2013-03-01

    Full Text Available Nikolaos Machairiotis,4 Paul Zarogoulidis,3 Aikaterini Stylianaki,1 Eleni Karatrasoglou,4 Georgia Sotiropoulou,4 Alvin Floreskou,4 Eleana Chatzi,4 Athanasia Karamani,4 Georgia Liapi,5 Eleni Papakonstantinou,5 Nikolaos Katsikogiannis,1 Nikolaos Courcoutsakis,2 Christodoulos Machairiotis4 1Surgery Department, 2Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 3Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4Obstetric Gynecology Department, 5Pathology Department, Thriasio General Hospital, Athens, Greece Abstract: Neurilemomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells. These tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area (less than 0.5% of reported cases, unless they are combined with von Recklinghausen disease (type 1 neurofibromatosis. We report the case of a 58-year-old female with pelvic schwannoma, 6.5 × 5.5 cm in size, in the right parametrium. This is the first case reported in the literature. Based on the rarity of this tumor and in order to ensure optimum treatment and survival for our patient, we performed laparotomy with total abdominal hysterectomy and en-block tumor excision. A frozen section was taken during the surgery before complete resection of the mass, which was ambiguous. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; diagnosis was a schwannoma. There were degenerative areas, including cystic degeneration, hemorrhagic infiltrations, ischemic foci with pycnotic cells, and collagen replacement. Pelvic schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe

  7. Mass Flux in the Ancient Earth-Moon System and Benign Implications for the Origin of Life on Earth

    Science.gov (United States)

    Ryder, Graham

    2002-01-01

    The origin of life on Earth is commonly considered to have been negatively affected by intense impacting in the Hadean, with the potential for the repeated evaporation and sterilization of any ocean. The impact flux is based on scaling from the lunar crater density record, but that record has no tie to any absolute age determination for any identified stratigraphic unit older than approx. 3.9 Ga (Nectaris basin). The flux can be described in terms of mass accretion, and various independent means can be used to estimate the mass flux in different intervals. The critical interval is that between the end of essential crustal formation (approx. 4.4 Ga) and the oldest mare times (approx. 3.8 Ga). The masses of the basin-forming projectiles during Nectarian and early Imbrian times, when the last 15 of the approx.45 identified impact basins formed, can be reasonably estimated as minima. These in sum provide a minimum of 2 x 10(exp 21)g for the mass flux to the Moon during those times. If the interval was 80 million years (Nectaris 3.90 Ga, Orientale 3.82 Ga), then the flux was approx. 2 x 10(exp 13) g/yr over this period. This is higher by more than an order of magnitude than a flux curve that declines continuously and uniformly from lunar accretion to the rate inferred for the older mare plains. This rate cannot be extrapolated back increasingly into pre-Nectarian times, because the Moon would have added masses far in excess of itself in post-crust-formation time. Thus this episode was a distinct and cataclysmic set of events. There are approx. 30 pre-Nectarian basins, and they were probably part of the same cataclysm (starting at approx. 4.0 Ga?) because the crust is fairly intact, the meteoritic contamination of the pre-Nectarian crust is very low, impact melt rocks older than 3.92 Ga are virtually unknown, and ancient volcanic and plutonic rocks have survived this interval. The accretionary flux from approx. 4.4 to approx. 4.0 Ga was comparatively benign. When scaled

  8. Schwannomas and their pathogenesis.

    Science.gov (United States)

    Hilton, David A; Hanemann, Clemens Oliver

    2014-04-01

    Schwannomas may occur spontaneously, or in the context of a familial tumor syndrome such as neurofibromatosis type 2 (NF2), schwannomatosis and Carney's complex. Schwannomas have a variety of morphological appearances, but they behave as World Health Organization (WHO) grade I tumors, and only very rarely undergo malignant transformation. Central to the pathogenesis of these tumors is loss of function of merlin, either by direct genetic change involving the NF2 gene on chromosome 22 or secondarily to merlin inactivation. The genetic pathways and morphological features of schwannomas associated with different genetic syndromes will be discussed. Merlin has multiple functions, including within the nucleus and at the cell membrane, and this review summarizes our current understanding of the mechanisms by which merlin loss is involved in schwannoma pathogenesis, highlighting potential areas for therapeutic intervention. PMID:24450866

  9. FT-IR spectroscopy characterization of schwannoma: a case study

    Science.gov (United States)

    Ferreira, Isabelle; Neto, Lazaro P. M.; das Chagas, Maurilio José; Carvalho, Luís. Felipe C. S.; dos Santos, Laurita; Ribas, Marcelo; Loddi, Vinicius; Martin, Airton A.

    2016-03-01

    Schwannoma are rare benign neural neoplasia. The clinical diagnosis could be improved if novel optical techniques are performed. Among these techniques, FT-IR is one of the currently techniques which has been applied for samples discrimination using biochemical information with minimum sample preparation. In this work, we report a case of a schwannoma in the cervical region. A histological examination described a benign process. An immunohistochemically examination demonstrated positivity to anti-S100 protein antibody, indicating a diagnosis of schwannoma. The aim of this analysis was to characterize FT-IR spectrum of the neoplastic and normal tissue in the fingerprint (1000-1800 cm-1) and high wavenumber region (2800-3600 cm-1). The IR spectra were collect from tumor tissue and normal nerve samples by a FT-IR spectrophotometer (Spotlight Perkin Elmer 400, USA) with 64 scans, and resolution of 4 cm-1. A total of twenty spectra were recorded (10 from schwannoma and 10 from nerve). Multivariate Analysis was used to classify the data. Through average and standard deviation analysis we observed that the main spectral change occurs at ≍1600 cm-1 (amide I) and ≍1400 cm-1 (amide III) in the fingerprint region, and in CH2/CH3 protein-lipids and OH-water vibrations for the high wavenumber region. In conclusion, FT-IR could be used as a technique for schwannoma analysis helping to establish specific diagnostic.

  10. Raman spectroscopy and immunohistochemistry for schwannoma characterization: a case study

    Science.gov (United States)

    Neto, Lazaro P. M.; das Chagas, Maurilio J.; Carvalho, Luis Felipe C. S.; Ferreira, Isabelle; dos Santos, Laurita; Haddad, Marcelo; Loddi, Vinicius; Martin, Airton A.

    2016-03-01

    The schwannomas is a tumour of the tissue that covers nerves, called the nerve sheath. Schwannomas are often benign tumors of the Schwan cells, which are the principal glia of the peripheral nervous system (PNS). Preoperative diagnosis of this lesion usually is difficult, therefore, new techniques are being studied as pre surgical evaluation. Among these, Raman spectroscopy, that enables the biochemical identification of the tissue analyzed by their optical properties, may be used as a tool for schwannomas diagnosis. The aim of this study was to discriminate between normal nervous tissue and schwannoma through the confocal Raman spectroscopy and Raman optical fiber-based techniques combined with immunohistochemical analysis. Twenty spectra were analyzed from a normal nerve tissue sample (10) and schwannoma (10) by Holospec f / 1.8 (Kayser Optical Systems) coupled to an optical fiber with a 785nm laser line source. The data were pre-processed and vector normalized. The average analysis and standard deviation was performed associated with cluster analysis. AML, 1A4, CD34, Desmin and S-100 protein markers were used for immunohistochemical analysis. Immunohistochemical analysis was positive only for protein S-100 marker which confirmed the neural schwanomma originality. The immunohistochemistry analysis were important to determine the source of the injury, whereas Raman spectroscopy were able to differentiated tissues types indicating important biochemical changes between normal and benign neoplasia.

  11. Hybrid Neurofibroma-Schwannoma.

    Science.gov (United States)

    Hussain, Namath S; Specht, Charles S; Frauenhoffer, Elizabeth; Glantz, Michael; Harbaugh, Kimberly

    2016-01-01

    Neurofibromas and schwannomas are common lesions that may be idiopathic or may occur in association with neural crest genetic syndromes such as neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. A hybrid tumor that contains pathological characteristics of both neurofibroma and schwannoma has been described as a rare entity. We present the clinical, radiographic, and pathological findings of such a case. PMID:27158577

  12. Ressecção de schwannoma mediastinal por cirurgia torácica videoassistida Resection of a mediastinal schwannoma using video-assisted thoracoscopy

    Directory of Open Access Journals (Sweden)

    Leonardo Ortigara

    2006-04-01

    Full Text Available Os schwannomas são tumores em sua maioria benignos, derivados das células de Schwann (células da glia pertencentes ao sistema nervoso periférico que ajudam a separar e isolar neurônios de estruturas adjacentes, normalmente localizados em nervos intracranianos, principalmente no VIII par (neuroma acústico. Quando extradurais, sua apresentação mais comum é através de massas tumorais que podem comprimir estruturas adjacentes, tornando-se sintomático, como é o caso dos schwannomas intratorácicos (presentes mais comumente no mediastino posterior. Este trabalho apresenta o relato de caso de um schwannoma tratado por videotoracoscopia e uma revisão literária sobre o assunto.Schwannomas are tumors that are typically benign. They are derived from Schwann cells (glial cells of the peripheral nervous system that serve to separate and isolate nerve cells from adjacent structures. The most common type of schwannoma is a benign tumor of cranial nerve VIII and is referred to as an acoustic neuroma. When extradural, such tumors usually present as masses that can invade adjacent structures, thereby becoming symptomatic, as in the case of intrathoracic schwannomas (typically found in the posterior mediastinum. Herein, we present a case of a schwannoma treated through video-assisted thoracoscopy, and we review the literature on the subject.

  13. Accessory Nerve Schwannoma Containing Multiple Calcifed Foci: Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Leila Aghaghazvini

    2009-01-01

    Full Text Available "nIntroduction: Schwannomas are benign neural tumors which arise from the nerve sheath. Schwannomas of the accessory nerve are rare lesions. The clinical presentation of cranial nerve XI schwannomas relates to their location and extent: intracranial, jugular foramen, upper neck, or cervical spine. The extra cranial form is the least common reported. Calcified accessory schwannoma is rare. These lesions most often occur in the third to sixth decades of life. These tumors are slightly more common in women. "nCase presentation: We present a 37-year-old woman with a painless right posterior neck space mass which gradually appeared during one year. Except for mild numbness of the overlying skin of the mentioned mass, there were no other associated symptoms. Examination confirmed a 25 × 18mm, firm, mobile, non tender lump in the right posterior neck. Ultrasonography revealed a 30×20 mm hypo-echoic mass with multiple calcified foci and in color Doppler mild vascularity was detected. On contrast-enhanced CT scan of the neck a 30×18mm heterogeneous enhancing mass with multiple calcified foci (on non contrast cuts was found posterior to the neck vessels and had displaced them anteriorly. No surrounding fat stranding or any other gross pathology was evident in the other neck spaces. "nAccording to the above findings, lymphadenopathy due to TB or less possibly, fungal infection, hemangioma, lymphangiomam, schwannoma were our differential diagnosis. Mass resection and histopathology revealed schwannoma of the accessory nerve with an unusual calcification presentation. No evidence of recurrence was detected after one year. "nDiscussion: The clinical presentation of cranial nerve XI Schwannomas relates to their location and extent. The interesting point of this case was the unusual manifestation of accessory nerve schwannoma, not only because of its rarity but also because of its unusual calcification presentation and symptom-free appearance.  

  14. Intrasellar Schwannoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yu Ri; Yoo, Won Jong; Lim, Yeon Soo; Kim, Jean A; Sung, Mi Sook; Lee, Hae Giu [Holy Family Hospital, College of Medicine, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2006-12-15

    Schwannomas usually arise from sensory nerves, and most often from the vestibular component of the acoustic nerve. Intrasellar and parasellar schwannomas are exceedingly rare. It is difficult to distinguish them from typical pituitary macroadenomas because of their clinical and radiological resemblance. In this report, we present an unusual case of an intrasellar schwannoma with a suprasellar extension that radiographically simulated a pituitary macroadenoma.

  15. Simultaneous Right Retroperitoneal Schwannoma and Left Renal Hydatid Cyst

    Directory of Open Access Journals (Sweden)

    Ali Kamalati

    2013-01-01

    Full Text Available Retroperitoneal schwannomas are quite rare tumors. Isolated renal hydatid cyst is also rare, and it forms 2–4% of hydatid disease. Because of their infrequent occurrence, nonspecific signs and symptoms, and lack of distinguishing radiologic features, we report herein a case of right retroperitoneal mass in a 26-year-old woman which was found to be benign schwannoma following a percutaneous core needle biopsy and a large cortical cyst in the lower pole of the left kidney which was diagnosed as isolated renal hydatid cyst following exploration.

  16. Simultaneous right retroperitoneal schwannoma and left renal hydatid cyst.

    Science.gov (United States)

    Kamalati, Ali; Tabrizchi, Hamid

    2013-01-01

    Retroperitoneal schwannomas are quite rare tumors. Isolated renal hydatid cyst is also rare, and it forms 2-4% of hydatid disease. Because of their infrequent occurrence, nonspecific signs and symptoms, and lack of distinguishing radiologic features, we report herein a case of right retroperitoneal mass in a 26-year-old woman which was found to be benign schwannoma following a percutaneous core needle biopsy and a large cortical cyst in the lower pole of the left kidney which was diagnosed as isolated renal hydatid cyst following exploration.

  17. Vestibular schwannoma: anatomical, medical and surgical perspective

    Directory of Open Access Journals (Sweden)

    Ashfaq Ul Hassan

    2013-06-01

    Full Text Available The term "acoustic" is a misnomer, as the tumor rarely arises from the acoustic (or cochlear division of the vestibulocochlear nerve. The correct medical term is vestibular schwannoma, because it involves the vestibular portion of the 8th cranial nerve. They are benign, rather rare tumors. They expand in size and grow larger; they can push against the brain. While the tumor does not actually invade the brain, the pressure of the tumor can displace brain tissue. [Int J Res Med Sci 2013; 1(3.000: 178-182

  18. Facial Nerve Schwannoma of Parotid Gland: Difficulties in Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Murat Damar

    2016-01-01

    Full Text Available Facial nerve schwannomas (FNS are encapsulated benign tumors arising from Schwann cells of seventh cranial nerve. Most of the facial nerve schwannomas are localized in intratemporal region; only 9% of cases involve a portion of the extratemporal segment. Preoperative diagnosis is often unclear; diagnosis is often made intraoperatively. Management of intraparotid FNS is troublesome because of the facial nerve paralysis. In this report we presented a case of intraparotid schwannoma in a 55-year-old male patient complaining of a painless mass without peripheral facial nerve palsy in left parotid gland. Clinical features, preoperative and intraoperative diagnosis, and difficulties during management are discussed with the review of the literature.

  19. Regression of Schwannomas Induced by Adeno-Associated Virus-Mediated Delivery of Caspase-1

    OpenAIRE

    Prabhakar, Shilpa; Taherian, Mehran; Gianni, Davide; Conlon, Thomas J.; Fulci, Giulia; Brockmann, Jillian; Stemmer-Rachamimov, Anat; Sena-Esteves, Miguel; Breakefield, Xandra O.; Brenner, Gary J.

    2012-01-01

    Schwannomas are tumors formed by proliferation of dedifferentiated Schwann cells. Patients with neurofibromatosis 2 (NF2) and schwannomatosis develop multiple schwannomas in peripheral and cranial nerves. Although benign, these tumors can cause extreme pain and compromise sensory/motor functions, including hearing and vision. At present, surgical resection is the main treatment modality, but it can be problematic because of tumor inaccessibility and risk of nerve damage. We have explored gene...

  20. Schwannomatosis presenting as pancreatic and submandibular gland schwannoma.

    Science.gov (United States)

    Val-Bernal, José Fernando; Mayorga, Marta; Sedano-Tous, María José

    2013-12-01

    Schwannomatosis is a well-established third form of neurofibromatosis, characterized by the presence of multiple non-vestibular, non-intradermal schwannomas, often associated with chronic pain. Herein, we report a 41-year-old man with a history of paternal neurofibromatosis 1, who presented with partially cystic tumors in the pancreas and in the right submandibular gland. Besides, he complained of neuropathic pain in the right inguinal and suprapubic area. Magnetic resonance imaging revealed multiple intradural-extramedullary tumors at the cervical, thoracic and lumbar spinal canal, suggestive of schwannomas. The vestibular nerves were not involved. Pathological examination of the glandular tumors disclosed benign schwannomas. These tumors had substantial myxoid stroma and prominent cystic change, and showed a mosaic pattern of loss of INI1/SMARCB1 expression by immunohistochemistry. Later, the patient developed three nodules in the right lung which were interpreted as schwannomas. To our knowledge, this is the first report of schwannomatosis presenting as pancreatic and salivary gland schwannomas. PMID:24054034

  1. Angiogenesis in vestibular schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Werther, Kim; Nalla, Amarnadh;

    2010-01-01

    Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis. It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking. This study t...

  2. Acoustic radiation force impulse elastography for evaluating tissue elasticity of benign schwannoma in extremities%声辐射力脉冲成像技术定量评估肢体良性神经鞘瘤弹性

    Institute of Scientific and Technical Information of China (English)

    刘卫勇; 隋秀芳; 康冰飞; 刘力; 叶显俊; 单立奎; 叶磊

    2012-01-01

    9 cases with schwannoma in the extremity were examined by ultrasonography. Sonographic imagings focused on the difference of ROI in VTQ values were performed retrospectively among the lesions, muscle tissues, and adipose tissues adjacent to the lesion. The longitudinal diameter of lesions was significantly greater than that of the transverse diameter, at ( 24. 20 ± 6. 54 ) mm and ( 14. 00 ± 3. 61 ) mm, respectively. The detectable rate of continuity with a nerve by ultrasonography was 77. 78%. The SWV values ( m/s ) were: 2. 36 ±0. 59 in lesions, 1. 39 ±0. 42 in muscle tissues, and 1. 69 ±0. 54 in adipose tissues respectively( P 脂肪组织>肌肉组织(P<0.01,P<0.05).

  3. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric;

    2010-01-01

    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology.......In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  4. Hypervascular vestibular Schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Yu, In Kyu [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

    2014-11-15

    Most vestibular schwannoma is hypovascular with well known poor tumor staining in cerebral angiography. However, hypervascular vestibular schwannoma might be observed as a rare subtype with increased risk of bleeding during surgery. Multimodal imaging features which represent hypervascularity of the tumor can be observed in hypervascular vestibular schwannoma. Here we report a case of hypervascular vestibular schwannoma with brief literature review.

  5. Pancreatic Tail Schwannoma in a 44-Year-Old Male: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

    Full Text Available Pancreatic schwannomas are exceedingly uncommon neoplasms. According to a recent study in 2012, less than 50 cases of pancreatic schwannoma have been described in the English literature over the past thirty years. The vast majority of pancreatic schwannomas take place in the head and body of pancreas, respectively. Herein, we report the case of pancreatic tail ancient schwannoma in a 44-year-old man who presented with a 4-month history of epigastric pain. On physical examination, epigastric region was moderately tender to palpation without evidence of a palpable mass. All laboratory tests were normal. Contrast-enhanced computed tomography (CT scan showed a 9.2 × 9.5 × 11.5 cm, huge, and well-defined left suprarenal mass arising either from adrenal gland, pancreas, or retroperitoneum. The mass demonstrated mild heterogeneous enhancement with central cystic/necrotic area. No evidence of distant metastasis was identified. At laparoscopy, the mass was noticed to originate from pancreatic tail. Patient underwent surgical resection of pancreatic tail. Microscopic and immunohistochemical examination of the pancreatic tail specimen showed ancient schwannoma. Patient received no adjuvant therapy. At a postoperative 6-month followup, patient was completely asymptomatic and CT scan imaging showed no evidence of tumor recurrence. Moreover, a literature review on pancreatic schwannomas is presented.

  6. Clinical experience with Leksell gamma knife in the treatment of trigeminal schwannomas

    Institute of Scientific and Technical Information of China (English)

    WANG En-min; PAN Li; ZHANG Nan; ZHOU Liang-fu; WANG Bing-jiang; DONG Ya-fei; DAI Jia-zhong; CAI Pei-wu

    2005-01-01

    @@ Trigeminal nerve schwannomas, which are rare, slowly growing, benign tumors, account for 0.2% to 1.0% of all intracranial tumors and 0.8% to 8.0% of intracranial schwannomas.1-5 These tumors are treated surgically.1-4 The development of microsurgery and skull base surgery has made complete resection possible in most patients. Nevertheless, cranial nerve sequelae appear after complete resection of these tumors because they are located close to the cavernous sinus and usually adhere to the vital vascular and neural structures. As an alternative to microsurgical resection, Leksell gamma knife (LGK) radiosurgery has been performed for patients with intracranial schwannomas to minimize the treatment-related morbidity and achieve a long-term control of tumor growth.6,7 In this report, we describe our 6-year experience in the treatment of 38 patients with trigeminal schwannomas by LGK.

  7. [Infraorbital schwannoma. Case report].

    Science.gov (United States)

    Mora-Ríos, Laura Evelyn; Ríos Y Valles-Valles, Dolores; Flores-Estrada, José Javier; Rodríguez-Reyes, Abelardo Antonio

    2014-01-01

    Antecedentes: el schwannoma infraorbitario es un tumor benigno de la vaina nerviosa periférica compuesto por células de Schwann. Suele aparecer entre los 20 y 70 años de edad, asintomático y producir proptosis progresiva e indolora durante su crecimiento. Caso clínico: paciente masculino de 32 años de edad que ingresó al hospital debido a un tumor no doloroso de crecimiento lentamente progresivo sobre el saco lagrimal izquierdo. A la exploración oftalmológica el tumor era de consistencia ahulada y estaba firmemente adherido a las estructuras vecinas. La transiluminación resultó negativa. El ultrasonido modo B mostró un ojo fáquico y un tumor infraorbitario homogéneo, bien circunstrito, con diámetro mayor de 19.7 mm, sin afectación de la vía lagrimal. El ultrasonido modo A mostró una reflectividad media-alta, con escasa vascularidad interna. La tomografía computada mostró un tumor de densidad homogénea, bien circunscrito a la región anterior y por debajo del globo ocular, sin erosión ósea. El tumor se extirpó mediante una incisión subdérmica. El diagnóstico histopatológico fue: schwannoma infraorbitario. Conclusiones: el schwannoma es un tumor benigno, poco frecuente en la órbita. Su diagnóstico definitivo se establece con base en los hallazgos histopatológicos, como: cápsula verdadera, áreas hiper e hipocelulares, engrosamiento y hialinización de las paredes vasculares. Sin esos hallazgos puede confundirse con tumores fusocelulares benignos. Se informa un nuevo caso de schwannoma infraorbitario y se compara con los casos previamente reportados.

  8. Computed tomographic findings of benign retroperitoneal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Matsuura, Takashi; Nakata, Hajime; Nakayama, Chikashi (Univ. of Occupational and Environmental Health School of Medicine, Kitakyushu, Fukuoka (Japan)); Nishitani, Hiroshi; Matsuura, Keiichi

    1983-07-01

    We have reviewed the computed tomographic (CT) findings of 8 cases of benign retroperitoneal tumors with histological proof. Two teratomas, two schwannomas, and one each of epidermoid cyst, simple cyst, bronchogenic cyst, and cystic lymphangioma were included. The most common CT appearance of these tumors was the solitary, round, well-demarcated, relatively low density mass. Capsule or calcification was demonstrated in some. CT is a highly valuable non-invasive examination method for a diagnosis of a benign retroperitoneal tumor.

  9. True incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Thomsen, Jens;

    2010-01-01

    The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.......The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging....

  10. Audiologic diagnostics of vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Komazec Zoran

    2004-01-01

    Full Text Available Introduction Vestibular schwannoma (acoustic neuroma is a rare, but important cause of sensorineural hearing loss. Patients with asymmetric hearing loss, or unilateral tinnitus should be evaluated expeditiously, to prevent further neurological damage. Audiologic diagnostics Audiologic diagnostics represents the basic diagnosis for early detection of vestibular schwannoma. Patients with vestibular schwannomas may present with a variety of clinical features, including retrocochlear pattern of sensorineural hearing loss. Supraliminary audiometry, tympano- metry, stapedius reflex and otoacoustic emissions as well as vestibular response to caloric testing are methods for selection of patients with suspicion of this tumor. Conclusion The golden standard for audiologic diagnostics of vestibular schwannoma is BAEP (Brainstem Auditory Evoked Potentials. Patients with pathological findings of BAEP should undergo MRI of the posterior fossa. Gadolinium-enhanced magnetic resonance imaging is the best and final tool for making a diagnosis of vestibular schwannoma.

  11. Granular Cell Schwannoma

    Directory of Open Access Journals (Sweden)

    Dheepa R

    2004-01-01

    Full Text Available An 11 year old female child had a small painful spot over the scalp of 4 months duration. Earlier, she had undergone a local excision for a similar problem, but it had recurred at the same site after a few months. Examination revealed a skin colored sessile tender firm papule of 3 mm size on the right parietal region. Excision biopsy showed broad fascicles of tumor cells with eosinopilic cytoplasmic granules infiltrating the dermis amongst the collagen bundles, which was consistent with granular cell schwannoma.

  12. Surgery of vestibular schwannomas

    Directory of Open Access Journals (Sweden)

    Madjid Samii

    2012-01-01

    Full Text Available Vestibular schwannomas (VS are the most common tumors of the cerebellopontine angle (CPA. Their surgical management has reached high standards in the last decade. Treatment options for VS are microsurgical removal or Radiosurgery. The following three basic operative approaches are currently utilized: Retrosigmoid approach (RSA, translabyrinthine and middle fossa approach. The following article elaborates the operative technique by the senior author based on his vast experience of VS surgery formed over the last three decades; during which period he has operated more than 3500 of such patients.

  13. Sigmoid schwannoma: A rare case

    Institute of Scientific and Technical Information of China (English)

    Constantine I. Fotiadis; Ilias A. Kouerinis; Ioannis Papandreou; George C. Zografos; George Agapitos

    2005-01-01

    Schwannomas are rare tumors derived from the cells of Schwann that form the neural sheath. When located in the gastrointestinal tract, they constitute together with leiomyoma, leiomyoblastoma, and leiomyosarcoma, the gastrointestinal stromal tumors (GIST). Peripheral nerve sheath tumors represent 2-6% GIST with most common location, the stomach and the small intestine. Schwannomas of the colon and rectum are extremely rare and radical excision with wide margins is mandatory, due to their tendency to recur locally and become malignant, if left untreated. In the present study, we report a rare case of a sigmoid schwannoma, which was successfully treated in our department and reviewed the literature.

  14. Methylation-based classification of benign and malignant peripheral nerve sheath tumors.

    Science.gov (United States)

    Röhrich, Manuel; Koelsche, Christian; Schrimpf, Daniel; Capper, David; Sahm, Felix; Kratz, Annekathrin; Reuss, Jana; Hovestadt, Volker; Jones, David T W; Bewerunge-Hudler, Melanie; Becker, Albert; Weis, Joachim; Mawrin, Christian; Mittelbronn, Michel; Perry, Arie; Mautner, Victor-Felix; Mechtersheimer, Gunhild; Hartmann, Christian; Okuducu, Ali Fuat; Arp, Mirko; Seiz-Rosenhagen, Marcel; Hänggi, Daniel; Heim, Stefanie; Paulus, Werner; Schittenhelm, Jens; Ahmadi, Rezvan; Herold-Mende, Christel; Unterberg, Andreas; Pfister, Stefan M; von Deimling, Andreas; Reuss, David E

    2016-06-01

    The vast majority of peripheral nerve sheath tumors derive from the Schwann cell lineage and comprise diverse histological entities ranging from benign schwannomas and neurofibromas to high-grade malignant peripheral nerve sheath tumors (MPNST), each with several variants. There is increasing evidence for methylation profiling being able to delineate biologically relevant tumor groups even within the same cellular lineage. Therefore, we used DNA methylation arrays for methylome- and chromosomal profile-based characterization of 171 peripheral nerve sheath tumors. We analyzed 28 conventional high-grade MPNST, three malignant Triton tumors, six low-grade MPNST, four epithelioid MPNST, 33 neurofibromas (15 dermal, 8 intraneural, 10 plexiform), six atypical neurofibromas, 43 schwannomas (including 5 NF2 and 5 schwannomatosis associated cases), 11 cellular schwannomas, 10 melanotic schwannomas, 7 neurofibroma/schwannoma hybrid tumors, 10 nerve sheath myxomas and 10 ganglioneuromas. Schwannomas formed different epigenomic subgroups including a vestibular schwannoma subgroup. Cellular schwannomas were not distinct from conventional schwannomas. Nerve sheath myxomas and neurofibroma/schwannoma hybrid tumors were most similar to schwannomas. Dermal, intraneural and plexiform neurofibromas as well as ganglioneuromas all showed distinct methylation profiles. Atypical neurofibromas and low-grade MPNST were indistinguishable with a common methylation profile and frequent losses of CDKN2A. Epigenomic analysis finds two groups of conventional high-grade MPNST sharing a frequent loss of neurofibromin. The larger of the two groups shows an additional loss of trimethylation of histone H3 at lysine 27 (H3K27me3). The smaller one retains H3K27me3 and is found in spinal locations. Sporadic MPNST with retained neurofibromin expression did not form an epigenetic group and most cases could be reclassified as cellular schwannomas or soft tissue sarcomas. Widespread immunohistochemical loss

  15. Gamma Knife radiosurgery for vestibular schwannoma: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Fairbanks Robert K

    2009-12-01

    Full Text Available Abstract Vestibular schwannomas, also called acoustic neuromas, are benign tumors of the vestibulocochlear nerve. Patients with these tumours almost always present with signs of hearing loss, and many also experience tinnitus, vertigo, and equilibrium problems. Following diagnosis with contrast enhanced MRI, patients may choose to observe the tumour with subsequent scans or seek active treatment in the form of microsurgery, radiosurgery, or radiotherapy. Unfortunately, definitive guidelines for treating vestibular schwannomas are lacking, because of insufficient evidence comparing the outcomes of therapeutic modalities. We present a contemporary case report, describing the finding of a vestibular schwannoma in a patient who presented with dizziness and a "clicking" sensation in the ear, but no hearing deficit. Audible clicking is a symptom that, to our knowledge, has not been associated with vestibular schwannoma in the literature. We discuss the diagnosis and patient's decision-making process, which led to treatment with Gamma Knife radiosurgery. Treatment resulted in an excellent radiographic response and complete hearing preservation. This case highlights an atypical presentation of vestibular schwannoma, associated with audible "clicks" and normal hearing. We also provide a concise review of the available literature on modern vestibular schwannoma treatment, which may be useful in guiding treatment decisions.

  16. Special problems encountering surgical management of large retroperitoneal schwannomas

    Directory of Open Access Journals (Sweden)

    Kondi-Pafitis Agathi

    2008-10-01

    Full Text Available Abstract Background Retroperitoneal schwannomas are rare, usually benign tumors that originate in the neural sheath and account for only a small percentage of retroperitoneal tumors. The aim of this clinical study is to present our experience in managing retroperitoneal schwannomas with a review of the current literature and to point out the surgical technical difficulties we faced, due to the tumor's strange behavior that eroded the vertebra in two cases without causing malignant invasion. Methods We reviewed the medical files of 69 patients treated in our department for retroperitoneal tumors from January 1991 until December 2006. Five patients had retroperitoneal schwannomas according to pathology report. Results There were two male and three female patients, with a mean age of 56 years (range 44–67 years. All patients were asymptomatic and none suffered from von Recklinghausen disease. Imaging workup included ultrasonography, computed tomography and magnetic resonance imaging. One patient, after having a non-diagnostic computed tomography fine needle aspiration (CT-FNA, underwent exploratory laparotomy and incisional biopsy that established the diagnosis of schwannoma. After complete excision of the tumors, postoperative course was uneventful in all patients. Tumors' maximum diameter was 12.7 cm (range 7–20 cm. No recurrences were detected during the follow up period (6–75 months. Conclusion Preoperative establishment of diagnosis is difficult in case of retroperitoneal schwannomas, however close relationship of retroperitoneal tumors with adjacent neural structures in imaging studies should raise a suspicion. Complete surgical resection is the treatment of choice. Histology and Immunohistochemistry confirms the diagnosis.

  17. Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

    OpenAIRE

    Niazi, Toba N.; Bowers, Christian A.; Schmidt, Meic H.

    2012-01-01

    Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The ...

  18. Misdiagnosis of Brachial Plexus Schwannoma as Cervical Radiculopathy

    Directory of Open Access Journals (Sweden)

    Mahnaz Khajepour

    2013-01-01

    Full Text Available Schwannomas are relatively rare but benign nerve sheath tumors deriving from Schwann cells with low tendency of transformation to malignancy. Extracranial shwannomas usually present insidiously and thus are often diagnosed incorrectly or after lengthy delays. We present the case of a 51 years old female patient with chronic cervical pain radiating in left upper limb who was treated as cervical radiculopathy for 5 years. By aggrevation of pain and paresthesia, imaging and electrodiagnostic study revealed schwannoma of brachial plexus. In case of radiating pain and paresthesia in upper limb (such as this case symptoms can be misleading for cervical radiculopathy but careful examination especialy in persistence of symptoms with negative imaging results for radiculopathies are important and electrodiagnostic study can be helpful.

  19. Multiple isolated cutaneous plexiform schwannomas

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    Enas A. S. Attia

    2011-01-01

    Full Text Available Plexiform schwannoma is a rare neurogenic tumor, arising from skin and subcutaneous tissue. The presence of multiple schwannomas suggests a possible association with neurofibromatosis type 2 (NF2. A 50-year old male patient presented with multiple papulo-nodular cutaneous lesions on both arms and forearms. Histopathological examination revealed a dermal multinodular pattern of well-circumscribed masses of closely packed cells, with peripheral myxoid tissue, well-encapsulated in a thin collagenous capsule. S-100 immunohistochemical staining was diffusely and strongly positive. Neuron-specific enolase was positive, confirming a neural tissue tumor. An audiogram and Magnetic Resonance Imaging (MRI of cerebro-pontine angle showed no detected abnormality, excluding acoustic neuroma. Thus, we present a case of multiple bilateral isolated cutaneous plexiform schwannomas, not associated with NF2. Multiple plexiform schwannomas is a very rare entity, distinct from neurofibromatosis (NF, and being confined to the dermis is even more rarely reported.

  20. Plexiform schwannoma of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Katsumi, Keiichi; Ogose, Akira; Hotta, Tetsuo; Hatano, Hiroshi; Kawashima, Hiroyuki; Endo, Naoto [Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi 1-751, 951-8510, Niigata (Japan); Umezu, Hajime [Division of Pathology, Niigata University Hospital, Niigata (Japan)

    2003-12-01

    We report a case of plexiform schwannoma located in the flexor muscles of the forearm in the absence of other signs of neurofibromatosis or schwannomatosis. Magnetic resonance examination revealed a multinodular irregular inhomogeneous mass. Some nodules displayed a peripheral, high intensity rim and a central low intensity (target sign) on T2-weighted images. Pre-operative diagnosis of the rare plexiform schwannoma may be possible with careful imaging examination for the target sign. (orig.)

  1. Vulval schwannoma: A cytological diagnosis

    Directory of Open Access Journals (Sweden)

    Das Subhashish

    2008-01-01

    Full Text Available Schwannomas are the most common peripheral nerve sheath tumors, the frequent sites of involvement being the head and neck, the flexor aspect of the limbs, especially near the elbow, wrist, knee, and trunk. Involvement of the female genital tract is extremely rare. We present one such rare case of a solitary vulval schwannoma which was diagnosed by fine needle aspiration cytology in a 48 year-old female, and confirmed by histopathological examination.

  2. Laryngeal schwannoma treated with a CO2 laser: A case report

    OpenAIRE

    KOU, WEI; Zhang, Cheng; Wei, Ping

    2015-01-01

    Laryngeal schwannoma is a rare benign tumor of the larynx, with a high recurrence rate. The present study reports the case of a 36-year-old male patient with a two-week history of hoarseness. Electronic laryngoscopy revealed that there was a submucosal mass at the level of the right supraglottic area. A computed tomography scan of the larynx showed an 8×11-mm expansile mass in the right supraglottic area. Histopathological examination diagnosed a schwannoma of the larynx. The tumor was remove...

  3. An unusual case of schwannomatosis with bilateral maxillary sinus schwannomas and a novel SMARCB1 gene mutation.

    Science.gov (United States)

    Toms, Jamie; Harrison, Jason; Richard, Hope; Childers, Adrienne; Reiter, Evan R; Graham, Robert S

    2016-01-01

    Schwannomas are benign tumors that arise from Schwann cells in the peripheral nervous system. Patients with multiple schwannomas without signs and symptoms of neurofibromatosis Type 1 or 2 have the rare disease schwannomatosis. Tumors in these patients occur along peripheral nerves throughout the body. Mutations of the SMARCB1 gene have been described as one of the predisposing genetic factors in the development of this disease. This report describes a patient who was observed for 6 years after having undergone removal of 7 schwannomas, including bilateral maxillary sinus schwannomas, a tumor that has not been previously reported. Genetic analysis revealed a novel mutation of c.93G>A in exon 1 of the SMARCB1 gene. PMID:26431068

  4. Malignant transformation in a hybrid schwannoma/perineurioma: Addition to the spectrum of a malignant peripheral nerve sheath tumor

    Directory of Open Access Journals (Sweden)

    Bharat Rekhi

    2011-01-01

    Full Text Available Benign nerve sheath tumors include schwannomas, neurofibromas and perineuriomas. The malignant counterpart of a nerve sheath tumor is designated as a malignant peripheral nerve sheath tumor (MPNST. Lately, benign nerve sheath tumors comprising more than one component have been described, including hybrid schwannomas/perineuriomas. However, malignant transformation in a hybrid schwannoma/perineurioma has not been documented so far. Herein, we present a rare case of a young adult male who presented with a soft tissue mass in his right thigh that was excised elsewhere and submitted to us for histopathological review. One of the tissue sections displayed histopathological features of a hybrid schwannoma/perineurioma, including alternate arrangement of benign schwann and perineurial cells, reinforced with S100-P and epithelial membrane antigen positivity, respectively, along with low MIB1 and negative p53 immunostaining. The other two tissue sections showed a spindly sarcomatous tumor that was immunohistochemically positive for S100-P, CD34, p53 and exhibited high MIB1 (30-40%. Diagnosis of a MPNST arising in a hybrid schwannoma/perineurioma was made. This unusual case forms yet another addition to the spectrum of a MPNST.

  5. Orbital Schwannoma. A Case Report Schwannoma orbitario. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Armando Rafael Milanés Armengol

    2012-09-01

    Full Text Available Schwannoma is a benign tumor of the myelin sheath composed of Schwann cells. It represents from 8 to 10% of all intracranial tumors. The case of a female, 37 years old patient, who attended the Ophthalmology Service because of non-specific pain mostly when performing ocular movements of the eye, proptosis and loss of vision in the left eye, is presented. Physical examination confirmed ocular visual acuity, left eye proptosis of 23 mm, pupillary hypokinesia with a relative afferent pupillary defect and fundus signs of papillary stasis. In imaging studies it was found: exophthalmos of the left eye and retro-ocular hyperdense lesion of 25 x 20 mm. Surgical procedure was performed with biopsy of the lesion. Schwannoma was diagnosed as partially encapsulated. Three months after surgery symptoms and proptosis disappeared. The patient achieved visual and fundoscopic recovery.El schwannoma es un tumor benigno de la vaina de mielina compuesto por células de Schwann. Constituyen del 8 al 10 % de los tumores intracraneales. Se presenta el caso de una paciente de 37 años de edad, que acudió al Servicio de Oftalmología por presentar dolor ocular inespecífico sobre todo a los movimientos del globo ocular, proptosis y pérdida de visión del ojo izquierdo. Al examen físico ocular se comprobó disminución de la agudeza visual, una proptosis de 23 mm del ojo izquierdo, hipoquinesia pupilar con un defecto pupilar aferente relativo y al fondo de ojo signos de estasis papilar. En los estudios imagenológicos aparecieron: exoftalmos del ojo izquierdo, lesión hiperdensa retro-ocular de 25 x 20 mm. Se realizó proceder quirúrgico con toma de biopsia de la lesión. Se diagnosticó como schwannoma parcialmente encapsulado. A los tres meses se constató desaparición de los síntomas y de la proptosis así como recuperación visual y fondoscópica.

  6. Multiple Schwannomas of the Spine: Review of the Schwannomatosis or Congenital Neurilemmomatosis: A Case Report.

    Science.gov (United States)

    Lee, Sang-Hoon; Kim, Se-Hoon; Kim, Bum-Joon; Lim, Dong-Jun

    2015-06-01

    Schwannomas are the most common benign nerve sheath tumors originating in Schwann cells. With special conditions like neurofibromatosis type 2 or entity called schwannomatosis, patients develop multiple schwannomas. But in clinical setting, distinguishing schwannomatosis from neurofibromatosis type 2 is challengeable. We describe 58-year-old male who presented with severe neuropathic pain, from schwannomatosis featuring multiple schwannomas of spine and trunk, and underwent surgical treatment. We demonstrate his radiologic and clinical findings, and discuss about important clinical features of this condition. To confirm schwannomatosis, we performed brain magnetic resonance imaging, and took his familial history. Staged surgery was done for pathological confirmation and relief of the pain. Schwannomatosis and neurofibromatosis type 2 are similar but different disease. There are diagnostic hallmarks of these conditions, including familial history, pathology, and brain imaging. Because of different prognosis, the two diseases must be distinguished, so diagnostic tests that are mentioned above should be performed in caution. PMID:26217390

  7. A RARE CASE OF SCHWANNOMA OF TRIGEMINAL NERVE WITH INTRAORBITAL EXTENSION

    Directory of Open Access Journals (Sweden)

    Shruti S.

    2015-10-01

    Full Text Available Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35 - year - old female presenting with an axial proptosis of right eyeball with right - sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right - sided heterogeneous, extra - axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post - operative period was uneventful.

  8. An allograft mouse model for the study of hearing loss secondary to vestibular schwannoma growth.

    Science.gov (United States)

    Bonne, Nicolas-Xavier; Vitte, Jérémie; Chareyre, Fabrice; Karapetyan, Gevorg; Khankaldyyan, Vazgen; Tanaka, Karo; Moats, Rex A; Giovannini, Marco

    2016-08-01

    Vestibular schwannoma is a benign neoplasm arising from the Schwann cell sheath of the auditory-vestibular nerve. It most commonly affects both sides in the genetic condition Neurofibromatosis type 2, causing progressive high frequency sensorineural hearing loss. Here, we describe a microsurgical technique and stereotactic coordinates for schwannoma cell grafting in the vestibular nerve region that recapitulates local tumor growth in the cerebellopontine angle and inner auditory canal with resulting hearing loss. Tumor growth was monitored by bioluminescence and MRI in vivo imaging, and hearing assessed by auditory brainstem responses. These techniques, by potentially enabling orthotopic grafting of a variety of cell lines will allow studies on the pathogenesis of tumor-related hearing loss and preclinical drug evaluation, including hearing endpoints, for NF2-related and sporadic schwannomas. PMID:27177628

  9. P07.04PROMOTER METHYLATION OF THE LATS1 AND LATS2 GENES IN SCHWANNOMAS

    Science.gov (United States)

    Ohta, T.; Oh, J.; Mittelbronn, M.; Paulus, W.; Ohgaki, H.

    2014-01-01

    Schwannoma is a benign nerve sheath tumor that is typically encapsulated and composed of well-differentiated Schwann cellswhich comprises 5-10% of all intracranial tumors in adults. Approximately 90% of schwannomas are solitary and sporadic, whereas ∼4% are considered to arise in the setting of neurofibromatosis type 2 (NF2) syndrome by NF2 germline mutations. The molecular basis of sporadic schwannomas is not fully understood, other than frequent NF2 mutations (∼60%). LATS1 and the related LATS2 are downstream molecules of NF2 and negative regulators of the YAP oncogene in the Salvador/Warts/Hippo (SWH) signaling pathway. Expression of these genes is reduced due to promoter methylation in a variety of neoplasms including gliomas. In the present study, methylation-specific PCR revealed promoter methylation of the LATS1 and LATS2 in 15 of 91 (16%) and 32 of 91 (35%) schwannomas, respectively. These alterations were significantly more frequent in spinal than in peripheral schwannomas (23% vs 3% for LATS1, P = 0.0171; 42% vs 21% for LATS2, P = 0.0386). LATS1 methylation was also detected in 3 of 4 schwannomatosis cases. Furthermore, neurofibroma / schwannoma hybrid tumors showed promoter methylation in LATS1 (3/14; 21%) and LATS2 (8/14; 57%). LATS1 and LATS2 promoter methylation were largely mutually exclusive, and there was a significant negative correlation (P = 0.003); only 10 cases had methylation in both genes. These results suggest that LATS1 and LATS2 promoter methylation may be additional molecular mechanisms resulting in an abnormal SWH pathway in schwannomas and related tumors.

  10. Schwannoma intercostal simulando neoplasia pulmonar

    OpenAIRE

    Henn L.A.; Gonzaga R.V.; Crestani J.; Cerski M.R.

    1998-01-01

    Schwannoma é uma neoplasia mesenquimal, usualmente solitária, encontrada no mediastino, retroperitônio ou pelve, sendo rara sua apresentação na parede torácica. OBJETIVO: Relatar o caso de um paciente masculino, tabagista, com um nódulo pulmonar direito com características de malignidade, detectado em radiografia de tórax de rotina, cujo diagnóstico anatomopatológico foi de schwannoma benigno de nervo intercostal. MÉTODOS: Revisaram-se os dados referentes ao quadro clínico, exames laboratoria...

  11. Radiation therapy for vestibular schwannomas.

    NARCIS (Netherlands)

    Mulder, J.J.S.; Kaanders, J.H.A.M.; Overbeeke, J.J. van; Cremers, C.W.R.J.

    2012-01-01

    PURPOSE OF REVIEW: Recently, new information on the natural course and on the results of radiation therapy of vestibular schwannomas has been published. The aim of this study is to summarize the most recent literature on the contemporary insights on the natural course and the results of the latest s

  12. Complications of Microsurgery of Vestibular Schwannoma

    OpenAIRE

    Jan Betka; Eduard Zvěřina; Zuzana Balogová; Oliver Profant; Jiří Skřivan; Josef Kraus; Jiří Lisý; Josef Syka; Martin Chovanec

    2014-01-01

    Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34...

  13. Intraosseous neurilemmoma of the mandible: Report of a rare ancient type

    Directory of Open Access Journals (Sweden)

    Gholamreza Jahanshahi

    2011-01-01

    Intraosseous schwannomas especially ancient ones are rare tumors. Here we present a case of intraosseous ancient schwannoma in the lower jaw of an 11-year-old girl which caused a non-tender expansion. Radiographic examination showed a well-circumscribed, unilocular radiolucent lesion with thin sclerotic borders in the mandibular body and the ramus. Histopathologic examination of the incisional biopsy showed areas of typical Antoni A with verocay bodies and Antoni B that was strongly suggestive of a schwannoma. Complete excision of the lesion was done under general anesthesia. The histopathologic examination confirmed the primary diagnosis and also degenerative changes such as hyalinization and calcification. Based on these findings, the diagnosis of ancient schwannoma was made. No recurrence was observed in the follow-up examination after 3 months.

  14. Radiologic finding of facial nerve schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Yang; Kim, Dong Ik; Lee, Byung Hee; Chung, Tae Sub [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-03-01

    To analyze the radilologic findings of facial nerve schwannoma. The authors retrospectively reviewed CT and/or MR images and clinical history of eight patients with histologically proven facial nerve schwannama. After classifying this extratemporal and intratemporal types, clinical and radilologic findings were analysed. The most common clinical findings of facial nerve schwannoma were facial nerve palsy and hearing impairment in an intratemporal schwannoma(4/5), and a palpable parotid mass in an extratemporal schwannoma(3/3). On CT, each involved segment of intratemporal schwannomas(five cases) showed characteristic radilologic findings, while extratemporal schwannomas(three cases) showed masses of various types. On MRI, all tumors(two cases) showed hypointensity of T1WI, hyperintensity on T2WI, and strong enhancement on Gd-DTPA enhanced T1WI. Intratemporal facial nerve schwannomas can be easily diagnosed by characteristic clinical and radilologic findings. Extratemporal facial nerve schwannomas show nonspecific findings. However, if the tumor is located between the superficial and the deep lobe of the parotid gland and extends to the posterior portion of the styloid process, then facial nerve schwannoma is strongly suspected.

  15. Intrascrotal extratesticular schwannoma: A clinical case and a review of literature

    Directory of Open Access Journals (Sweden)

    M. B. Zingerenko

    2016-01-01

    Full Text Available Schwannoma is a benign tumor that grows from the Schwann cells forming the myelin sheath of peripheral nerves. The clinical manifestations are nonspecific and generally due to compression of the adjacent structures of a growing tumor. The location of the tumor in the scrotum is rare; its primary diagnosis is difficult and only immunohistochemical examination allows the final diagnosis to be established. The authors present a clinical case of a patient operated on at the Urology Department, Moscow Clinical Research Center, for intrascrotal schwannoma causing impaired microcirculation in the scrotal skin to form purulent scrotal ulcers. In terms of the benign pattern and extratesticular localization of the tumor, its removal without orchifuniculectomy can yield a good clinical result.

  16. Ganglioneuroma of the Internal Auditory Canal Presenting as a Vestibular Schwannoma

    OpenAIRE

    Bekelis, Kimon; Meiklejohn, Duncan A; Missios, Symeon; Harris, Brent; Saunders, James E; Erkmen, Kadir

    2011-01-01

    In most series, 90% of cerebellopontine angle tumors are vestibular schwannomas. Meningiomas and epidermoid tumors follow with decreased frequency. Ganglioneuroma is a benign tumor usually found in the retroperitoneum and posterior mediastinum. We report a case of a 21-year-old man with gradual sensorineural hearing loss and a minimally enhancing lesion of the internal auditory canal, which was excised through a middle fossa approach and found histologically to be a ganglioneuroma. Like vesti...

  17. Isolated Primary Schwannoma of Urinary Bladder

    Science.gov (United States)

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  18. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2011-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  19. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2012-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  20. Epidemiology and natural history of vestibular schwannomas

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, Per

    2012-01-01

    This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma. A treatm...

  1. Schwannoma of the brachial plexus: cross-sectional imaging diagnosis using CT, sonography, and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rettenbacher, Thomas; Soegner, Peter; Springer, Peter; Nedden, Dieter zur [Department of Radiology II, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Fiegl, Michael [Department of Internal Medicine, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Hussl, Heribert [Department of Plastic and Reconstructive Surgery, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)

    2003-08-01

    Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed. (orig.)

  2. A large dumbbell glossopharyngeal schwannoma involving the vagus nerve: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Zhao Hongyu

    2008-10-01

    Full Text Available Abstract Introduction Schwannoma arising from the glossopharyngeal nerve is a rare intracranial tumor. Fewer than 40 cases have been reported. Accurate pre-operative diagnosis and optimal treatment are still difficult. Case presentation We present one case of schwannoma originating from the ninth cranial nerve with palsies of the trigeminal nerve, facial-acoustic nerve complex, and vagus nerve in addition to ninth nerve dysfunction. Magnetic resonance imaging showed tumors located in the cerebellopontine angle with extracranial extension via the jugular foramen, with evident enhancement on post-contrast scan. Surgical management single-staged with the help of gamma knife radiosurgery achieved total removal. Conclusion Glossopharyngeal schwannoma is devoid of clinical symptoms and neurological signs. High resolution magnetic resonance imaging may play a key role as an accurate diagnostic tool. A favorable option of approach and appropriate planning of surgical strategy should be the goal of operation for this benign tumor.

  3. Cytological Features of the Cystic Fluid of Pancreatic Schwannoma with Cystic Degeneration. A Case Report

    Directory of Open Access Journals (Sweden)

    Kenichi Hirabayashi

    2008-03-01

    Full Text Available Context Schwannomas are benign neoplasms arising from peripheral nerve tissue. Pancreatic schwannoma is a very rare condition. We present the histological and cytological features of a pancreatic schwannoma with cystic degeneration. Case report A 51-year-old male was diagnosed with a cystic tumor measuring approximately 6 cm in the tail of the pancreas. Distal pancreatectomy and splenectomy were performed. Cystic fluid from the tumor was obtained intraoperatively by fine-needle aspiration, and it showed scattered spindle tumor cells against a background of hemosiderin-laden histiocytes. During the operation, we informed the surgeon that the tumor consisted of “atypical spindle cells”. Histologically, the tumor was diagnosed as a schwannoma with cystic degeneration which had originated in the pancreas. The diagnosis was confirmed by positive immunostaining of the tumor cells in both histological and cytological materials for S-100 protein. Conclusion Problems occasionally arise with the use of fine-needle aspiration in the diagnosis of cystic diseases of the pancreas because of the difficulty in obtaining adequate specimens. Nevertheless, it should be emphasized that intraoperative fine-needle aspiration is as informative as a frozen section diagnosis, when appropriately performed.

  4. Melanotic schwannoma arising in association with nevus of Ota: 2 cases suggesting a shared mechanism.

    Science.gov (United States)

    Trufant, Joshua W; Brenn, Thomas; Fletcher, Christopher D M; Virata, Andrew R; Cook, Deborah L; Bosenberg, Marcus W

    2009-12-01

    Melanotic schwannoma is a rare markedly pigmented peripheral nerve sheath tumor comprising cells with prominent melanization and schwannian features. The psammomatous variety is associated with Carney complex, a multiple neoplasia syndrome with spotty skin pigmentation. We present the first 2 reported cases of melanotic schwannoma arising in patients with a history of nevus of Ota, a rare dermal melanosis believed to represent a failure of melanocyte migration to the epidermis during embryogenesis. Case 1 involves a 40-year-old woman with a 1.8-cm, deeply pigmented, trigeminal nerve mass and pigmentation of the maxillary sinus mucosa and bone. Case 2 involves a 53-year-old woman with a 1.5-cm mass adjacent to the clavicle. Microscopically, both masses consist of partially encapsulated epithelioid and spindle cells with abundant melanin pigment, arising in association with peripheral nerves. Morphological, immunohistochemical, and ultrastructural features support a diagnosis of melanotic schwannoma. No psammoma bodies are noted, and neither patient exhibits any additional features of Carney complex. Melanotic schwannoma is most often benign but has been associated with malignant behavior in some cases. Distinguishing this nerve sheath tumor from malignant melanoma can be difficult but is of great clinical importance due to differences in prognosis and treatment.

  5. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    Science.gov (United States)

    Carlson, Matthew L; Gompel, Jamie J Van

    2016-06-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appearing to arise from the superior vestibular nerve. The patient denied a family history of NF2. Neurotologic examination was unremarkable and close review of magnetic resonance imaging did not find any other stigmata of NF2. Results The patient underwent left-sided retrosigmoid craniotomy with gross total resection of both tumors. Final pathology confirmed benign schwannoma. The INI1/SMARCB1 staining pattern did not suggest NF2 or schwannomatosis. Conclusions This is only the third report of a case with multiple unilateral VSs occurring in a patient without other features of NF2. Herein, the authors review the two other reports and discuss potential mechanisms for this rare phenomenon. PMID:27354931

  6. [Radiotherapy of benign intracranial tumors].

    Science.gov (United States)

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects. PMID:27523417

  7. Ileal schwannoma developing into ileocolic intussusception

    Institute of Scientific and Technical Information of China (English)

    Shoji Hirasaki; Hiromitsu Kanzaki; Kohei Fujita; Seiyuu Suzuki; Kazuyasu Kobayashi; Hiromitsu Suzuki; Hideyuki Saeki

    2008-01-01

    Intussusception is rare in adults. We describe a 47-year-old man with ileal schwannoma that led to ileocolic intussusception. Abdominal ultrasonography, abdominal CT scan and barium enema confirmed an ileal tumor. Colonoscopy revealed a peduncular submucosal tumor (SMT) 75 mm long with an ulcerated apex at the ascending colon. The provisional diagnosis was a gastrointestinal stromal tumor of the terminal ileum. Ileocecal resection was carried out and the tumor was historically diagnosed as schwannoma. Abdominal pain resolved postoperatively. This case reminds us that ileal schwannoma should be included in the differential diagnosis of intussusception caused by an SMT in the intestine.

  8. Giant dumbbell-shaped intra- and extracranial nerve schwannoma in a child presenting with glossopharyngeal neuralgia syncope syndrome: a case report and review of the literature.

    Science.gov (United States)

    Sarikaya-Seiwert, Sevgi; Klenzner, Thomas; Schipper, Jörg; Steiger, Hans-Jakob; Haenggi, Daniel

    2013-01-01

    Lower cranial nerve schwannomas are benign tumors of the neurolemmocytes of the cranial nerves. Among children, cranial nerve schwannomas are extremely rare and are predominantly associated with neurofibromatosis (NF) type 2. The purpose of the current case report is to describe a unique giant extra- and intracranial foramen jugular schwannoma in a young boy with lower cranial nerve deficits and glossopharyngeal neuralgia syncope syndrome and to review the pertinent literature. In the current case report, we illustrate the course of disease in a 14-year-old boy with a 4-month history of recurrent syncope and a big bulge on the left side of his neck. Audiometry showed deafness of the left ear. Magnetic resonance imaging (MRI) demonstrated a giant unilateral dumbbell-shaped intra- and extracranial foramen jugular schwannoma with a volume of 156 cm3 causing severe brain stem compression and obstructive hydrocephalus. The tumor was removed completely in a two-step surgery. The tumor was confirmed during surgery to originate from the glossopharyngeal nerve. The histological examination revealed the characteristic features of a schwannoma. The MRI 3 months after the second surgery confirmed complete tumor removal. The genetic examination for NF was negative. Review of literature showed that dumbbell-shaped lower cranial nerve schwannomas in the childhood population are rare. PMID:23104590

  9. Central pancreatectomy for pancreatic schwannoma: A case report and literature review

    Science.gov (United States)

    Xu, Shao-Yan; Sun, Ke; Owusu-Ansah, Kwabena Gyabaah; Xie, Hai-Yang; Zhou, Lin; Zheng, Shu-Sen; Wang, Wei-Lin

    2016-01-01

    Schwannomas are mesenchymal tumors originating from Schwann cells in peripheral nerve sheaths. Although the tumor can be located in any part of the human body, the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are rare. To our knowledge, only 64 cases of pancreatic schwannoma have been reported in the English literature over the past 40 years. In this paper, we present a pancreatic schwannoma in a 59-year-old female. Ultrasound, computed tomography and magnetic resonance imaging revealed the tumor located in the pancreatic body; however, accurate diagnosis was hard to obtain preoperatively and a pancreatic cystadenoma was preliminarily considered. During laparotomy, the mass was found in the body of the pancreas. An enlarged gallbladder with multiple stones was also observed. We performed central pancreatectomy, end-to-side pancreaticojejunostomy and cholecystectomy. Notably, central pancreatectomy has been reported in only one case prior to this report. The gross specimen showed a mass with a thin capsule, 1.6 cm × 1.1 cm × 1.1 cm in size. Microscopic examination showed that the tumor was mainly composed of spindle-shaped cells with palisading arrangement and no atypia, which is consistent with a benign tumor. Both hypercellular and hypocellular areas were visible. Immunohistochemical staining revealed strongly positive results for protein S-100. Finally, the tumor was diagnosed as a schwannoma of the pancreatic body. Postoperatively, the patient recovered well and left the hospital 6 d later. During the 53-mo follow-up period, the patient remained well and free of complications. PMID:27729750

  10. Taste dysfunction in vestibular schwannomas

    Directory of Open Access Journals (Sweden)

    Sahu Rabi

    2008-01-01

    Full Text Available Background: Gustatory dysfunction associated with vestibular schwannomas (VS is a poorly represented clinical presentation. Materials and Methods: One hundred and forty-nine cases operated from 1997 to 2005 where at least six-month follow-up was available were included. All patients were tested for taste sensations using four modalities of standard taste solutions. Apart from the taste sensations, any altered or abnormal taste perceptions were recorded both in the preoperative and postoperative period. Results: After applying the exclusion criteria, the taste dysfunction was studied in 142 patients. The evidence of decreased taste sensation was found in 58 (40.8% patients prior to surgery. Preoperatively, taste disturbance was found in 29 (37.2% giant, 28 (45.9% large and one (33.3% medium-sized tumors, respectively. There were no significant age or sex-related differences. The postoperative taste disturbances were found in 65 (45.8% patients. Among patients with anatomically preserved facial nerve, postoperative taste disturbances were found in 55 (42.3% patients whereas nine (6.9% patients reported improvement in taste sensations. Conclusions: Taste dysfunction is common following vestibular schwannoma surgery. Patient counseling prior to surgery is necessary to avoid any distress caused by taste dysfunction. Taste dysfunction should be included in the facial nerve functional grading system while assessing outcome.

  11. Vestibular Schwannoma or acoustic neuroma

    Directory of Open Access Journals (Sweden)

    Hekmatara M

    1997-04-01

    Full Text Available Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response, and SDS (speech discrimination score with 90% success, but computer Tomography (CT scan and MRI (Magnetic Resonance Image are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA, since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle. Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.

  12. Cystic cervical intramedullary schwannoma with syringomyelia

    Directory of Open Access Journals (Sweden)

    Shenoy S

    2005-01-01

    Full Text Available We report a case of cervical intramedullary cystic schwannoma associated with segmental syrinx in a young adult without evidence of neurofibromatosis. The relevant literature is reviewed.

  13. A Rare Adrenal Incidentaloma: Adrenal Schwannoma

    OpenAIRE

    Adas, Mine; Ozulker, Filiz; Adas, Gokhan; Koc, Bora; Ozulker, Tamer; Sahin, Ilknur Mansuroglu

    2013-01-01

    Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [18F] fluorodeoxyglucose positron emission tomography (PET) were...

  14. Multiple schwannomas of the digital nerves and superficial radial nerve: two unusual cases of segmental schwannomatosis.

    Science.gov (United States)

    Gosk, Jerzy; Gutkowska, Olga; Kuliński, Sebastian; Urban, Maciej; Hałoń, Agnieszka

    2015-01-01

    Two cases of segmental sporadic schwannomatosis characterized by unusual location of multiple schwannomas in digital nerves (case 1) and the superficial radial nerve (case 2) are described in this paper. In the first of the described cases, 6 tumours located at the base of the middle finger and in its distal portion were excised from both digital nerves. In the second case, 3 tumours located in the proximal 1/3 and halfway down the forearm were removed from the superficial radial nerve. In both cases, symptoms such as palpable tumour mass, pain, paraesthesias, and positive Tinel-Hoffman sign resolved after operative treatment. Final diagnoses were made based on histopathological examination results. In the second of the described cases, the largest of the excised lesions had features enabling diagnosis of a rare tumour type - ancient schwannoma. PMID:26216119

  15. Fourth Ventricular Schwannoma: Identical Clinicopathologic Features as Schwann Cell-Derived Schwannoma with Unique Etiopathologic Origins

    Directory of Open Access Journals (Sweden)

    Tiffany R. Hodges

    2011-01-01

    Full Text Available Background. To our knowledge, this is the sixth reported case in the literature of fourth ventricular schwannoma. The etiology and natural history of intraventricular schwannomas is not well understood. A thorough review of potential etiopathogenic mechanisms is provided in this case report. Case Description. A 69-year-old man presented with an incidentally found fourth ventricular tumor during an evaluation for generalized weakness, gait instability, and memory disturbance. Magnetic resonance imaging (MRI revealed a heterogeneously enhancing lesion in the fourth ventricle. A suboccipital craniotomy was performed to resect the lesion. Histopathological examination confirmed the diagnosis of schwannoma (WHO grade I. Conclusions. Schwannomas should be considered in the differential diagnosis of intraventricular tumors. Although the embryologic origins may be different from nerve sheath-derived schwannomas, the histologic, clinical, and natural history appear identical and thus should be managed similarly.

  16. Glossopharyngeal schwannoma : a case report and review of literature.

    Directory of Open Access Journals (Sweden)

    Gupta V

    2002-04-01

    Full Text Available We report a rare case of glossopharyngeal schwannoma whose clinical presentation and the radiological work up suggested an acoustic schwannoma. The diagnosis was made at surgery, once attachment to ninth cranial nerve was seen. The clinical presentation, radiological features and surgical findings of the glossopharyngeal schwannoma are presented along with the review of literature.

  17. Osteoma of the internal auditory canal mimicking vestibular schwannoma: case report and review of 17 recent cases.

    Science.gov (United States)

    Suzuki, Jun; Takata, Yusuke; Miyazaki, Hiromitsu; Yahata, Izumi; Tachibana, Yasuhiko; Kobayashi, Toshimitsu; Kawase, Tetsuaki; Katori, Yukio

    2014-01-01

    Osteoma of the internal auditory canal (IAC) is an uncommon benign bone tumor. Its imaging features may be similar to other IAC lesions, such as vestibular schwannomas that are benign and usually slow-growing but sometimes life-threatening tumors. Thus, detecting IAC lesions and differentiating osteoma from other IAC lesions are both important clinically. We report a case of misdiagnosis of an IAC osteoma as an IAC schwannoma based on magnetic resonance (MR) imaging using the three-dimensional constructive interference in steady state (CISS) sequence instead of T1-weighted MR imaging with gadolinium. We also review 17 cases of IAC osteomas reported in the past 22 years. A 61-year-old female was admitted to our department with IAC lesion incidentally discovered by the CISS sequence. The lesion was diagnosed as an IAC schwannoma, and was followed up annually under "wait and scan" management. Follow-up T1-weighted MR imaging with gadolinium showed no enhancement of the tumor, and additional computed tomography (CT) of the temporal bone showed a solitary pedunculated bony lesion, resulting in the diagnosis of IAC osteoma. The CISS sequence is useful for detecting small IAC lesions, such as vestibular schwannomas. However, the CISS sequence has limitations for qualitative diagnosis and can misdiagnose osteomas as schwannomas. Use of the CISS sequence without T1-weighted MR imaging with gadolinium for the screening of a lesion of the IAC and cerebellopontine angle should consider the possibility of IAC osteomas, and temporal bone CT or T1-weighted MR imaging with gadolinium should be performed when an IAC lesion is detected.

  18. CT evaluation of primary benign retroperitoneal tumor

    Energy Technology Data Exchange (ETDEWEB)

    Hayasaka, Kazumasa; Yamada, Tomonori; Saitoh, Yasuhiro; Yoshikawa, Daihei; Aburano, Tamio; Hashimoto, Hiroshi; Yachiku, Sunao (Asahikawa Medical Coll., Hokkaido (Japan))

    We studied CT patterns in 21 cases of primary benign retroperitoneal tumor including teratoma in nine cases, schwannoma in six, leiomyoma in three, lipoma in one, lymphangioma in one, and neurofibroma in one. The tumors were analyzed for size, internal homogeneity, CT density, calcification, border with neighboring organs, and contrast enhancement (CE). The mean diameter of the tumors was 10.2 ([+-]4.8) cm. Internal homogeneous distribution was observed in 33%, calcification in 43%, and well-defined border in 86%. The CT density and calcification were compared according to histology, and the results were as follows: teratoma showed fat density in 78%, water density in 100%, and calcification in 89%; schwannoma showed water density in 100% and septal CE in 33%; leiomyoma showed soft tissue density in 100%, CE in 100%, and water density in 33%; lipoma showed fat density and calcification; and lymphangioma and neurofibroma showed water density. Internal homogeneity, fat density, cyst formation, and calcification are considered to be important predictors of primary benign retroperitoneal tumor on CT. (author).

  19. Epithelioid Schwannomas: An Analysis of 58 Cases Including Atypical Variants.

    Science.gov (United States)

    Hart, Jesse; Gardner, Jerad M; Edgar, Mark; Weiss, Sharon W

    2016-05-01

    The histologic features and outcome of 58 cases of epithelioid schwannoma were studied to determine the significance of atypical histologic features. Cases were retrieved from personal consultation files from 1999 to 2013. Patients (31 male and 26 female patients) ranged in age from 14 to 80 years (median, 38 y). Two patients had schwannomatosis 1. Tumors developed in the dermis/subcutis (n=56) or muscle (n=2) of the upper extremity (34.5%), lower extremity (34.5%), thorax/abdomen/back (18%), and less common anatomic locations including the scalp, neck, lip, and breast. They ranged in size from 0.25 to 4.5 cm (median, 2.0 cm). Typically circumscribed and surrounded by a perineurium, they comprised single or small groups of epithelioid schwann cells with a moderate amphophilic cytoplasm and occasional nuclear pseudoinclusions. Stroma varied from myxoid to hyalinized, often with thick-walled vessels (55 cases). Mitotic rate ranged from 0 to 9 mitoses/10 high-power field (HPF) (2.37 mm) in the most active areas (mean, 2 to 3 mitoses/10 HPFs). Thirteen cases (22%) were "atypical," defined by a high mitotic rate (≥3 mitoses per 10 HPFs) and nuclear size variation (≥3:1). All (56/56) expressed S100 protein; type IV collagen invested groups or individual cells (16/17). Melanoma markers were negative, except for melan A (1 case). Follow-up in 39 patients (median, 78 mo; range, 6 to 174 mo) indicated that 31 (79%) were alive without disease (including 9/13 atypical cases; median, 78 mo), 7 (18%) were alive with unknown status, and 1 patient had died of unrelated causes. One tumor recurred, but none metastasized. Epithelioid schwannomas, even those with atypical features, are benign and do not constitute a histologic continuum with epithelioid malignant peripheral nerve sheath tumors, which typically occur in deep soft tissues and have more anaplastic features. PMID:26752543

  20. Multiple schwannomas of the upper limb related exclusively to the ulnar nerve in a patient with segmental schwannomatosis.

    Science.gov (United States)

    Molina, Alexandra R; Chatterton, Benjamin D; Kalson, Nicholas S; Fallowfield, Mary E; Khandwala, Asit R

    2013-12-01

    Schwannomas are benign encapsulated tumours arising from the sheaths of peripheral nerves. They present as slowly enlarging solitary lumps, which may cause neurological defects. Multiple lesions are rare, but occur in patients with neurofibromatosis type 2 or schwannomatosis. Positive outcomes have been reported for surgical excision in solitary schwannomas. However, the role of surgery in patients with multiple lesions is less clear. The risk of complications such as iatrogenic nerve injury and the high likelihood of disease recurrence mean that surgical intervention should be limited to the prevention of progressive neurological deficit. We report a case of a 45 year old male who presented with multiple enlarging masses in the upper limb and sensory deficit in the distribution of the ulnar nerve. The tumours were found to be related exclusively to the ulnar nerve during surgical exploration and excision, a rare phenomenon. The masses were diagnosed as schwannomas following histopathological analysis, allowing our patient to be diagnosed with the rare entity segmental schwannomatosis. One year post-operatively motor function was normal, but intermittent numbness still occurred. Two further asymptomatic schwannomas developed subsequently and were managed conservatively. PMID:23810216

  1. Trochlear Nerve Schwannoma With Repeated Intratumoral Hemorrhage.

    Science.gov (United States)

    Liu, Pengfei; Bao, Yuhai; Zhang, Wenchuan

    2016-09-01

    Trochlear nerve schwannoma is extremely rare, with only 35 pathologically confirmed patients being reported in the literature. Here, the authors report a patient of trochlear nerve schwannoma in the prepontine cistern manifesting as facial pain and double vision and presenting the image characteristics of repeated intratumoral hemorrhage, which has never been reported in the literature. Total tumor along with a portion of the trochlear nerve was removed by using a retrosigmoid approach. Facial pain disappeared after operation, and the diplopia remained. Follow-up studies have shown no tumor recurrence for 2 years and the simultaneous alleviation of diplopia. Information regarding the clinical presentation, radiological features and surgical outcomes of trochlear nerve schwannoma are discussed and reviewed in the paper. PMID:27607129

  2. Outcome after translabyrinthine surgery for vestibular schwannomas

    DEFF Research Database (Denmark)

    Springborg, Jacob Bertram; Fugleholm, Kåre; Poulsgaard, Lars;

    2012-01-01

    The objective of this article is to study the outcome after translabyrinthine surgery for vestibular schwannomas, with special focus on the facial nerve function. The study design is a case series from a national centralized database and it is set in two University Hospitals in Denmark. Participa......The objective of this article is to study the outcome after translabyrinthine surgery for vestibular schwannomas, with special focus on the facial nerve function. The study design is a case series from a national centralized database and it is set in two University Hospitals in Denmark...

  3. Vestibular schwannoma surgery and headache.

    Science.gov (United States)

    Levo, H; Blomstedt, G; Pyykkö, I

    2000-01-01

    The aim of the study was to evaluate aetiological factors for postoperative headache after vestibular schwannoma (VS) surgery with respect to asymmetric activation of vestibular reflexes. After surgery, 27 VS patients with persistent postoperative headache, 16 VS patients without headache and 9 healthy controls were examined. The vestibular, cervicocollic and cervicospinal reflexes were evaluated to study whether asymmetric activation of vestibular reflexes could cause headache. The effect of neck muscle and occipital nerve anaesthesia and the effect of sumatriptan on headache were also evaluated. The vestibular function of VS patients with headache did not differ from that of VS patients without headache, but was abnormal when compared to that of normal controls. The cervicospinal and cervicocollic reflexes did not differ in the patient groups. Injection of lidocaine around the operation scar gave pain relief to two patients, and one of them had occipital nerve entrapment. Infiltration of lidocaine deep in the neck muscles in the vicinity of the C2 root did not alleviate headache, but caused vertigo. Nine patients with musculogenic headache got pain relief from supportive neck collars, and two patients with cervicobrachial syndrome got pain relief from manual neck traction. The study shows that asymmetric activation of cervicocollic reflexes does not seem to be the reason for headache. Headache seems to be linked to neuropathic pain, allegedly caused by trigeminal irritation of the inner ear and the posterior fossa, which has recently been linked to vascular pain. PMID:10908966

  4. Type 1 papillary renal cell carcinoma in a patient with schwannomatosis: Mosaic versus loss of SMARCB1 expression in respectively schwannoma and renal tumor cells.

    Science.gov (United States)

    Hulsebos, Theo J M; Kenter, Susan; Baas, Frank; Nannenberg, Eline A; Bleeker, Fonnet E; van Minkelen, Rick; van den Ouweland, Ans M W; Wesseling, Pieter; Flucke, Uta

    2016-04-01

    In schwannomatosis, germline SMARCB1 or LZTR1 mutations predispose to the development of multiple benign schwannomas. Besides these, other tumors may occur in schwannomatosis patients. We present a 45-year-old male patient who developed multiple schwannomas and in addition a malignant type 1 papillary renal cell carcinoma (pRCC1). We identified a duplication of exon 7 of SMARCB1 on chromosome 22 in the constitutional DNA of the patient (c.796-2246_986 + 5250dup7686), resulting in the generation of a premature stop codon in the second exon 7 copy (p.Glu330*). The mutant SMARCB1 allele proved to be retained in three schwannomas and in the pRCC1 of the patient. Loss of heterozygosity analysis demonstrated partial loss of the wild-type SMARCB1 allele containing chromosome 22, suggesting loss of that chromosome in only a subset of tumor cells, in all four tumors. Immunohistochemical staining with a SMARCB1 antibody revealed a mosaic SMARCB1 expression pattern in the three benign schwannomas, but absence of expression in the malignant tumor cells of the pRCC1. To our knowledge, this difference in SMARCB1 protein expression has not been reported before. We conclude that a germline SMARCB1 mutation may predispose to the development of pRCC1, thereby further widening the spectrum of tumors that can develop in the context of schwannomatosis. PMID:26799435

  5. Complications of Microsurgery of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Jan Betka

    2014-01-01

    Full Text Available Background. The aim of this study was to analyze complications of vestibular schwannoma (VS microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225 removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI was observed in 124 cases (45% immediately after surgery and in 104 cases (33% on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%, headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.

  6. Ancient DNA

    DEFF Research Database (Denmark)

    Willerslev, Eske; Cooper, Alan

    2004-01-01

    ancient DNA, palaeontology, palaeoecology, archaeology, population genetics, DNA damage and repair......ancient DNA, palaeontology, palaeoecology, archaeology, population genetics, DNA damage and repair...

  7. THE ANALYSIS OF NF2 GENE MUTATION IN SPORADIC SCHWANNOMAS

    Institute of Scientific and Technical Information of China (English)

    卞留贯; 孙青芳; 沈建康; 赵卫国; 罗其中

    2002-01-01

    Objective To analyze the mutation of NF2 gene (exon 2,4,6 and 13) in schwannomas. Methods The NF2 gene mutation in 36 schwannomas were observed by PCR-SSCP and DNA sequence. The proliferative index of schwannoma was detected by immunohistochemistry. Results We found 13 mutations in 36 schwannomas, including 6 deletion or insertion resulting in a frameshift, 2 nonsense mutations, 2 missense mutations, and 3 alterations affecting acceptor or donor of splicing sites in E4,E6,E13. The proliferative index of schwannomas with mutation were significantly higher than those without mutation (P< 0.05). Conclusion NF2 gene mutation is the frequent event in the tumorigenesis of schwannomas, and there is some correlation between the mutation and clinical behavior(tumor proliferation).

  8. Surgical Planning by 3D Printing for Primary Cardiac Schwannoma Resection.

    Science.gov (United States)

    Son, Kuk Hui; Kim, Kun-Woo; Ahn, Chi Bum; Choi, Chang Hu; Park, Kook Yang; Park, Chul Hyun; Lee, Jae-Ik; Jeon, Yang Bin

    2015-11-01

    We report herein a case of benign cardiac schwannoma in the interatrial septum. A 42-year-old woman was transferred from a clinic because of cardiomegaly as determined by chest X-ray. A transthoracic echocardiography and chest computed tomography examination revealed a huge mass in the pericardium compressing the right atrium, superior vena cava (SVC), left atrium, and superior pulmonary vein. To confirm that the tumor originated from either heart or mediastinum, cine magnetic resonance imaging was performed, but the result was not conclusive. To facilitate surgical planning, we used 3D printing. Using a printed heart model, we decided that tumor resection under cardiopulmonary bypass (CPB) through sternotomy would be technically feasible. At surgery, a huge tumor in the interatrial septum was confirmed. By incision on the atrial roof between the aorta and SVC, tumor enucleation was performed successfully under CPB. Pathology revealed benign schwannoma. The patient was discharged without complication. 3D printing of the heart and tumor was found to be helpful when deciding optimal surgical approach.

  9. Recurrent orbital schwannomas: clinical course and histopathologic correlation

    OpenAIRE

    Kron Michelle; Bohnsack Brenda L; Archer Steven M; McHugh Jonathan B; Kahana Alon

    2012-01-01

    Abstract Background Schwannomas are slow-growing typically encapsulated tumors composed of differentiated Schwann cells, the primary class of peripheral glial cells. Complete excision is the treatment of choice for orbital schwannomas that cause pain, disfigurement, diplopia, or optic neuropathy. The presence of multiple schwannomas in a single patient suggests possible association with neurofibromatosis type 2 (NF2) or schwannomatosis. Case presentation We present 2 patients who experienced ...

  10. Clinicopathological, immunohistochemical, and ultrastructural study of 13 cases of melanotic schwannoma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-ying; ZHANG Yuan-heng; YANG Guang-hua; CHEN Hui-jiao; WEI Bing; KE Qi; GUO Hua; YE Lü; BU Hong; YANG Ke

    2005-01-01

    Background Melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS).Methods Tumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen Ⅳ and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy.Results Of the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger

  11. An Unusual Cause of Cardiac Arrhythmias; Mediastinal Schwannoma

    Directory of Open Access Journals (Sweden)

    Serdar Ozkan

    2014-02-01

    Full Text Available Schwannomas are rare tumours, which originated from neural crest cells. Thoracic schwannomas are very rare and most commonly seen in posterior mediastinum. In a 39 year old female patient whose tumor story dated back to 4 years, a 14 cm extra parenchymal intrathoracic tumor was observed to put minimal pressure on the heart. The patient%u2019s arrhythmia, who had preoperative complaints of palpitations, was improved after tumor excision. Although schwannomas generally are asympthomatic masses, they can lead mass effect according to their localization. In this study, patient with thoracic schwannoma presented with cardiac arrhythmia which never reported in literature so far.

  12. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case.

    Science.gov (United States)

    Sulhyan, Kalpana R; Deshmukh, Bhakti D; Gosavi, Alka V; Ramteerthakar, Nayan A

    2015-10-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis. PMID:26715928

  13. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case

    OpenAIRE

    Kalpana R Sulhyan; Deshmukh, Bhakti D; Gosavi, Alka V.; Ramteerthakar, Nayan A

    2015-01-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis.

  14. Benign positional vertigo

    Science.gov (United States)

    Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional ... Benign positional vertigo is also called benign paroxysmal positional vertigo (BPPV). It is caused by a problem in the inner ear. ...

  15. Repeat Gamma Knife surgery for vestibular schwannomas

    OpenAIRE

    Sarah Lonneville; Carine Delbrouck; Cécile Renier; Daniel Devriendt; Nicolas Massager

    2015-01-01

    Background: Gamma Knife (GK) surgery is a recognized treatment option for the management of small to medium-sized vestibular schwannoma (VS) associated with high-tumor control and low morbidity. When a radiosurgical treatment fails to stop tumor growth, repeat GK surgery can be proposed in selected cases. Methods : A series of 27 GK retreatments was performed in 25 patients with VS; 2 patients underwent three procedures. The median time interval between GK treatments was 45 months. The me...

  16. Facial myokymia as a presenting symptom of vestibular schwannoma.

    Directory of Open Access Journals (Sweden)

    Joseph B

    2002-07-01

    Full Text Available Facial myokymia is a rare presenting feature of a vestibular schwannoma. We present a 48 year old woman with a large right vestibular schwannoma, who presented with facial myokymia. It is postulated that facial myokymia might be due to a defect in the motor axons of the 7th nerve or due to brain stem compression by the tumor.

  17. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko;

    2010-01-01

    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  18. Schwanoma de plexo braquial: relato de dois casos Schwannoma of brachial plexus: report of two cases

    Directory of Open Access Journals (Sweden)

    Manoel Baldoíno Leal Filho

    2004-03-01

    Full Text Available Schwanomas, neurinomas ou neurilemomas são tumores benignos de nervos periféricos. Podem ocorrer em associação com a neurofibromatose tipo 2. Relatamos dois casos de tumor cervical originado em plexo braquial sem associação com neurofibromatose. Uma mulher, de 31 anos apresentando uma tumefação em região supraclavicular direita, dor irradiada para o membro ipsilateral e sinal de Tinel à percussão da região. Outra mulher, 52 anos, com cervicobraquialgia persistente à direita há um ano. Ambas foram submetidas a microcirurgia, com ressecção total da lesão. O estudo histopatológico foi compatível com schwanoma. As duas pacientes tiveram boa evolução neurológica, com desaparecimento dos sinais e sintomas.Schwannomas, neurinomas or neurilemmomas are benign peripheral nerve tumors. The literature report some cases associated with neurofibromatosis 2. We report two cases of cervical schwannoma originating from the brachial plexus unassociated with neurofibromatosis. A 31-year-old woman presented with a mass in the right supraclavicular region, irradiating pain and distal tingling to percussion (Tinel's sign for 6 months. And a 52-year-old woman presented with pain in the cervical region and right arm for one year. Both the patients underwent to a microsurgery with total resection of the lesion. Histology of the surgical specimen confirmed the diagnosis of schwannoma. Postoperatively, the patients had a good recovery.

  19. Minimally Invasive Resection of an Extradural Far Lateral Lumbar Schwannoma with Zygapophyseal Joint Sparing: Surgical Nuances and Literature Review

    Directory of Open Access Journals (Sweden)

    Vítor M. Gonçalves

    2014-01-01

    Full Text Available Introduction. Spinal schwannomas are benign nerve sheath tumors. Completely extradural schwannomas of the lumbar spine are extremely rare lesions, accounting for only 0,7–4,2% of all spinal NSTs. Standard open approaches have been used to treat these tumors, requiring extensive muscle dissection, laminectomy, radical foraminotomy, and facetectomy. In this paper the authors present the case of a minimally invasive resection of a completely extradural schwannoma. Operative technique literature review is presented. Material & Methods. A 50-year-old woman presented with progressive complains of chronic right leg pain and paresthesia. The magnetic resonance imaging revealed a giant well-encapsulated dumbbell-shaped extradural lesion at the L3-L4 level. The patient underwent a minimally invasive gross total resection of the tumor using a tubular expandable retractor system. Results. The patient had complete resolution of radiculopathy in the immediate postoperative period and she was discharged home, neurologically intact, on the second postoperative day. Postoperative MRI demonstrated no evidence of residual tumor. At latest follow-up (18 months the patient remains asymptomatic. Conclusion. Although challenging, this minimally invasive procedure is safe and effective, being an appropriate alternative, with many potential advantages, to the open approach.

  20. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2004-07-01

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation.

  1. Cervical sympathetic chain schwannoma: A case report

    Directory of Open Access Journals (Sweden)

    Inès Nacef

    2014-07-01

    Full Text Available Nerve tumors arising from the sympathetic chain are uncommon slow-growing tumors and represent a diagnosis challenge. Their malignant degeneration is rare. Definitive pre-operative diagnosis may be difficult as investigations are not usually helpful. We report the case of a 23-year old woman who presented with an asymptomatic solitary left cervical swelling. She was evaluated with sonography and computed tomography. Complete surgical excision of the lesion was carried out and histologic examination revealed a schwannoma. Post-operatively, the patient showed clinical findings of Horner’s syndrome. Pathologic and radiological evaluation, differential diagnosis of this neoplasm and its management are discussed.

  2. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Hansen, Søren; Caye-Thomasen, Per

    2015-01-01

    density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas...... are associated with distinctive disease of the peripheral vestibular tissue structures, suggesting anterograde degeneration and that dizziness in these patients may be caused by deficient peripheral vestibular nerve fibers, neurons, and end organs. In smaller tumors, a highly localized disease occurs, which...

  3. Schwannoma of the conus medullaris: a rare case

    Institute of Scientific and Technical Information of China (English)

    Suat Canbay; Askin Esen Hasturk; Fatma Markoc; Sukru Caglar

    2011-01-01

    Intradural schwannoma of the conus medullaris is a rare form of spinal neoplasm,which commonly occurs in the lumbar region.Conus medullaris level is unusual for schwannomas.A 49-year-old woman presented with chronic sciatica,mild bladder dysfunction,and paresthesia in the buttocks.Magnetic resonance imaging of the spine showed a mass lesion in the conus medullaris region with nerve compression.The tumor was completely resected and diagnosed histologically as schwannoma.The patient recovered after surgery.Clinical and radiologic features of this rare tumor are reviewed and are accompanied by literature findings.

  4. Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

    Directory of Open Access Journals (Sweden)

    Toba N. Niazi

    2012-01-01

    Full Text Available Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

  5. Facial Nerve Paralysis due to a Pleomorphic Adenoma with the Imaging Characteristics of a Facial Nerve Schwannoma.

    Science.gov (United States)

    Nader, Marc-Elie; Bell, Diana; Sturgis, Erich M; Ginsberg, Lawrence E; Gidley, Paul W

    2014-08-01

    Background Facial nerve paralysis in a patient with a salivary gland mass usually denotes malignancy. However, facial paralysis can also be caused by benign salivary gland tumors. Methods We present a case of facial nerve paralysis due to a benign salivary gland tumor that had the imaging characteristics of an intraparotid facial nerve schwannoma. Results The patient presented to our clinic 4 years after the onset of facial nerve paralysis initially diagnosed as Bell palsy. Computed tomography demonstrated filling and erosion of the stylomastoid foramen with a mass on the facial nerve. Postoperative histopathology showed the presence of a pleomorphic adenoma. Facial paralysis was thought to be caused by extrinsic nerve compression. Conclusions This case illustrates the difficulty of accurate preoperative diagnosis of a parotid gland mass and reinforces the concept that facial nerve paralysis in the context of salivary gland tumors may not always indicate malignancy.

  6. The outermost "dura-like membrane" of vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Ryosuke Tomio

    2016-01-01

    Conclusions: A dura-like membrane sometimes envelops vestibular schwannoma around the internal acoustic meatus. Recognition of this membranous structure is important for the surgical preservation of facial and acoustic nerves.

  7. Concomitant occurrence of vestibular schwannoma and epidermoid tumor

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    B V Savitr Sastri

    2013-01-01

    Full Text Available The occurrence of two tumors adjacent to each other at the same site is very rare. We present here, a patient with a vestibular schwannoma found adjacent to an epidermoid tumor in the cerebellopontine angle.

  8. Natural history of hearing deterioration in intracanalicular vestibular schwannoma

    NARCIS (Netherlands)

    Pennings, R.J.E.; Morris, D.P.; Clarke, L.; Allen, S.; Walling, S.; Bance, M.L.

    2011-01-01

    BACKGROUND: Intracanalicular vestibular schwannomas have a range of treatment options that can preserve hearing: microsurgery, stereotactic radiotherapy, and conservative observation. OBJECTIVE: To evaluate the natural course of hearing deterioration during a period of conservative observation. METH

  9. Vestibular schwannoma with contralateral facial pain – case report

    Directory of Open Access Journals (Sweden)

    Ghodsi Mohammad

    2003-03-01

    Full Text Available Abstract Background Vestibular schwannoma (acoustic neuroma most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. Case presentation Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. Conclusion The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.

  10. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma.

    Science.gov (United States)

    Huang, Xiaowen; Caye-Thomasen, Per; Stangerup, Sven-Eric

    2013-04-01

    We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed conservatively. Extreme shrinkage of the tumor may occur spontaneously. PMID:22858145

  11. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

    Huang, Xiaowen; Cayé-Thomasen, Per; Stangerup, Sven-Eric

    2013-01-01

    We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage...... of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles...... on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed...

  12. Risk factors associated with vestibulocochlear nerve schwannoma: systematic review Fatores de risco associados ao Schwannoma do nervo vestibular: revisão sistemática

    Directory of Open Access Journals (Sweden)

    Ana Paula Corona

    2009-08-01

    Full Text Available The vestibulocochlear nerve schwannoma (VS is a benign tumor that stems from the edge of the Schwann´s sheath. It is considered the most frequent intracranial benign tumor, of low lethality rate and unknown etiology. AIM: to identify risk factors associated with VS. STUDY DESIGN: systematic review. METHODS: electronic search of studies using the following key words: "risk", "schwannoma", "vestibular", "neuroma" and "acoustic". All original articles on epidemiological studies published in Portuguese, English or Spanish describing measures of association were included. RESULTS: twenty case-control studies were found, most of them published in the United States. The analysis of those studies shows educational level, household income, occupation, exposure to ionizing radiation and noise, allergic diseases as well as the use of both cellular and cordless phones as risk factors for the VS. CONCLUSION: methodological limitations and lack of precision in the findings impose limits to definitive conclusions concerning those risk factors. The current study contributes with information which can subsidize decisions related to the methodology to be used, having in mind new investigations on risk factors for VS. Therefore, it is of great help for knowledge improvement in this field.O Schwannoma do nervo vestibular (SV é um tumor benigno que se origina da bainha de Schwann do VIII par craniano. É o tumor benigno intracraniano mais frequente, de baixa letalidade e etiologia obscura. OBJETIVO: Identificar fatores de risco associados ao SV. DESENHO DO ESTUDO: Revisão sistemática. MATERIAL E MÉTODO: Identificação de estudos em bases de dados eletrônicos utilizando as palavras-chaves "risk", "risco", "schwannoma", "vestibular", "neuroma" e "acoustic". Incluíram-se artigos originais de pesquisa epidemiológica publicados em português, espanhol ou inglês, que referiam alguma medida de associação. Foram comparados e analisados aspectos metodológicos e

  13. Benign Multicystic Peritoneal Mesothelioma

    Science.gov (United States)

    ... Center (GARD) Print friendly version Benign multicystic peritoneal mesothelioma Table of Contents Overview Treatment Prognosis Living With ... Names for this Disease BMPM Benign cystic peritoneal mesothelioma Multilocular peritoneal inclusion cysts Multilocular peritoneal cysts About ...

  14. Mesothelioma - benign-fibrous

    Science.gov (United States)

    Mesothelioma - benign; Mesothelioma - fibrous; Pleural fibroma; Solitary fibrous tumor of the pleura ... other reasons. Other tests that may show benign mesothelioma include: CT scan of the chest Open lung ...

  15. Sciatica due to Schwannoma at the Sciatic Notch

    Directory of Open Access Journals (Sweden)

    Yavuz Haspolat

    2013-01-01

    Full Text Available Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.

  16. Vagal nerve schwannoma--a new diagnostic sign.

    OpenAIRE

    Morrissey, M. S.; Sellars, S. L.

    1990-01-01

    A case of vagal nerve schwannoma with a new physical sign is presented. The tumour was largely cystic and aspiration, performed twice, immediately elicited a cough reflex from the patient. Treatment was by total excision and the patient made a good recovery. Complete cystic degeneration of a vagal nerve schwannoma is uncommon. A search of the literature has failed to find any previous reports of fine needle aspiration causing a cough reflex in these tumours.

  17. Ancient Egypt.

    Science.gov (United States)

    Evers, Virginia

    This four-week fourth grade social studies unit dealing with religious dimensions in ancient Egyptian culture was developed by the Public Education Religion Studies Center at Wright State University. It seeks to help students understand ancient Egypt by looking at the people, the culture, and the people's world view. The unit begins with outlines…

  18. Posterior fossa vermian cystic schwannoma mimicking as pilocytic astrocytoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Alok Umredkar

    2011-01-01

    Full Text Available Intraparenchymal schwannomas are rare and most of the reported cases are in supratentorial region with frontal lobe being most common. Infratentorial location is very rare. We report a posterior fossa midline large cystic schwannoma with mural nodule mimicking as pilocytic astrocytoma. The pathogenesis and neuroradiological findings of intraparenchymal schwannomas are discussed with review of the related literature.

  19. Nonvestibular schwannoma tumors in the cerebellopontine angle: A structured approach and management guidelines

    DEFF Research Database (Denmark)

    Springborg, J.B.; Poulsgaard, L.; Thomsen, Jens Christian

    2008-01-01

    The most common cerebellopontine angle (CPA) tumor is a vestibular schwannoma, but one in five CPA tumors are not vestibular schwannomas. These tumors may require different management strategies. Compared with vestibular schwannomas, symptoms and signs from cranial nerve VIII are less frequent...

  20. Loss of heterozygosity on chromosome 22 in sporadic schwannoma and its relation to the proliferation of tumor cells

    Institute of Scientific and Technical Information of China (English)

    BIAN Liu-guan; SUN Qing-fang; Tirakotai Wuttipong; ZHAO Wei-guo; SHEN Jian-kang; LUO Qi-zhong; Bertalanffy Helmut

    2005-01-01

    Background Schwannoma is the tumor arising mainly from the cranial and spinal nerves. Bilateral vestibular schwannoma is the hallmark of neurofibromatosis type 2 (NF2). The NF2 gene has been cloned with comprehensive analysis of its mutations in schwannoma. However, most studies focused on vestibular schwannoma. There are differences in proliferation of tumor cell and ultrastructure between vestibular and spinal schwannomas. It is unknown whether genetic alterations in vestibular schwannoma are different from those in non-vestibular schwannoma. We analyzed the loss of heterozygosity (LOH) on chromosome 22 in patients with sporadic schwannoma including vestibular and spinal schwannomas and correlated this genetic alteration with tumor proliferation. Methods In 54 unrelated patients without clinical NF1 or NF2, 36 patients had sporadic vestibular schwannoma, and 18 dorsal spinal root schwannoma. Four highly polymorphic linkage to NF2 gene microsatellite DNA markers (D22S264, D22S268, D22S280, CRYB2) were used to analyze LOH. The proliferative index was evaluated by Ki-67 and proliferative cell nuclear antigen (PCNA) immunostaining. Student's t test was used to analyze the difference of the proliferative index between schwannoma with LOH and that without LOH. The difference of the frequency of LOH in vestibular and spinal schwannomas was investigated by the chi-square test. Results Twenty-three schwannomas (42.6%, 23/54) showed allele loss. The frequency of LOH in vestibular schwannoma was significantly higher than that in spinal schwannoma (χ2=5.14, P<0.05). The proliferative index of schwannoma with LOH was significantly higher than that without LOH (tki-67=2.97, P=0.0045; tPCNA=2.93, P=0.0051). Conclusions LOH on chromosome 22 is a frequent event in the tumorigenesis of sporadic schwannoma. And, there is a correlation between LOH on chromosome 22 and proliferative activity in schwannoma. The frequency of LOH in vestibular schwannoma is significantly different from

  1. Staging in giant vestibular schwannoma surgery: A two consecutive day technique for complete resection in basic neurosurgical setups

    OpenAIRE

    Deepak Bandlish; Nilay Biswas; Sumit Deb

    2014-01-01

    Introduction: Vestibular schwannomas constitute 8% of all intracranial tumors. A majority of vestibular schwannomas are sporadic and unilateral. Giant vestibular schwannomas are seen in our country due to the late diagnosis and long duration of symptoms before diagnosis. These giant schwannomas are challenging to manage as most of the patients are having brainstem compression. Materials and Methods: Twelve cases of a giant vestibular schwannoma were operated in our department between May 2011...

  2. Schwannoma de plexo braquial en el diagnóstico diferencial del hombro doloroso: Diferential diagnostic in the shoulder pain Brachial plexus schwannoma

    Directory of Open Access Journals (Sweden)

    S. Cortés

    2006-11-01

    Full Text Available Los schwannomas son tumores derivados de las células de Schwann, infrecuentes y generalmente de comportamiento benigno. El dolor y la radiculopatía son los síntomas iniciales más frecuentes. El diagnóstico se realiza mediante resonancia magnética y la resección quirúrgica es el tratamiento de elección. Presentamos el caso de una paciente de 50 años con omalgia atraumática izquierda de 5 años de evolución, durante los cuáles fue valorada por diferentes especialistas que incluían traumatólogos, reumatólogos, neurólogos y rehabilitadores. Inicialmente la paciente fue tratada con diversos AINES, rehabilitación (fisioterapia, onda corta, magnetoterapia sin mejoría. Como pruebas complementarias se realizaron un estudio neurofisiológico del miembro superior izquierdo (informado como normal, una resonancia magnética (RM cervical y una RM de hombro donde se informa de una rotura parcial del tendón supraespinoso y bursitis subacromial, por lo que se decide llevar a cabo una descompresión subacromial artroscópica. A pesar del tratamiento quirúrgico la paciente no mejora y se mantiene un dolor severo (EVA > 6. Posteriormente fue tratada con AINEs asociados a parches de fentanilo, pregabalina, infiltraciones de corticoides y nuevas sesiones de rehabilitación sin mejoría. Se decidió ampliar las pruebas de imagen y realizar una tomografia axial computerizada (TAC torácica, ecografía de hombro izquierdo y RM de plexo braquial que mostraron la existencia de una lesión compatible con schwannoma del plexo braquial. La paciente fue intervenida quirúrgicamente para resección del tumor mejorando del dolor progresivamente encontrándose actualmente asintomática.Schwannomas are tumors origined from Schwann cells, unfrequent, and generally benign. Pain and radiculopathy are common initial symptoms. Diagnosis is based in magnetic resonance imaging (MRI and surgery is the election treatment. We describe the case of a 50 years old woman

  3. Gastric schwannomas: radiological features with endoscopic and pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Hong, H.S. [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul (Korea, Republic of); Ha, H.K. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)], E-mail: hkha@amc.seoul.kr; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Lee, G.H. [Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Kim, M.J. [Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)

    2008-05-15

    Aim: To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. Materials and methods: The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. Results: On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. Conclusion: Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.

  4. Recurrent orbital schwannomas: clinical course and histopathologic correlation

    Directory of Open Access Journals (Sweden)

    Kron Michelle

    2012-08-01

    Full Text Available Abstract Background Schwannomas are slow-growing typically encapsulated tumors composed of differentiated Schwann cells, the primary class of peripheral glial cells. Complete excision is the treatment of choice for orbital schwannomas that cause pain, disfigurement, diplopia, or optic neuropathy. The presence of multiple schwannomas in a single patient suggests possible association with neurofibromatosis type 2 (NF2 or schwannomatosis. Case presentation We present 2 patients who experienced recurrent orbital schwannoma without evidence for neurofibromatosis. The recurrence in one patient, a 59-year old man, occurred 6 years after complete excision of the initial tumor. This recurrence consisted of 2 independent tumors in the same orbit. The recurrence in the second patient, a 5 year-old girl, occurred multiple times within days to weeks of partial excisions until eventually a complete excision was performed. Conclusion The clinical history, histopathologic features and particularly the intraoperative findings suggest that the 59 year old man suffers from orbital schwannomatosis, while the rapid recurrence in the second patient correlated with the cellular features of her plexiform schwannoma. Hence, the recurrence in each patient is linked to a different etiology, with implications for treatment and patient counseling given the difficulty in treating orbital schwannomatosis. To our knowledge, this is the first description of isolated orbital schwannomatosis.

  5. CT and MRI diagnosis of intracranial trigeminal schwannoma

    International Nuclear Information System (INIS)

    Objective: To investigate the diagnostic value of CT and MRI on intracranial trigeminal schwannoma. Methods: CT and MRI findings of 16 patients with intracranial trigeminal schwannoma confirmed by pathology were analyzed retrospectively, including 9 case of CT, 8 case of MRI. Results: Intracranial trigeminal schwannoma was divided into three types: posterior cranial fossa type (4 cases), middle cranial fossa type (3 cases), and transcranianial fossa type (9 cases). CT features of the tumors included mixed density, no calcification, petrous apex bone resorption or destruction (n=4). The tumors demonstrated as low-signal intensity on MR T1-weighted images, and high signal intensity on T2-weighted images, with heterogeneous enhancement after Gd-DTPA injection. Cystic degeneration was occurred in 6 cases, with ring-like enhancement after Gd-DTPA injection. Conclusion: CT and MRI can accurately show the tumor site, shape, internal structure and enhancement performance. CT and MRI have a great diagnostic and differential diagnostic value in intracranial trigeminal schwannoma. MRI is better than CT in qualitative diagnosis of trigeminal schwannoma. (authors)

  6. Schwannoma of the tip of the nose: MRI

    International Nuclear Information System (INIS)

    We report a schwannoma with a rare location at the tip of the nose in a 20-year-old woman with an otherwise unremarkable medical history. The imaging findings unterline the usefulness of MRI in narrowing down the differential diagnosis of masses in this region. Once the diagnosis was focussed on a neural origin of the mass, the exact nature of the tumour could not be predicted from the MRI, although the presence of a capsule on imaging studies as well as at operation suggested it was probably a schwannoma. A schwannoma must be considered when one encounters a sharply delineated mass at the tip of the nose, showing high signal on T2-weighted images and strongly contrast enhancement. (orig.)

  7. Normal pressure hydrocephalus after gamma knife radiosurgery for vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Mohammed T

    2010-01-01

    Full Text Available Vestibular schwannomas are not uncommon, and gamma knife radiosurgery is one of the treatment options for symptomatic tumors. Hydrocephalus is a complication of gamma knife treatment of vestibular schwannoma, though the mechanism of the development of hydrocephalus remains controversial. We present an unusual case of normal pressure hydrocephalus (NPH after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of the hydrocephalus. This is probably the first case of NPH post radiosurgery with normal cerebrospinal fluid protein. Communicating hydrocephalus should be treated with placement of shunt while non-communicating hydrocephalus can be treated with third ventriculostomy. Frequent monitoring and early intervention post radiosurgery is highly recommended to prevent irreversible cerebral damage.

  8. Gamma-knife radiosurgery in the treatment of trigeminal schwannomas

    International Nuclear Information System (INIS)

    Trigeminal nerve schwannomas account for 0.07 %-0.28 % of all intracranial tumors. Advances in skull base surgery have led to more aggressive resection of these tumors, but surgery may associated with development of new neurological deficits. In this report, we analyse the long-term results 15 patients with newly diagnosed or residual/recurrent trigeminal schwannoma who underwent gamma-knife treatment. During a mean 61 months of follow-up, MRI revealed reduction of tumor size in 13 and no size change in 2 patients. The tumor growth control rate was 100 % and only 1 patient had transient facial numbness and diplopia. For patients with small to moderate size trigeminal schwannomas, gamma-knife radiosurgery is associated with good tumor control and a minimal risk of adverse radiation effects. (author)

  9. Retroperitoneal Gastrointestinal Type Schwannoma Presenting as a Renal Mass

    Directory of Open Access Journals (Sweden)

    Susan J. Hall

    2015-11-01

    Full Text Available Retroperitoneal schwannomas are extremely rare, and unreported in Urology. Often thought to be malignant from imaging the diagnosis is often delayed until Histology. We report a case of retroperitoneal schwanoma thought to be a malignant renal mass. Seventy three year old lady presented with abdominal pain. Imaging showed a mass attached to the renal pelvis thus she underwent a radical nephrectomy. Histology reported retroperitoneal schwannoma. Malignant forms are rare however treatment for these is surgical excision. Awareness of the existence of these tumors may help in avoiding unnecessary radical surgeries by opting for biopsy preoperatively.

  10. Increasing annual incidence of vestibular schwannoma and age at diagnosis

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Caye-Thomasen, Per;

    2004-01-01

    During the last 26 years the annual number of diagnosed vestibular schwannomas (VS) has been increasing. The aim of this study is to describe and analyse this increase. Since 1976, 1446 new cases of VS have been diagnosed at the authors' centre. Special focus was on the age at diagnosis, the loca......During the last 26 years the annual number of diagnosed vestibular schwannomas (VS) has been increasing. The aim of this study is to describe and analyse this increase. Since 1976, 1446 new cases of VS have been diagnosed at the authors' centre. Special focus was on the age at diagnosis...

  11. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    Science.gov (United States)

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  12. Ancient genomics

    DEFF Research Database (Denmark)

    Der Sarkissian, Clio; Allentoft, Morten Erik; Avila Arcos, Maria del Carmen;

    2015-01-01

    , archaic hominins, ancient pathogens and megafaunal species. Those have revealed important functional and phenotypic information, as well as unexpected adaptation, migration and admixture patterns. As such, the field of aDNA has entered the new era of genomics and has provided valuable information when...

  13. Ancient mitogenomics

    DEFF Research Database (Denmark)

    Ho, Simon Y W; Gilbert, M Thomas P

    2010-01-01

    the technical challenges that face researchers in the field. We catalogue the diverse sequencing methods and source materials used to obtain ancient mitogenomic sequences, summarise the associated genetic and phylogenetic studies that have been conducted, and evaluate the future prospects of the field....

  14. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...

  15. Benign prostate hyperplasia (BPH) - resources

    Science.gov (United States)

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... The following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ... Urology Care Foundation -- www. ...

  16. Fractionated stereotactic radiotherapy of benign skull-base tumors: a dosimetric comparison of volumetric modulated arc therapy with Rapidarc® versus non-coplanar dynamic arcs

    OpenAIRE

    Martin, Fanny; Magnier, Florian; Berger, Lucie; Miroir, Jessica; Chautard, Emmanuel; Verrelle, Pierre; Lapeyre, Michel; Biau, Julian

    2016-01-01

    Background Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient’s outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). Methods Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three m...

  17. Near Total Extirpation of Vestibular Schwannoma With Salvage Radiosurgery

    NARCIS (Netherlands)

    Jeltema, Hanne Rinck; Bakker, Nicolaas A.; Bijl, Hendrik P.; Wagemakers, Michiel; Metzemaekers, Jan D. M.; van Dijk, J. Marc C.

    2015-01-01

    Objectives/Hypothesis: The management of a sporadic vestibular schwannoma (VS) has changed with the introduction of stereotactic radiosurgery (SRS). Because functional outcome is important, particularly regarding the facial nerve, a policy of near-total surgical resection of a large-size VS has emer

  18. Varied Presentation of Schwannoma – A Case Study

    Directory of Open Access Journals (Sweden)

    Ruquaya Mir

    2010-10-01

    Full Text Available Schwannomas can occur anywhere in the body with unusual presentation. They are difficult to diagnose preoperatively. Fine needle aspiration biopsy does not appear to provide an accurate preoperative diagnosis. Complete excision of the mass should be the goal of surgical excision.

  19. What is the real incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

    Tos, Mirko; Stangerup, Sven-Eric; Cayé-Thomasen, Per;

    2004-01-01

    OBJECTIVES: To present the incidence of vestibular schwannoma (VS) in Denmark, compare the incidence with that of previous periods, and discuss the real incidence of VS. DESIGN, SETTING, AND PATIENTS: Prospective registration of all diagnosed VS in Denmark, with a population of 5.1 to 5.2 million...

  20. Socio-demographic distribution of vestibular schwannomas in Denmark

    DEFF Research Database (Denmark)

    Stepanidis, Karen; Kessel, Marie; Caye-Thomasen, Per;

    2014-01-01

    CONCLUSION: Vestibular schwannomas (VSs) are diagnosed less frequently in the remote parts of Denmark, whereas the diagnostic age and tumor size is the same across the different socio-demographic areas of Denmark. OBJECTIVE: To determine whether VSs are diagnosed equally often in different socio-...

  1. Sociodemographic factors and vestibular schwannoma: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Schüz, Joachim; Steding-Jessen, Marianne; Hansen, Søren;

    2010-01-01

    Vestibular schwannoma (VS) (or acoustic neuroma) accounts for about 5%-6% of all intracranial tumors; little is known about the etiology. We investigated the association between various sociodemographic indicators and VS in a cohort of 3.26 million Danish residents, with 1087 cases identified in 35...

  2. 前庭神经鞘瘤%Vestibular schwannoma

    Institute of Scientific and Technical Information of China (English)

    焦德让

    2003-01-01

    @@ 前庭神经鞘瘤(vestibular schwannoma,VS)亦称听神经瘤(acoustic neuroma),是颅内较为常见的良性肿瘤之一,约占颅内良性肿瘤的10%,占小脑桥脑角(cerebellopontine angle,CPA)肿瘤的65%~72%.

  3. Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Claesson, Magnus; Stangerup, Sven-Eric;

    2012-01-01

    To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hear...

  4. Increasing annual incidence of vestibular schwannoma and age at diagnosis

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Caye-Thomasen, Per;

    2004-01-01

    During the last 26 years the annual number of diagnosed vestibular schwannomas (VS) has been increasing. The aim of this study is to describe and analyse this increase. Since 1976, 1446 new cases of VS have been diagnosed at the authors' centre. Special focus was on the age at diagnosis, the loca...

  5. Benign positional vertigo - aftercare

    Science.gov (United States)

    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare ... Your doctor may have treated your vertigo with the Epley maneuver. ... ear problem that causes BPPV. It usually works quickly. For ...

  6. Surgical outcome in cystic vestibular schwannomas

    Science.gov (United States)

    Nair, Suresh; Baldawa, Sachin S.; Gopalakrishnan, Chittur Viswanathan; Menon, Girish; Vikas, Vazhayil; Sudhir, Jayanand B.

    2016-01-01

    Background: Cystic vestibular schwannomas (VS) form a rare subgroup that differs from the solid variant clinically, radiologically, and histopathologically. These tumors also vary in their surgical outcome and carry a different risk of post-operative complications. We analyzed our series of 64 patients with cystic VS and discuss the technical difficulties related to total excision of these tumors and focus on complication avoidance. Materials and Methods: A retrospective review of cystic VS surgically managed over a span of 11 years. The case records were evaluated to record the clinical symptoms and signs, imaging findings, surgical procedure, complications, and follow-up data. Post-operative facial nerve palsy was analyzed with respect to tumor size and tumor type. Results: Progressive hearing impairment was the most common initial symptom (76.6%). Atypical initial symptoms were present in 15 patients (23.4%). Preoperatively, 78% patients had good facial nerve function (HB grade 1, 2) and 22% had intermediate (HB grade 3, 4) to poor (HB grade 5 and 6) function. Mean tumor size was 4.1 cm. Complete tumor removal was achieved in 53 patients (83%). The facial nerve was anatomically intact but thinned out after tumor excision in 38 patients (59.4%). Ninety percent patients had either intermediate or poor facial nerve function at follow-up. Poor facial nerve outcome was associated with giant tumors and peripherally located, thin-walled cystic tumors. Conclusion: Resection of cystic VS is complicated by peritumoral adhesions of the capsule to the nerve. Extensive manipulation of the nerve in order to dissect the tumor–nerve barrier results in worse facial nerve outcome. The outcome is worse in peripherally located, thin-walled cystic VS as compared to centrally located, thick-walled cystic tumors. Subtotal excision may be justified, especially in tumors with dense adhesion of the cyst wall to the facial nerve in order to preserve nerve integrity. PMID:27366248

  7. The outermost “dura-like membrane” of vestibular schwannoma

    Science.gov (United States)

    Tomio, Ryosuke; Yoshida, Kazunari; Kohno, Maya; Kamamoto, Dai; Mikami, Shuji

    2016-01-01

    Background: The membranous structure of vestibular schwannoma is an important factor in its surgical treatment. Herein, we report intraoperative and microscopic findings relating to an outermost dura-like membrane in cases of vestibular schwannoma and the importance of these findings. Methods: Intraoperative findings of 16 cases of vestibular schwannoma treated with an initial surgery were studied with an aim to determine if the cases had a dura-like membrane. Then we studied microscopic findings of the dura-like membrane using hematoxylin and eosin, Masson trichrome, and immunohistochemical staining in 2 cases. Results: The dura-like membrane was observed in 8 out of 16 cases. The average tumor size of the cases that had a dura-like membrane was 30 ± 8.1 mm, and Koos grading 4 was in 7 out of 8 cases, and one was grade 3. In cases without a dura-like membrane, these values were significantly smaller, with an average tumor size of 12.8 ± 5.2 mm, and Koos grading 4 was only in 1 of 8 cases, grade 3 was in 2 cases, and other 5 cases were grade 2. The outermost dura-like membrane enveloped the vestibular schwannoma around the internal acoustic meatus and was continuous with the dura mater. Reactive angiogenesis was observed in the dura mater. Microscopic findings proved its continuity with the dura mater. In one case, the facial nerve was damaged before it was identified during subcapsular dissection. In that case, the dura-like membrane negatively affected our ability to identify the facial nerve. Conclusions: A dura-like membrane sometimes envelops vestibular schwannoma around the internal acoustic meatus. Recognition of this membranous structure is important for the surgical preservation of facial and acoustic nerves. PMID:27453796

  8. Intrinsic brainstem schwannoma – A rare clinical entity and a histological enigma

    Directory of Open Access Journals (Sweden)

    Anil Kumar Sharma

    2016-01-01

    Full Text Available Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma.

  9. Large oculomotor nerve schwannoma - Rare entity: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    L Pavan Kumar

    2014-01-01

    Full Text Available Schwannomas commonly arise from peripheral nerves. Intracranial schwannomas are comparatively rare and are seen commonly as vestibular tumors. Oculomotor nerve schwannomas are extremely rare tumors, these are usually symptomatic. A 29 year aged male presented with diplopia and blurring of vision in left eye and found to have an extra-axial lesion at left cavernous sinus involving oculomotor nerve. The excised tumor showed classic morphology of a schwannoma. Postoperatively patient developed complete oculomotor nerve palsy. The tumor recurred after 2 years. It was re-excised followed by radiotherapy.

  10. Multiple intracranial lipomas, hypogenetic corpus callosum and vestibular schwannoma: an unusual spectrum of MR findings in a patient.

    Directory of Open Access Journals (Sweden)

    Shah J

    1999-04-01

    Full Text Available We describe imaging findings of a patient with multiple intracranial lipomas, hypogenetic corpus callosum and a vestibular schwannoma. We did not find association of intracranial lipomas and vestibular schwannoma in English literature.

  11. Benign cystic peritoneal mesothelioma

    Directory of Open Access Journals (Sweden)

    Santhosh Shetty

    2014-04-01

    Full Text Available A well-defined but rare entity of Benign Cystic Peritoneal Mesothelioma (BCPM is reported. The aetiology of this neoplasm remains obscure. The presenting features make a precise preoperative diagnosis difficult but information provided by computed tomography and cytology may help. A firm diagnosis can only come from an electronic microscopy or immunohistological examination of the tumour. Diagnostic accuracy and diligent follow up are essential because, although the tumour is considered benign, it does tend towards local recurrence. [Int J Res Med Sci 2014; 2(2.000: 762-764

  12. Ancient neurilemmoma: A rare oral tumor

    Directory of Open Access Journals (Sweden)

    J Muruganandhan

    2013-01-01

    Full Text Available Neurilemmomas are benign tumors of neural origin composed of Schwann cell proliferation in characteristic patterns. Ancient neurilemmomas are usually longstanding growths that exhibit degenerative features that could be mistaken for malignancy. They are extremely rare in the oral cavity and present in older individuals of long duration. The authors report a case of ancient neurilemmoma in a young patient with short duration of growth. This unique case presented with remarkable histopathological features with respect to vascularity and atypia associated with degenerative change. It is essential to not mistake these features as malignant transformation so as to avoid radical procedures.

  13. Ancient Egypt

    Science.gov (United States)

    Swamy, Ashwin Balegar

    This thesis involves development of an interactive GIS (Geographic Information System) based application, which gives information about the ancient history of Egypt. The astonishing architecture, the strange burial rituals and their civilization were some of the intriguing questions that motivated me towards developing this application. The application is a historical timeline starting from 3100 BC, leading up to 664 BC, focusing on the evolution of the Egyptian dynasties. The tool holds information regarding some of the famous monuments which were constructed during that era and also about the civilizations that co-existed. It also provides details about the religions followed by their kings. It also includes the languages spoken during those periods. The tool is developed using JAVA, a programing language and MOJO (Map Objects Java Objects) a product of ESRI (Environmental Science Research Institute) to create map objects, to provide geographic information. JAVA Swing is used for designing the user interface. HTML (Hyper Text Markup Language) pages are created to provide the user with more information related to the historic period. CSS (Cascade Style Sheets) and JAVA Scripts are used with HTML5 to achieve creative display of content. The tool is kept simple and easy for the user to interact with. The tool also includes pictures and videos for the user to get a feel of the historic period. The application is built to motivate people to know more about one of the prominent and ancient civilization of the Mediterranean world.

  14. Calcification of vestibular schwannoma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang Yang

    2012-10-01

    Full Text Available Abstract Calcification rarely occurs in vestibular schwannoma (VS, and only seven cases of calcified VS have been reported in the literature. Here, we report a 48-year-old man with VS, who had a history of progressive left-sided hearing loss for 3 years. Neurological examination revealed that he had left-sided hearing loss and left cerebellar ataxia. Magnetic resonance imaging and computerized tomography angiography showed a mass with calcification in the left cerebellopontine angle (CPA. The tumor was successfully removed via suboccipital craniotomy, and postoperative histopathology showed that the tumor was a schwannoma. We reviewed seven cases of calcified VS that were previously reported in the literature, and we analyzed and summarized the characteristics of these tumors, including the calcification, texture, and blood supply. We conclude that calcification in VS is associated with its texture and blood supply, and these characteristics affect the surgical removal of the tumor.

  15. Intratemporal and extratemporal facial nerve schwannoma: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won [Pohang Medical Center, Pohang (Korea, Republic of); Lee, Ho Kyu; Shin, Ji Hoon; Choi, Choong Gon; Suh, Dae Chul [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Cheong, Hae Kwan [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-05-01

    To analyze the characteristics of CT and MRI findings of facial nerve schwannoma in ten patients. Ten patients with pathologically confirmed facial nerve schwannoma, underwent physical and radilolgic examination. The latter involved MRI in all ten and CT scanning in six. We analyzed the location (epicenter), extent and number of involved segments of tumors, tuumor morphology, and changes in adjacent bony structures. The major symptoms of facial nerve schwannoma were facial nerve paralysis in seven cases and hearing loss in six. Epicenters were detected at the intraparotid portion in five cases, the intracanalicular portion in two, the cisternal portion in one, and the intratemporal portion in two. The segment most frequently involved was the mastoid (n=6), followed by the parotid (n=5), intracanalicular (n=4), cisternal (n=2), the labyrinthine/geniculate ganglion (n=2) and the tympanic segment (n=1). Tumors affected two segments of the facial nerve in eight cases, only one segment in one, and four continuous segments in one. Morphologically, tumors were ice-cream cone shaped in the cisternal segment tumor (1/1), cone shaped in intracanalicular tumors (2/2), oval shaped in geniculate ganglion tumors (1/1), club shaped in intraparotid tumors (5/5) and bead shaped in the diffuse-type tumor (1/1). Changes in adjacent bony structures involved widening of the stylomastoid foramen in intraparotid tumors (5/5), widening of the internal auditary canal in intracanalicular and cisternal tumors (3/3), bony erosion of the geniculate fossa in geniculate ganglion tumors (2/2), and widening of the facial nerve canal in intratemporal and intraparotid tumors (6/6). The characteristic location, shape and change in adjacent bony structures revealed by facial schwannomas on CT and MR examination lead to correct diagnosis.

  16. Ruptured Pseudoaneurysm after Gamma Knife Surgery for Vestibular Schwannoma

    OpenAIRE

    MURAKAMI, Mamoru; KAWARABUKI, Kentaro; INOUE, Yasuo; Ohta, Tsutomu

    2015-01-01

    Ruptured aneurysms of anterior inferior cerebellar artery (AICA) after radiotherapy for vestibular schwannoma (VS) are rare, and no definite treatment has been established for distal AICA pseudoaneurysms. We describe a 61-year-old man who underwent Gamma Knife surgery (GKS) for left VS. Follow-up magnetic resonance imaging (MRI) revealed partial regression of the tumor. Twelve years after GKS, he suffered from subarachnoid hemorrhage. Initial angiogram showed no vascular lesions; second left ...

  17. Olfactory region schwannoma: Excision with preservation of olfaction

    Directory of Open Access Journals (Sweden)

    Pravin Salunke

    2014-01-01

    Full Text Available Olfactory region schwannomas are rare, but when they occur, they commonly arise from the meningeal branches of the trigeminal nerve and may present without involvement of the olfaction. A 24 year old lady presented with hemifacial paraesthesias. Radiology revealed a large olfactory region enhancing lesion. She was operated through a transbasal with olfactory preserving approach. This manuscript highlights the importance of olfactory preservation in such lesions.

  18. Radiosurgical treatment of sporadic vestibular schwannomas: A prospective cohort study

    International Nuclear Information System (INIS)

    Objective: To analyze the preliminary experience of radiosurgery for Vestibular Schwannomas at the Pontificia Universidad Catolica de Chile. Material and methods: The first 17 patients with sporadic Vestibular Schwannomas treated by radiosurgery at our institution are reported. The marginal dose used was 12 to 12.5 Gy. prescribed at the 70 or 80 isodose fine. Patients were controlled at 6, 12 and 24 months with magnetic resonance, audiometric study and clinical examination. Results: In all of the 17 patients treated a decrease tumor enhancement on MR was demonstrated. In 16 patients (94%) a pattern of central tumor necrosis was observed during the firs year Actuarial useful hearing was maintained in 62.5% at 2 year after treatment. Facial nerve function was maintained in all of the 15 patients with normal function at treatment (100%). Trigeminal function was maintained in ah of the 14 patients (100%) with previous normal trigeminal function. The mean time to return to work or normal activities was 11.5 days after treatment. Conclusions: These preliminary results are comparable with results published in the literature and reinforce the demonstrate role of radiosurgery in the management of vestibular schwannomas

  19. Vestibular schwannoma or tanycytic ependymoma: Immunohistologic staining reveals

    Directory of Open Access Journals (Sweden)

    Anthony Divito

    2014-01-01

    Full Text Available Background: The cerebellopontine angle (CPA is a common location for primary tumors, most often vestibular schwannomas, and also meningiomas, dermoids, and a host of other neoplasms. Our case report illustrates how radiologic and histopathologic presentations of an unusual variant of ependymal neoplasm can be diagnostically challenging and how accurate diagnosis can affect treatment protocols. Case History: Our patient had a CPA mass that was a variant of ependymoma known as tanycytic ependymoma that mimicked vestibular schwannoma radiologically and during intraoperative pathologic examination. Diagnosis as a World Health Organization (WHO grade II tanycytic ependymoma was supported by its appearance on evaluation of the permanent sections, its diffuse immunoreactivity for glial fibrillary acidic protein (GFAP, and the perinuclear dot-and-ring-like staining for epithelial membrane antigen (EMA. Conclusions: Our patient′s CPA mass initially believed to be a vestibular schwannoma on preoperative evaluation, surgical appearance, and intraoperative pathologic consultation was then correctly diagnosed as a WHO grade II tanycytic ependymoma on permanent histologic sections with the assistance of immunohistochemical stains, including EMA. After this definitive diagnosis, our patient′s adjuvant treatment was adjusted. Earlier diagnosis could have provided guidance for goals of resection and prompt initiation of adjuvant treatment.

  20. Intratumoral hemorrhage, vessel density, and the inflammatory reaction contribute to volume increase of sporadic vestibular schwannomas

    OpenAIRE

    de Vries, Maurits; Hogendoorn, Pancras C W; Briaire-de Bruyn, Inge; Malessy, Martijn J. A.; van der Mey, Andel G L

    2012-01-01

    Vestibular schwannomas show a large variation in growth rate, making prediction and anticipation of tumor growth difficult. More accurate prediction of clinical behavior requires better understanding of tumor biological factors influencing tumor progression. Biological processes like intratumoral hemorrhage, cell proliferation, microvessel density, and inflammation were analyzed in order to determine their role in vestibular schwannoma development. Tumor specimens of 67 patients surgically tr...

  1. Spontaneous tumour shrinkage in 1261 observed patients with sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

    Huang, Xiaoshan; Caye-Thomasen, P; Stangerup, S-E

    2013-01-01

    To determine the rate of spontaneous tumour shrinkage in a group of patients with sporadic vestibular schwannoma managed with a 'wait and scan' approach.......To determine the rate of spontaneous tumour shrinkage in a group of patients with sporadic vestibular schwannoma managed with a 'wait and scan' approach....

  2. Schwannoma of the left foot: a brief overview with focus on associated clinical syndromes.

    Science.gov (United States)

    Kallini, Joseph R; Khachemoune, Amor

    2014-01-01

    In this article, we present a 25-year-old man who developed an asymptomatic schwannoma on his left lateral heel and review the salient features of this cutaneous condition. A schwannoma is a slowly growing neoplasm of Schwann cell origin. Histology shows high cellularity (Antoni A regions), nuclear palisades (Verocay bodies), and alternating myxoid regions (Antoni B regions). Very few cases have been reported on the foot or ankle. As with this patient, most schwannomas do not cause symptoms, but some result in dysesthesia and nerve dysfunction. Multiple schwannomas may indicate an underlying syndrome such as neurofibromatosis type 1, type 2, and schwannomatosis. The differential diagnosis for schwannoma includes fibrosarcoma, leiomyosarcoma, and neurofibroma. The definitive treatment is surgical excision. This usually results in complete resolution with minimal recurrence, as was the case for this patient. PMID:25275746

  3. Cyst formation after gamma knife radiosurgery for trigeminal schwannoma. A case report

    International Nuclear Information System (INIS)

    Radiosurgery for small vestibular schwannomas is an established and effective treatment, and it has been used for trigeminal schwannoma recently. Delayed cyst formation is well recognized as complication after gamma knife radiosurgery for arteriovenous malformation. We encountered a case of delayed cyst formation after gamma knife radiosurgery for trigeminal schwannoma. An 81-year-old male presented with abducens palsy and ataxia 6 years after gamma knife radiosurgery for trigeminal schwannoma. A cyst development in the posterior fossa was identified, and the brain stem was compressed by the cyst. The cyst was removed and the abducens palsy and ataxia improved within a month. Histological findings revealed variable tumor tissue in the cyst wall. Delayed cyst formation should be recognized as a complication after radiosurgery for schwannoma. (author)

  4. LOSS OF HETEROZYGOSITY FOR MARKERS ON 22CHROMOSOME IN SPORADIC SCHWANNOMA

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To analyze the loss of heterozygosity ( LOH) for markers on chromosome 22 ( CHR 22 ) and its significance with their clinical behaviors. Methods The frequency of CHR22 LOH in 36 schwannomas was observed by dena tured polyacrylamide gels and silver staining, and the proliferative index of schwannoma was calculated by Ki-67 and PCNA im munohistochemistry. Results 15 schwannomas (41.6%) showed allele loss. The proliferative index of schwannomas with LOH were significantly higher than those without LOH (P<0.05). In acoustic neuromas, patients with LOH were younger at the age of diagnosis, larger size of tumor, shorter history and higher growth rate than those without LOH, but with no signifi cance. Conclusion CHR22 LOH was the frequent event in the tumorigenesis of sporadic schwannoma. There were some links between CHR22 LOH and clinical behavior.

  5. 喉神经鞘瘤3例及文献复习%Laryngeal schwannoma: A report of 3 cases and literature review

    Institute of Scientific and Technical Information of China (English)

    彭莉莉; 李进让

    2012-01-01

    目的 探讨最佳喉神经鞘瘤的诊断方法与治疗方案.方法 回顾性分析3例喉神经鞘瘤患者的临床诊治资料.结果 3例中男1例(9岁),女2例(35岁、59岁),病变分别位于左侧声门下、室带和会厌喉面.3例均行手术治疗,喉裂开切除l例,支撑喉镜下CO2激光辅助切除2例,随访半年以上均未见复发.结论 喉神经鞘瘤为少见的喉部良性肿瘤,手术是最有效的治疗方法.%Objective To explore the diagnosis and optimal management of laryngeal Schwannoma.Methods The clinical data of 3 laryngeal Schwannoma cases, from August 2000 to July 2011, were analyzed retrospectively.In addition , the literatures about this disease were reviewed.Results There were 2 female and one male patients, and their ages were 9, 3 and 59 years old, respectively.The lesions were located in the subglottic area, vestibular fold and laryngeal surface of the epiglottis, respectively.The tumors were removed through laryngofissure approach in one case and trans-oral CO2 laser-assisted laryngeal microsurgery in 2 cases.No recurrence was found in 6-month follow up.Conclusion Laryngeal Schwannoma is a rare benign neurogenic tumor of the larynx.Surgical resection is the most effective treatment.

  6. Uptake of 4-borono-2-[{sup 18}F]fluoro-L-phenylalanine in sporadic and neurofibromatosis 2-related schwannoma and meningioma studied with PET

    Energy Technology Data Exchange (ETDEWEB)

    Havu-Auren, Katja; Kiiski, Johanna; Lehtioe, Kaisa; Eskola, Olli; Oikonen, Vesa [University of Turku, Turku PET Centre, P.O. Box 52, Turku (Finland); Kulvik, Martti; Vaehaetalo, Jyrki [Helsinki University Central Hospital, Department of Neurology, Helsinki (Finland); Vuorinen, Ville [Turku University Central Hospital, Department of Neurosurgery, Turku (Finland); Jaeaeskelaeinen, Juha [Kuopio University Central Hospital, Department of Neurosurgery, Kuopio (Finland); Minn, Heikki [University of Turku, Turku PET Centre, P.O. Box 52, Turku (Finland); Turku University Central Hospital, Department of Oncology and Radiotherapy, Turku (Finland)

    2007-01-15

    Meningiomas and schwannomas associated with neurofibromatosis 2 (NF2) are difficult to control by microsurgery and stereotactic radiotherapy alone. Boron neutron capture therapy (BNCT) is a chemically targeted form of radiotherapy requiring increased concentration of boron-10 in tumour tissue. PET with the boron carrier 4-borono-2-[{sup 18}F]fluoro-L-phenylalanine ([{sup 18}F]FBPA) allows investigation of whether 4-borono-L-phenylalanine (BPA) concentrates in NF2 tumours, which would make BNCT feasible. We studied dynamic uptake of [{sup 18}F]FBPA in intracranial meningiomas (n=4) and schwannomas (n=6) of five sporadic and five NF2 patients. Tracer input function and cerebral blood volume were measured. [{sup 18}F]FBPA uptake in tumour and brain was assessed with a three-compartmental model and graphical analysis. These, together with standardised uptake values (SUVs), were used to define tumour-to-brain [{sup 18}F]FBPA tissue activity gradients. Model fits with three parameters K{sub 1} (transport), k{sub 2} (reverse transport) and k{sub 3} (intracellular metabolism) were found to best illustrate [{sup 18}F]FBPA uptake kinetics. Maximum SUV was two- to fourfold higher in tumour as compared with normal brain and independent of NF2 status. The increased uptake was due to higher transport of [{sup 18}F]FBPA in tumour. In multiple-time graphical analysis (MTGA, Gjedde-Patlak plot) the tumour-to-brain [{sup 18}F]FBPA influx constant (K{sub i} -MTGA) ratios varied between 1.8 and 5.4 in NF2-associated tumours while in sporadic tumours the ratio was 1-1.4. [{sup 18}F]FBPA PET offers a viable means to evaluate BPA uptake in meningiomas and schwannomas in NF2. Based on our results on tumour uptake of [{sup 18}F]FBPA, some of these benign neoplasms may be amenable to BNCT. (orig.)

  7. Investigation of the in vitro therapeutic efficacy of nilotinib in immortalized human NF2-null vestibular schwannoma cells.

    Directory of Open Access Journals (Sweden)

    Nesrin Sabha

    Full Text Available Vestibular schwannomas (VS are a common posterior fossa brain tumor, and though benign can cause significant morbidity, particularly loss of hearing, tinnitus, vertigo and facial paralysis. The current treatment options for VS include microsurgical resection, stereotactic radiosurgery or close surveillance monitoring, with each treatment option carrying associated complications and morbidities. Most importantly, none of these options can definitively reverse hearing loss or tinnitus. Identification of a novel medical therapy, through the use of targeted molecular inhibition, is therefore a highly desirable treatment strategy that may minimize complications arising from both tumor and treatment and more importantly be suitable for patients whose options are limited with respect to surgical or radiosurgical interventions. In this study we chose to examine the effect of Nilotinib on VS. Nilotinib (Tasigna® is a second-generation receptor tyrosine kinase (RTK inhibitor with a target profile similar to that of imatinib (Gleevec®, but increased potency, decreased toxicity and greater cellular and tissue penetration. Nilotinib targets not only the BCR-ABL oncoprotein, but also platelet-derived growth factor (PDGF receptor signalling. In this preclinical study, the human NF2-null schwannoma cell line HEI-193 subjected to nilotinib inhibition demonstrated decreased viability, proliferation and anchorage-independent growth, and increased apoptosis. A daily dose of nilotinib for 5 days inhibited HEI-I93 proliferation at a clinically-relevant concentration in a dose-dependent manner (IC(50 3-5 µmol/L in PDGF-stimulated cells. These anti-tumorigenic effects of nilotinib were correlated to inhibited activation of PDGFR-α and PDGFR-β and major downstream signalling pathways. These experiments support a therapeutic potential for Nilotinib in VS.

  8. Benign pneumatosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Fenton, L.Z.; Buonomo, C. [Department of Radiology, Children' s Hospital, Boston, MA (United States)

    2000-11-01

    Background. In pediatrics, pneumatosis intestinalis (PI) is usually due to necrotizing enterocolitis in premature newborns. Beyond infancy, PI is uncommon. ''Benign pneumatosis'' is PI in patients with few or no symptoms that resolves with conservative management. Objective. Our goal was to better characterize benign PI in children. Our investigation focused on identifying underlying risk factors, symptoms at time of diagnosis, management and outcome. Materials and methods. Available medical records and radiographs of children with pneumatosis intestinalis from 1990 to 1998 were reviewed for underlying conditions, symptoms at time of radiographs, management and outcome. Results. Thirty-seven children (mean age 4 years) were included. Thirty-two children had identifiable risk factors. Twenty -five children were immunocompromised by their underlying conditions or therapeutic regimen. Thirty-five children were managed conservatively with resolution of PI. Two patients, however, required surgery and one patient died. Conclusion. Benign pneumatosis does occur in children. The majority have underlying risk factors, most commonly related to immunosuppression. Clinical deterioration is the most useful indicator for surgical intervention. In most patients PI resolves with conservative management. (orig.)

  9. Correlation of magnetic resonance imaging findings of spinal intradural extramedullary schwannomas with pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Ju; Park, In Suh; Yoon, Seung Hwan; Choi, Suk Jin; Kim, Youn Jeong; Kang, Young Hye; Lee, Ha Young; Kim, Woo Chul; Han, Jun Gu; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)

    2015-06-15

    To evaluate the magnetic resonance imaging (MRI) findings of spinal intradural extramedullary schwannomas with pathologic correlation and to determine whether these schwannomas share the imaging features of schwannomas in the peripheral nerves. The MRIs of 17 cases of pathologically proven spinal intradural extramedullary schwannomas were reviewed retrospectively, and cystic changes, enhancement, and intratumoral hemorrhage of the tumors were evaluated. Imaging features known to be common findings of schwannoma in the peripheral nerves, such as encapsulation, the target sign, the fascicular sign, and visualization of entering or exiting nerve rootlets, were also evaluated. The histopathology of the tumors was correlated with the MRI findings. Cystic changes were detected in 14 cases by MRI and in 16 cases by pathology. The most common pattern of enhancement was a thick peripheral septal pattern (70.59%). Intratumoral hemorrhage was detected in four cases on MRI, but in all cases on pathology. Encapsulation was observed in all cases. The fascicular sign was seen in only four cases, and thickening of an exiting rootlet was visualized in one case. None of the cases showed the target sign. Spinal intradural extramedullary schwannomas were typical encapsulated cystic tumors and had few imaging features of schwannomas in the peripheral nerves.

  10. Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Yang Isaac

    2009-10-01

    Full Text Available Abstract Introduction Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. Case presentation A 26-year-old Hispanic man with no previous medical problems presented with acute periumbilical pain. After extensive work-up including an exploratory laparotomy for appendectomy, magnetic resonance imaging scans of the lumbar and thoracic spine revealed a giant intradural extramedullary thoracic schwannoma within the spinal canal posterior to the T9, T10, and T11 vertebral bodies. Magnetic resonance imaging signal prolongation was noted in the spinal cord both rostral and caudal to the schwannoma. The patient underwent an urgent laminectomy from T8 to L1. After sacrificing the T10 root, the tumor was removed en bloc. Postoperatively, the patient improved significantly gaining antigravity strength in both lower extremities. Conclusion The T10 dermatome is represented by the umbilical region. This referred pain may represent a mechanism by which a giant thoracic schwannoma may present as acute abdominal pain. Acute, intense abdominal pain with delayed neurologic deficit is a rare presentation of a thoracic schwannoma but should be considered as a possible cause of abdominal pain presenting without clear etiology. Although these lesions may be delayed in their diagnosis, early diagnosis and treatment may lead to an improved clinical outcome.

  11. Nerve sheath tumor, benign neurogenic slow-growing solitary neurilemmoma of the left ulnar nerve: A case and review of literature

    Directory of Open Access Journals (Sweden)

    Martin Andra Elena

    2016-06-01

    Full Text Available This paper represent a report of a case with ulnar nerve schwannoma (neurilemmoma, benign neurogenic slow-growing, tumors originating from Schwann cells along the course of a nerve (1 (2 (3. Schwannomas are the most common tumors of the peripheral nerves which occur in the adults (0.8–2% (5. Usually they progress slowly and so they can remain painless swellings for a few years before other symptoms appear. Most of these lesions could be diagnosed clinically, are mobile in the longitudinal plane along the course of the involved nerve but not in the transverse plane (7. EMG, MRI, and ultrasonography are useful tools in the diagnosis. The definitive treatment of benign peripheral nerve schwannomatosis is complete enucleation of the tumor mass without damaging the intact nerve fascicles followed by confirmatory hystopathological examination (12. We present the case of a 62 years old right hand-dominant female who notice a slow increasing bulge over the inner aspect of her distal volar left forearm superior to the wrist, for a longer period of time not exactly specified; this was tracked and associated by pain, tingling and numbness over inner one and half fingers of her left hand in progress until the presentations. A diagnosis of soft-tissue tumor was presumed clinically. The other investigations were ultrasonography (US, nerve conduction studies (NCSs such as sensory nerve action potential (SNAP and compound muscle action potential (CMAP. In this case IRM was suggestive of a benign growth in her left ulnar nerve in the forearm region. Microsurgical techniques were used for ample enucleation of the tumor the distal volar left forearm. Subsequent histopathological examination confirmed the presumed diagnosis of a benign cellular schwannoma. At her last follow-up one month after surgery, the patient was neurological gradually improving sensory and motor function and she is highly satisfied with the results of surgery.

  12. Scwannoma intramedular: relato de caso Intramedullary schwannoma: case report

    Directory of Open Access Journals (Sweden)

    Carlos H. A. Botelho

    1996-09-01

    Full Text Available A localização intramedular de schwannoma é rara, correspondendo a 0,3% dos tumores nesta topografia. Os autores relatam o caso de uma paciente leucoderma de 52 anos, que apresentou sintomas de compressão devido à presença de schwannoma intramedular localizado em nível de C4 a C6. Não foram encontrados sinais de neurofibromatose, enfermidade que tem sido associada ao desenvolvimento da lesão. Os exames de ressonância magnética nuclear e a biópsia transoperatórIa foram fatores decisivos no planejamento e na execução do tratamento, ao estabelecer as características, localização e diagnóstico da lesão. Sua boa delimitação e sua localização posterior facilitaram a exérese total. O exame histopatológico transoperatórIo permitiu a instituição de procedimento cirúrgico adequado. A célula de Schwann não é normalmente encontrada no sistema nervoso central e sua presença neste local tem sido objeto de várias teorias expostas no texto deste trabalho, que aborda também revisão de aspectos clínicos, diagnóstico por imagem, patologia, diagnóstico diferencial e tratamento dos schwannomas. E provável que, com os métodos propedêuticos atualmente disponíveis, venha a ser encontrado maior número destas lesões no futuro.The intramedullary localization of schwannomas is rare, corresponding to 0.3% of all intraspinal tumors. The authors report the case of a 52 year-old white female patient that presented with symptoms of spinal compression by the presence of an intramedullary schwannoma at the level C4-C6. There were no symptoms of neurofibromatosis, entity frequently related to the lesion. The magnetic resonance imaging examination and the per-operatory biopsy were decisive factors in planning and executing the treatment , by establishing the characteristics, location and diagnosis of the lesion. Its delimitation and posterior location have facilitated total surgical exeresis. The transoperatively histopathologic

  13. Benign cephalic histiocytosis.

    Science.gov (United States)

    Gianotti, F; Caputo, R; Ermacora, E; Gianni, E

    1986-09-01

    Benign cephalic histiocytosis is a self-healing non-X, nonlipid cutaneous histiocytosis of children, characterized by a papular eruption on the head. Mucous membranes and viscera are always spared. In the 13 cases reported herein, the children were otherwise in good general health. The disease appeared during the first three years of life, and spontaneous regression was complete by the age of nine years in the four cases healed to date. The histiocytic infiltrate was localized in the upper and middle dermis and contained no lipids at any stage of evolution. All the histiocytes contained coated vesicles, and 5% to 30% also contained comma-shaped bodies in their cytoplasm.

  14. Surgical management of schwannomas in spinal eloquent areas

    Directory of Open Access Journals (Sweden)

    CHEN Yong-jie

    2013-11-01

    Full Text Available Objective To investigate the clinical characteristics and surgical management of schwannomas in spinal eloquent areas. Methods Clinical data of 58 patients with schwannomas in spinal eloquent areas was retrospectively studied. All the tumors were excised by microsurgery assisted with intraoperative neurophysiological monitoring. If the tumor originated from cervical enlargement, somatosensory-evoked potentials (SEPs and motor-evoked potentials (MEPs of both upper and lower extremities and EMG of upper extremities were performed. If the tumor originated from intumescentia lumbalis and conus medullaris, SEPs and MEPs of lower extremities and EMG of lower extremities and sphincter ani were performed. All the tumors were excised through posterior median approach. Laminectomy or hemilaminectomy was chosen according to the size and location of tumors. The internal fixation was accepted for the reconstruction of spinal stability if facetectomy was performed. The intraoperative neurophysiological monitoring could be helpful during the procedure of internal fixation. Results Total resection was achieved in all of the 58 patients. There was no new neurological deficit after surgery. The preoperative pain symptoms in 42 patients disappeared in 39 patients and relieved obviously in 3 patients after operation. Twenty-two patients had numbness on the involved nerve root dominate regions, and maybe it was concerned with the resection of tumors and parent nerve roots. The preoperative weakness symptoms in 17 patients and constipation symptoms in 2 patients were significantly improved when discharge. One patient with severe weakness of bilateral lower extremities and 2 patients with sphincter dysfunction were transferred to Physiatry Department when their condition became stable. During the follow-up period of 3-12 months, the preoperative neurological deficit improved significantly and there was no tumor recurrence. Conclusion The intraoperative

  15. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    Science.gov (United States)

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. PMID:23891013

  16. Germinoma in the Internal Auditory Canal Mimicking a Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Rubén Martín-Hernández

    2014-01-01

    Full Text Available The appearance of a primary germinoma in the central nervous system but not on or near the midline or within the brain is exceptional. It may occur at any age; however, it is rare in patients over 50 years old. Only a handful of cases of germinomas located in the cerebellopontine angle were presented, but to our knowledge, there has been no description of an isolated germinoma in the internal auditory canal. We report a case of germinoma in the internal auditory canal in a 51-year-old man simulating the clinical and radiological characteristics of a vestibular schwannoma.

  17. Critical Airway Compromise due to a Massive Vagal Schwannoma

    LENUS (Irish Health Repository)

    McDermott, AM

    2016-05-01

    We describe the case of a 37-year-old man with a slowly enlarging neck lump and compressive symptoms. He presented to a separate institution 10 years prior where an observational approach was advocated. Following preoperative investigations and embolization, an 11cm vagal schwannoma was excised and vagus nerve was sacrificed. Although conservative management is appropriate for a select patient population, surgical excision is treatment of choice for cervical neurogenic tumours and paraganglionomas and must be considered in young patients or rapidly expanding tumours to avoid compressive symptoms, as in this case.

  18. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    OpenAIRE

    Carlson, Matthew L.; Van Gompel, Jamie J.

    2016-01-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appear...

  19. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    Science.gov (United States)

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months.

  20. Misdiagnosis Analysis of Gastric Schwannoma by CT Scanning%胃神经鞘瘤CT检查误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    王文娜; 周倩静; 蔡鹏杰; 曾利泉; 李泽龄; 文戈

    2012-01-01

    Objective To explore the CT manifestations of gastric schwannoma and to analyze the misdiagnosis causes.Methods Clinical data of 5 cases with gastrie schwannoma, which were misdiagnosed by CT and finally diagnosed by pathological examinations for operation, went retrospectively analyzrd. Results All the patients complained of epipgastrie discomfort, upper ab-dominal mass and dark stools and underwent CT examination. Iimiging features showed as roundish humogenous masses with dislinct margin which was hypodense in eonparison with muscle and had an endoluminal or exophytie growth puttern. The average long di-ameter of foeus were (6. 2 ±2. 3)cm, and among them was above 5. 0 em in 4 of 5 cases. All the imagings of the 5 casex were misdi-agnosed as malignant gastric interstitialoma (n =2), leiomyoma of stomach (n =1 ) , gastrie extrrior neoplasms (n =1) and benign gastric interstitialoma (n = 1). The final diagnosis of gastric schwannoma was proven by pathology and chernie hromoscopy. Conclusion The diagnosis of gastric schwannoma should be taken into cunsideration when a homogenous and well-defined mass of gas-tral wall without hemorrhage, necrosis and eystie change are found by CT imagen.%目的 探讨胃神经鞘瘤CT影像特征并分析误诊原因.方法 回顾性分析5例经手术病理检查证实但CT检查误诊的胃神经鞘瘤临床资料.结果 5例均以上腹部不适、上腹部肿块、黑便等就诊,均行上腹部CT扫描.CT影像表现为边界锐利的类圆形均质肿块,与肌肉组织比较呈低密度,向腔内或腔外生长,病灶长径平均(6.2 ±2.3)cm,其中 4例病变长径>5.0 cm.5例CT检查误诊为恶性胃间质瘤2例,胃平滑肌瘤、胃外肿瘤及偏良性胃间质瘤各1例,均经手术病理及免疫组织化学染色检查确诊胃神经鞘瘤.结论 对CT表现为胃肠道壁内均质性、边界清晰的肿块,且无出血、坏死和囊变时,应警惕胃神经鞘瘤.

  1. Vestibular schwannoma: 825 cases from a 25-year experience

    Directory of Open Access Journals (Sweden)

    Bento, Ricardo Ferreira

    2012-01-01

    Full Text Available Introduction: Acoustic nerve tumors have been recognized as a clinico-pathologic entity for at least 200 years, and they represent 90% of cerebellopontine angle diseases. Histologically, the tumors are derived from Schwann cells of the myelin sheath, with smaller tumors consisting of elongated palisade cells, while in large tumors, cystic degeneration can be found in the central areas, possibly due to deficient vascularization. We retrospectively reviewed 825 cases of vestibular schwannomas, reported between January 1984 and August 2006, in which the patients underwent surgery to remove the tumor. Objective: To evaluate signs, symptoms, aspects of clinical diagnosis, including the results of audiological and imaging studies, and surgical techniques and complications. Methods: A retrospective chart review. The medical records of all patients undergoing surgical treatment for schwannoma during the period indicated were reviewed. Results and Conclusion: Hearing loss was the first symptom reported in almost all cases, and tumor size was not proportional to the impairment of the auditory threshold. The surgical techniques allowed safe preservation of facial function. In particular, the retrolabyrinthine route proved useful in small tumors, with 50% preservation of hearing.

  2. Pathogenesis of vestibular schwannoma in ring chromosome 22

    Directory of Open Access Journals (Sweden)

    Debiec-Rychter Maria

    2009-09-01

    Full Text Available Abstract Background Ring chromosome 22 is a rare human constitutional cytogenetic abnormality. Clinical features of neurofibromatosis type 1 and 2 as well as different tumour types have been reported in patients with ring chromosome 22. The pathogenesis of these tumours is not always clear yet. Methods We report on a female patient with a ring chromosome 22 presenting with severe mental retardation, autistic behaviour, café-au-lait macules and facial dysmorphism. Peripheral blood lymphocytes were karyotyped and array CGH was performed on extracted DNA. At the age of 20 years she was diagnosed with a unilateral vestibular schwannoma. Tumour cells were analyzed by karyotyping, array CGH and NF2 mutation analysis. Results Karyotype on peripheral blood lymphocytes revealed a ring chromosome 22 in all analyzed cells. A 1 Mb array CGH experiment on peripheral blood DNA showed a deletion of 5 terminal clones on the long arm of chromosome 22. Genetic analysis of vestibular schwannoma tissue revealed loss of the ring chromosome 22 and a somatic second hit in the NF2 gene on the remaining chromosome 22. Conclusion We conclude that tumours can arise by the combination of loss of the ring chromosome and a pathogenic NF2 mutation on the remaining chromosome 22 in patients with ring chromosome 22. Our findings indicate that patients with a ring 22 should be monitored for NF2-related tumours starting in adolescence.

  3. Prevalence of hydrocephalus in 157 patients with vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Rogg, Jeffrey M.; Ahn, S.H.; Tung, G.A. [Rhode Island Hospital, Department of Diagnostic Imaging, Providence, Rhode Island (United States); Reinert, S.E. [Rhode Island Hospital, Lifespan Medical Computing, Providence, Rhode Island (United States); Noren, G. [Rhode Island Hospital, Department of Neurosurgery, Providence, Rhode Island (United States)

    2005-05-01

    The purpose of this study was to determine the prevalence of hydrocephalus in patients with vestibular schwannoma. A second objective was to investigate possible etiologies for hydrocephalus in this population by attempting to correlate the incidence and severity of hydrocephalus with tumor volume and extent of fourth ventricular compression. The MRI examinations of 157 adult patients with vestibular schwannoma were retrospectively reviewed. Tumor size was quantified, and the presence of accompanying hydrocephalus was assessed, categorized as communicating type or non-communicating type and then rated as mild, moderate or severe (grades 1-3). Next, the degree of fourth ventricular distortion caused by tumor mass effect was evaluated and categorized as mild, moderate or severe (grades 1-3). Spearman's rank correlation coefficient was used to test the relationships between tumor volume and (1) the extent of fourth ventricular effacement and (2) severity of hydrocephalus. Hydrocephalus was present in 28/157 (18%) cases and was categorized as mild in 11/28 (39%), moderate in 15/28 (54%) and severe in 2/28 (7%). Communicating-type hydrocephalus was present in 17/28 (61%) and non-communicating type in 11/28 (39%). There was a positive correlation between the grade of non-communicating hydrocephalus and tumor volume (r=0.38; P<0.001) and between the severity of fourth ventricular compression and extent of hydrocephalus in this group(r=0.43; P<0.001). (orig.)

  4. An infrequent plexiform variant of schwannoma of the glans penis: a rare finding

    Institute of Scientific and Technical Information of China (English)

    Tzu-Chun Lin; Po-Yuan Wu; Tze-Yi Lin; Tsong-Liang Lee

    2010-01-01

    @@ Dear Editor, I am Dr Tzu-Chun Lin, from the Department of Dermatology, China Medical University Hospital,Taichung, Taiwan, China. We write to you to present a rare case of plexiform variant of schwannoma on the glans penis.

  5. Simultaneous Translabyrinthine Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patients.

    Science.gov (United States)

    Kim, Jin Won; Han, Ji Hyuk; Kim, Jin Woong; Moon, In Seok

    2016-11-01

    Refinement of surgical techniques has allowed hearing preservation after tumor resection to be prioritized. Moreover, restoration of hearing after tumor removal can be attempted in patients with bilateral vestibular schwannomas or those with a schwannoma in the only-hearing ear. Cochlear implantation (CI) has emerged as a proper method of acoustic rehabilitation, provided that the cochlear nerve remains intact. Studies of electrical promontory stimulation in patients after vestibular schwannoma resection have demonstrated favorable results. We describe herein two cases of hearing rehabilitation via CI implemented at the time of vestibular schwannoma resection. Tumors were totally removed, and cochlear implant electrodes were successfully inserted in both cases. Also, post operative CI-aided hearing showed improved results. PMID:27593888

  6. The bony crescent sign - a new sign of facial nerve schwannoma

    International Nuclear Information System (INIS)

    Schwannomas are relatively uncommon intracranial tumours. They most commonly involve the acoustic nerve followed in frequency by the trigeminal nerve. Other cranial nerves are rarely involved. Facial nerve schwannomas occurring within the petrous temporal bone are very rare. Their diagnosis may be missed prospectively even when appropriate computerized tomography (CT) scans are performed. Even in retrospect the site of abnormality may be difficult to identify, especially if there is an associated middle ear mass such as a cholesteatoma. In the 4 cases presented the facial nerve schwannoma was seen on high resolution CT as a soft tissue mass bounded anteriorly by a thin rim of bone. This bony crescent sign is a previously undescribed feature of facial nerve schwannoma which appears to be strongly indicative of the presence of this tumour. Recognition of this sign makes these tumours arising in the region of the geniculate ganglion easy to diagnose prospectively. 12 refs., 6 figs

  7. Angiogenesis in vestibular schwannomas: expression of extracellular matrix factors MMP-2, MMP-9, and TIMP-1

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Werther, Kim; Nalla, Amarnadh;

    2010-01-01

    Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis. It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking. This study...

  8. Apps for Ancient Civilizations

    Science.gov (United States)

    Thompson, Stephanie

    2011-01-01

    This project incorporates technology and a historical emphasis on science drawn from ancient civilizations to promote a greater understanding of conceptual science. In the Apps for Ancient Civilizations project, students investigate an ancient culture to discover how people might have used science and math smartphone apps to make their lives…

  9. The Neurofibromatosis Type 2 Gene Product, merlin, Reverses the F-Actin Cytoskeletal Defects in Primary Human Schwannoma Cells

    OpenAIRE

    Bashour, Anne-Marie; Meng, J.-J.; Ip, Wallace; MacCollin, Mia; Ratner, Nancy

    2002-01-01

    Schwannoma tumors, which occur sporadically and in patients with neurofibromatosis, account for 8% of intracranial tumors and can only be treated by surgical removal. Most schwannomas have biallelic mutations in the NF2 tumor suppressor gene. We previously showed that schwannoma-derived Schwann cells exhibit membrane ruffling and aberrant cell spreading when plated onto laminin, indicative of fundamental F-actin cytoskeletal defects. Here we expand these observations to a large group of spora...

  10. Giant Cauda Equina Schwannoma with Dystrophic Calcifications : Case Report and Review of the Literature

    OpenAIRE

    Hyun, Seung-Jae; Rhim, Seung-Chul

    2012-01-01

    Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was compl...

  11. A meta-analysis of treatment of vestibular schwannoma using Gamma Knife radiosurgery

    OpenAIRE

    Rykaczewski, Bartosz; Zabek, Miroslaw

    2014-01-01

    Aim of the study One of the alternative methods of surgical treatment of vestibular schwannoma is Gamma Knife radiosurgery. The purpose of this metaanalysis was to analyze the progress in treatment of vestibular schwannoma using Gamma Knife radiosurgery based on data in the literature of the last five years. Material and methods In the collected English-language literature from the years 2007–2011, contained in 20 scientific journals, clinical articles of many years study at a single center w...

  12. MS-25GAMMA KNIFE RADIOSURGERY FOR VESTIBULAR SCHWANNOMA: ASSESSMENT OF QUALITY AND OUTCOMES

    OpenAIRE

    Straza, Michael; Garcia, Guilherme; Hariri, Benjamin; Patel, Ruchin; Albano, Katherine; Schultz, Christopher; Friedland, David; Bovi, Joseph

    2014-01-01

    OBJECTIVE: To assess and improve quality and outcomes for vestibular schwannoma cases treated with Gamma Knife radiosurgery and determine if a novel assessment of tumor and necrosis volumes correlate with outcomes. METHODS: We performed a retrospective review assessing patients with vestibular schwannoma treated with 12-13Gy from July 2009 to July 2013. A volumetric analysis was performed on a subset of patients. Pre-treatment and follow up MRIs were imported into a medical imaging software (...

  13. A case of multiple cutaneous schwannomas; schwannomatosis or neurofibromatosis type 2?

    OpenAIRE

    Murray, A. J.; Hughes, T A T; Neal, J W; Howard, E.; Evans, D G R; P.S. Harper

    2006-01-01

    A 54 year old man presented with numerous cutaneous schwannomas, cranial nerve lesions, and spinal cord lesions, but no evidence of vestibular nerve involvement. There was no family history of neurocutaneous lesions. To help discriminate between the various possible diagnoses in this patient, molecular analysis of two cutaneous schwannomas was undertaken. An identical point mutation in the NF2 gene in the two anatomically distinct tumours was found, confirming this as a case of NF2 mosaicism.

  14. Need for facial reanimation after operations for vestibular schwannoma: patients perspective

    DEFF Research Database (Denmark)

    Tos, Tina; Caye-Thomasen, Per; Stangerup, Sven-Eric;

    2003-01-01

    A total of 779 patients operated on for vestibular schwannoma mostly by the translabyrinthine approach in Denmark during the period 1976-2000 answered a questionnaire about various postoperative consequences. In this paper we describe the patients' facial function evaluated by professionals one...... in Denmark. In conclusion, there seem to be a considerable and unmet need for surgical reanimation of facial function in patients with facial palsy after operations for vestibular schwannoma in Denmark....

  15. Critical neurological structure sparing radiosurgery of vestibular schwannoma: Dosimetric comparison of different techniques and dose prescription methods

    Directory of Open Access Journals (Sweden)

    Shamurailatpam Dayananda Sharma

    2014-01-01

    Conclusion: This dosimetric data provides a guideline for choosing optimum treatment option and scope of inter institutional dosimetric comparison for further improvement in radiosurgery of Vestibular Schwannoma (VS.

  16. Staging in giant vestibular schwannoma surgery: A two consecutive day technique for complete resection in basic neurosurgical setups

    Directory of Open Access Journals (Sweden)

    Deepak Bandlish

    2014-01-01

    Full Text Available Introduction: Vestibular schwannomas constitute 8% of all intracranial tumors. A majority of vestibular schwannomas are sporadic and unilateral. Giant vestibular schwannomas are seen in our country due to the late diagnosis and long duration of symptoms before diagnosis. These giant schwannomas are challenging to manage as most of the patients are having brainstem compression. Materials and Methods: Twelve cases of a giant vestibular schwannoma were operated in our department between May 2011 and December 2012. Vestibular schwannomas with a maximal diameter of more than 4 cm were defined as a giant vestibular schwannoma. All the patients had a unilateral vestibular schwannoma. Performance status of all the patients were graded as per the Karnofsky performance score. Pre-operative assessment of 5 th , 7 th , 8 th and lower cranial nerve status was done in all cases. Ventriculoperitoneal shunting was done pre-operatively in all cases. All patients were operated through retromastoid suboccipital craniectomy and retrosigmoid approach. These patients were operated in two stages in two consecutive days with overnight elective ventilation in ICU. Ultrasonic aspirator and nerve monitoring techniques were not used. Results: Giant acoustic schwannomas can be safely resected completely by a staged resection on two consecutive days without any increased morbidity or mortality. This technique may be employed to achieve complete resection of such lesions without deterioration of facial nerve function in institutions which do not have advanced facilities like nerve monitoring or ultrasonic aspirator.

  17. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...... astrocytomas treated in the period 1956 to 1991. The pilocytic type of astrocytoma was found to have an outstandingly good prognosis and should be regarded as a distinct nosological entity. For the non-pilocytic supratentorial astrocytomas, a multivariate regression analysis showed that age, tumour site...... time of patients with non-pilocytic supratentorial benign astrocytomas. The study emphasizes the necessity of a prospective combined multicenter analysis of the effect of radiation on benign astrocytomas....

  18. Nihilism: a benign denial.

    Science.gov (United States)

    Skandalakis, John E; Mirilas, Petros

    2003-06-01

    Nihilism is the belief that all possible knowledge on a given topic has been amassed and codified. Ranging from benign denial to deliberate attempts at excommunication, nihilism is often encountered in the history of medicine. Eustachius, Columbus, and Sylvius strongly criticized Vesalius and defended the authority of Galen. Riolan fervently rejected Harvey's monumental work on the circulation of blood. Gross stated that no honest and sensible surgeon would ever sanction thyroidectomy. Sandstrom's discovery of the parathyroids was met with silence. Transplantation of parathyroids by Mandl was not appreciated when announced. Aristotle's dictum that the heart cannot withstand serious injury led to Paget's statement that cardiac surgery had reached the limits set by nature, which no new techniques could overcome. The first Billroth I operation was welcomed as, "Hopefully, also the last." Pancreatic surgery was opposed because the organ was of no clinical interest and was impossible for surgeons to reach. Pancreatic transplantation was rejected for many years, despite good results. When Blundell used blood transfusion for postpartum hemorrhage, critics averred that his next exploit would be radical removal of the spleen. Bassini stated that it could be risky to publish more about radical treatment of inguinal hernias. Carcinomas of the lower sigmoid and upper rectum were deemed untreatable because of their inaccessibility. Colostomy during pediatric surgery was rejected many times. Although it is difficult for the human mind to move from a familiar point of view, this propensity should not infect science, thereby impeding advancement.

  19. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis

    Directory of Open Access Journals (Sweden)

    Emma Brown

    2016-01-01

    Full Text Available We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia.

  20. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis.

    Science.gov (United States)

    Brown, Emma; Staines, Konrad

    2016-01-01

    We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. PMID:27022490

  1. Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, Rune, E-mail: rune333@gmail.com [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark); Claesson, Magnus [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark); Stangerup, Sven-Eric [Ear, Nose, and Throat Department, Rigshospitalet, Copenhagen (Denmark); Roed, Henrik [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Christensen, Ib Jarle [Finsen Laboratory, Rigshospitalet, Copenhagen (Denmark); Caye-Thomasen, Per [Ear, Nose, and Throat Department, Rigshospitalet, Copenhagen (Denmark); Juhler, Marianne [Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark)

    2012-08-01

    Objective: To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hearing preservation was also investigated. Methods and Materials: Forty-two patients receiving FSRT between 1997 and 2008 with a minimum follow-up of 2 years were included. All patients received 54 Gy in 27-30 fractions during 5.5-6.0 weeks. Clinical and audiometry data were collected prospectively. From a 'wait-and-scan' group, 409 patients were selected as control subjects, matched by initial audiometric parameters. Radiation dose to the cochlea was measured using the original treatment plan and then related to changes in acoustic parameters. Results: Actuarial 2-, 4-, and 10-year tumor control rates were 100%, 91.5%, and 85.0%, respectively. Twenty-one patients had serviceable hearing before FSRT, 8 of whom (38%) retained serviceable hearing at 2 years after FSRT. No patients retained serviceable hearing after 10 years. At 2 years, hearing preservation rates in the control group were 1.8 times higher compared with the group receiving FSRT (P=.007). Radiation dose to the cochlea was significantly correlated to deterioration of the speech reception threshold (P=.03) but not to discrimination loss. Conclusion: FSRT accelerates the naturally occurring hearing loss in patients with vestibular schwannoma. Our findings, using fractionation of radiotherapy, parallel results using single-dose radiation. The radiation dose to the cochlea is correlated to hearing loss measured as the speech reception threshold.

  2. Clinical, radiological, surgical, and pathological determinants of olfactory groove schwannoma

    Directory of Open Access Journals (Sweden)

    Andi Sadayandi Ramesh

    2014-01-01

    Full Text Available Background: Olfactory groove schwannomas (OGS are rare anterior cranial fossa base tumors with only 41 cases reported in literature. Olfactory ensheathing cell schwannoma (OECS has similar clinico-radiological features as OGS, but a different cell of origin. In recent years, there is growing interest in OECS as more cases are being reported. Aims: The objective was to study the clinico-radiological features of OGS and define the histological differentiation from OECS. Materials and Methods: We retrospectively analyzed clinical, radiological, surgical and histopathological picture of all cases of OGS managed in our institute. Immuno histochemical studies were performed in these tumors for differentiating from OECS. A comprehensive review of articles published until date describing the operative treatment was done. Results: All three cases had presented with seizures, two had anosmia and papilledema. Gross-total resection was achieved in all our patients. One patient expired in the postoperative period due to septicemia. Positive expression to newer immuno histochemical biomarker CD57 (Leu7, with negative staining to smooth muscle α-actin (SMA was helpful in confirming the diagnosis of OGS and differentiating it from OECS in all our cases. Conclusions: OECS, though rare has to be differentiated from OGS using immuno histochemistry. Gross-total resection of OGS with preservation of olfactory function is often possible and curative. Although these tumors are commonly treated with microsurgical skull base approaches, an endoscopic endonasal approach can be considered in some cases, with repair using mucoperiosteal pedicled flap to prevent cerebrospinal fluid leak.

  3. Electrical vestibular stimulation after vestibular deafferentation and in vestibular schwannoma.

    Directory of Open Access Journals (Sweden)

    Swee Tin Aw

    Full Text Available BACKGROUND: Vestibular reflexes, evoked by human electrical (galvanic vestibular stimulation (EVS, are utilized to assess vestibular function and investigate its pathways. Our study aimed to investigate the electrically-evoked vestibulo-ocular reflex (eVOR output after bilateral and unilateral vestibular deafferentations to determine the characteristics for interpreting unilateral lesions such as vestibular schwannomas. METHODS: EVOR was recorded with dual-search coils as binocular three-dimensional eye movements evoked by bipolar 100 ms-step at EVS intensities of [0.9, 2.5, 5.0, 7.5, 10.0] mA and unipolar 100 ms-step at 5 mA EVS intensity. Five bilateral vestibular deafferented (BVD, 12 unilateral vestibular deafferented (UVD, four unilateral vestibular schwannoma (UVS patients and 17 healthy subjects were tested with bipolar EVS, and five UVDs with unipolar EVS. RESULTS: After BVD, bipolar EVS elicited no eVOR. After UVD, bipolar EVS of one functioning ear elicited bidirectional, excitatory eVOR to cathodal EVS with 9 ms latency and inhibitory eVOR to anodal EVS, opposite in direction, at half the amplitude with 12 ms latency, exhibiting an excitatory-inhibitory asymmetry. The eVOR patterns from UVS were consistent with responses from UVD confirming the vestibular loss on the lesion side. Unexpectedly, unipolar EVS of the UVD ear, instead of absent response, evoked one-third the bipolar eVOR while unipolar EVS of the functioning ear evoked half the bipolar response. CONCLUSIONS: The bidirectional eVOR evoked by bipolar EVS from UVD with an excitatory-inhibitory asymmetry and the 3 ms latency difference between normal and lesion side may be useful for detecting vestibular lesions such as UVS. We suggest that current spread could account for the small eVOR to 5 mA unipolar EVS of the UVD ear.

  4. Radiation treatment of benign diseases

    International Nuclear Information System (INIS)

    The report deals with an estimation of the volume of radiation treatment of benign diseases in Norway and gives a survey of the subjective opinion of patients regarding the result of the treatment. Reported subjective recovery after radiation treatment seems to be at the same level as recovery without treatment. For an indication of the objective effect of radiation treatment of benign diseases, the subjective effect of this treatment has to be compared with objective findings

  5. Lectin histochemistry of normal and neoplastic peripheral nerve sheath. 2. Lectin binding patterns of schwannoma and neurofibroma.

    Science.gov (United States)

    Matsumura, K; Nakasu, S; Nioka, H; Handa, J

    1993-01-01

    Lectin binding patterns of 31 schwannomas and 6 neurofibromas were examined using 12 lectins, and the results were compared with those of normal peripheral nerves. Tumors obtained from 10 cases of neurofibromatosis and 4 recurrent schwannomas were included. Changes of glycoconjugates were observed in association with a neoplastic transformation of Schwann cells; Arachis hypogaea (PNA) staining after neuraminidase treatment seen in normal Schwann cells was reduced in schwannoma of Antoni type A, and bindings with Glycine max (SBA) and Helix pomatia (HPA) after sialic acid removal, which were not seen in normal Schwann cells, appeared in schwannoma cells. Intensities of staining of tumor cells with each lectin were higher in Antoni type B than those in Antoni type A. No differences in lectin binding patterns were observed between schwannomas in patients with neurofibromatosis or recurrent schwannomas and ordinary, primary schwannomas in patients without stigmata of neurofibromatosis. Lectin binding patterns of Schwann cells and perineurial cells in neurofibroma were almost similar to those in normal peripheral nerves with an exception of faint stain of Schwann cells with HPA after neuraminidase pretreatment. This result suggests differences in extent of differentiation between schwannoma cells and neoplastic Schwann cells in neurofibroma. Specific PNA binding to perineurial cells in neurofibroma indicates the significance of this lectin as a marker of these cells. PMID:8310811

  6. Long-term socio-economic impact of vestibular schwannoma for patients under observation and after surgery

    DEFF Research Database (Denmark)

    Tos, Tina; Caye-Thomasen, Per; Stangerup, Sven-Eric;

    2003-01-01

    This study describes and compares the long-term socio-economic impact for patients diagnosed with a vestibular schwannoma and either operated on or observed. A consecutive sample of patients diagnosed with vestibular schwannoma in Denmark and either operated on (748 patients) or observed by the w...

  7. Naso-ethmoid schwannoma with intracranial extension: case report Schwannoma naso-etmoidal com extensão intracraniana: relato de caso

    Directory of Open Access Journals (Sweden)

    Mario G. Siqueira

    2001-06-01

    Full Text Available Intranasal schwannomas are rare lesions, specially when they present with an intracranial extension. The fifth case in the medical literature of a naso-ethmoid schwannoma with extension into the anterior cranial fossa is presented. The magnetic resonance findings and the details of the combined intracranial / transfacial operative approach used are described. The possible origin and the clinical characteristics of this rare lesion are reviewed.Schwannomas intranasais são lesões raras, principalmente quando apresentam um extensão intracraniana. Estamos apresentando o quinto caso da literatura médica de um schwannoma naso-etmoidal com extensão para o interior da fossa craniana anterior. São descritos os achados da ressonância magnética e os detalhes da via de acesso cirúrgico combinada intracraniana/transfacial. A possível origem e as características clínicas dessa lesaõ rara são revistas.

  8. Long-term mobile phone use and the risk of vestibular schwannoma: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Schüz, Joachim; Steding-Jessen, Marianne; Hansen, Søren;

    2011-01-01

    Vestibular schwannomas grow in the region within the brain where most of the energy by radiofrequency electromagnetic fields from using mobile phones is absorbed. The authors used 2 Danish nationwide cohort studies, one a study of all adult Danes subscribing for a mobile phone in 1995 or earlier...... and one on sociodemographic factors and cancer risk, and followed subjects included in both cohorts for occurrence of vestibular schwannoma up to 2006 inclusively. In this study including 2.9 million subjects, a long-term mobile phone subscription of =11 years was not related to an increased vestibular...... reported holding their mobile phone to the right ear. Vestibular schwannomas in long-term male subscribers were not of larger size than expected. Overall, no evidence was found that mobile phone use is related to the risk of vestibular schwannoma. Because of the usually slow growth of vestibular schwannoma...

  9. Expression of estrogen and progesterone receptors in vestibular schwannomas and their clinical significance

    Directory of Open Access Journals (Sweden)

    Pandey Rakesh

    2009-11-01

    Full Text Available Abstract Objective The objective was to determine the expression of estrogen and progesterone receptors in vestibular schwannomas as well as to determine predictive factors for estrogen and progesterone receptor positivity. Materials and methods The study included 100 cases of vestibular schwannomas operated from January 2006 to June 2009. The clinical details were noted from the medical case files. Formaldehyde-fixed parafiin-embedded archival vestibular schwannomas specimens were used for the immunohistochemical assessment of estrogen and progesterone receptors. Results Neither estrogen nor progesterone receptors could be detected in any of our cases by means of well known immunohistochemical method using well documented monoclonal antibodies. In the control specimens, a strongly positive reaction could be seen. Conclusion No estrogen and progesterone receptor could be found in any of our 100 cases of vestibular schwannomas. Hence our study does not support a causative role of estrogen and progesterone in the growth of vestibular schwannoma as well as hormonal manipulation in the treatment of this tumor.

  10. Radical pancreaticoduodenectomy for benign disease.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2008-01-01

    Whipple\\'s procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple\\'s procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple\\'s procedure during a 15-year period (1987-2002) were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%). One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30-75). The major presenting features included jaundice (five), pain (two), gastric outlet obstruction (one), and recurrent gastrointestinal haemorrhage (one). Investigations included ultrasound (eight), computerised tomography (eight), endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology), and endoscopic ultrasound (two). The pathological diagnosis included benign biliary stricture (two), chronic pancreatitis (two), choledochal cyst (one), inflammatory pseudotumour (one), cystic duodenal wall dysplasia (one), duodenal angiodysplasia (one), and granular cell neoplasm (one). There was no operative mortality. Morbidity included intra-abdominal collection (one), anastomotic leak (one), liver abscess (one), and myocardial infarction (one). All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple\\'s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) may reduce the need for Whipple\\'s operation

  11. Radical Pancreaticoduodenectomy for Benign Disease

    Directory of Open Access Journals (Sweden)

    D. O. Kavanagh

    2008-01-01

    Full Text Available Whipple's procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple's procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple's procedure during a 15-year period (1987–2002 were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%. One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30–75. The major presenting features included jaundice (five, pain (two, gastric outlet obstruction (one, and recurrent gastrointestinal haemorrhage (one. Investigations included ultrasound (eight, computerised tomography (eight, endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology, and endoscopic ultrasound (two. The pathological diagnosis included benign biliary stricture (two, chronic pancreatitis (two, choledochal cyst (one, inflammatory pseudotumour (one, cystic duodenal wall dysplasia (one, duodenal angiodysplasia (one, and granular cell neoplasm (one. There was no operative mortality. Morbidity included intra-abdominal collection (one, anastomotic leak (one, liver abscess (one, and myocardial infarction (one. All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple'’s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound–guided fine needle aspirate (EUS-FNA may reduce the need for Whipple's operation in

  12. Benign fibrous histiocytoma of the lumbar vertebrae

    Energy Technology Data Exchange (ETDEWEB)

    Demiralp, Bahtiyar; Oguz, Erbil; Sehirlioglu, Ali [Gulhane Military Medical Academy, Department of Orthopedics and Traumatology, Ankara (Turkey); Kose, Ozkan [Diyarbakir Education and Research Hospital, Department of Orthopedics and Traumatology, Diyarbakir (Turkey); Ataslar Serhat Evleri, Diclekent Bulvari, Diyarbakir (Turkey); Sanal, Tuba [Gulhane Military Medical Academy, Department of Radiology, Ankara (Turkey); Ozcan, Ayhan [Gulhane Military Medical Academy, Department of Pathology, Ankara (Turkey)

    2009-02-15

    Benign fibrous histiocytoma is an extremely rare spinal tumor with ten reported cases in the literature. Benign fibrous histiocytoma constitutes a diagnostic challenge because it shares common clinical symptoms, radiological characteristics, and histological features with other benign lesions involving the spine. We present a case of benign fibrous histiocytoma of the lumbar spine and discuss its differential diagnosis and management. (orig.)

  13. Benign mixed tumor of the lacrimal sac

    Directory of Open Access Journals (Sweden)

    Jong-Suk Lee

    2015-01-01

    Full Text Available Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

  14. Studying Ancient History.

    Science.gov (United States)

    Barrow, Robin

    1982-01-01

    Defends the value and relevance of the study of ancient history and classics in history curricula. The unique homogeneity of the classical period contributes to its instructional manageability. A year-long, secondary-level course on fifth-century Greece and Rome is described to illustrate effective approaches to teaching ancient history. (AM)

  15. The Molecular Biology of Vestibular Schwannomas and Its Association with Hearing Loss: A Review

    Directory of Open Access Journals (Sweden)

    Erika Celis-Aguilar

    2012-01-01

    Full Text Available Hearing loss is the most common symptom in patients with vestibular schwannoma (VS. In the past, compressive mechanisms caused by the tumoral mass and its growth have been regarded as the most likely causes of the hearing loss associated with VS. Interestingly, new evidence proposes molecular mechanisms as an explanation for such hearing loss. Among the molecular mechanisms proposed are methylation of TP73, negative expression of cyclin D1, expression of B7-H1, increased expression of the platelet-derived growth factor A, underexpression of PEX5L, RAD54B, and PSMAL, and overexpression of CEA. Many molecular mechanisms are involved in vestibular schwannoma development; we review some of these mechanisms with special emphasis on hearing loss associated with vestibular schwannoma.

  16. Common bile duct schwannoma: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Luigi Fenoglio; Rodolfo Brizio; Felice Borghi; Sara Severini; Paola Cena; Elena Migliore; Christian Bracco; Fulvio Pomero; Sergio Panzone; Giovan Battista Cavallero; Alberto Silvestri

    2007-01-01

    Schwannoma is a myelin sheath tumor complicated with neurofibroma, neurofibromatosis and neurogenic sarcoma. Peripheral nerve sheath tumors represent 2%-6% of gastrointestinal tract stromal tumors (GIST),but there are deficient data about location of neurogenic tumors in the biliary system and only nine cases of schwannoma of the extrahepatic biliary tract have been reported. These tumors are clinically non-specific. They are usually symptomatic by compressing the close or adjacent structures when being retroperitoneal, and their preoperative diagnosis is extremely difficult. This paper reviews the literature data and describes a case of schwannoma of the common bile duct associated with cholestasis in a healthy young woman, diagnosed and treated in our department. This case is of interest on account of the complexity of its diagnosis and the atypical macroscopic growth pattern of the tumor.

  17. Sciatica from a Foraminal Lumbar Root Schwannoma: Case Report and Review of Literature

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Parekh, Aseem N.

    2012-01-01

    Sciatica is commonly caused by lumbar prolapsed intervertebral disc (PID) and other spinal lesions. Uncommon causes like nerve root schwannoma are rarely considered in the differential diagnosis of sciatica. Spinal schwannomas occur both sporadically and in association with neurofibromatosis type 1 (NF1; von Recklinghausen's disease). This case report describes lumbar foraminal schwannoma as an unusual cause of radiculopathy, presenting clinically as a lumbar disc prolapse. The diagnosis was confirmed on MRI scan. Patient had complete symptomatic recovery following surgical enucleation of the tumour mass from the L5 nerve root. This case report is of particular interest as it highlights the diagnostic confusion, which is bound to arise, because the clinical presentation closely mimics a lumbar PID. This often leads to delay in diagnosis and “failure of conservative treatment.” PMID:23259107

  18. Biliary tract schwannoma: A rare cause of obstructive jaundice in a young patient

    Institute of Scientific and Technical Information of China (English)

    Gilton Marques Fonseca; André Luis Montagnini; Manoel de Souza Rocha; Rosely Antunes Patzina; Mário Vinícius Angelete Alvarez Bernardes; Ivan Cecconello; José Jukemura

    2012-01-01

    Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities,trunk,head and neck,retroperitoneum,mediastinum,pelvis,and peritoneum.However,it can arise in the gastrointestinal tract,including biliary tract.We present a 24-year-old male patient with obstructive jaundice,whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct,difficult to differentiate with hilar adenocarcinoma.He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection.The patient recovered well without signs of recurrence of the lesion after 12 mo.We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar.Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases.

  19. Acute necrosis after Gamma Knife surgery in vestibular schwannoma leading to multiple cranial nerve palsies.

    Science.gov (United States)

    Kapitza, Sandra; Pangalu, Athina; Horstmann, Gerhard A; van Eck, Albert T; Regli, Luca; Tarnutzer, Alexander A

    2016-08-01

    We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss. A diagnosis of acute vestibulocochlear and facial neuropathy was made. Brain MRI demonstrated focal contrast sparing within the schwannoma, likely related to acute radiation necrosis. Acute multiple cranial neuropathies of the cerebellopontine angle after Gamma Knife treatment should raise suspicion of acute tissue damage within the schwannoma and should result in urgent MRI. Treatment with steroids may be considered based on accompanying swelling and edema. PMID:26947104

  20. Sciatica from a foraminal lumbar root schwannoma: case report and review of literature.

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Parekh, Aseem N

    2012-01-01

    Sciatica is commonly caused by lumbar prolapsed intervertebral disc (PID) and other spinal lesions. Uncommon causes like nerve root schwannoma are rarely considered in the differential diagnosis of sciatica. Spinal schwannomas occur both sporadically and in association with neurofibromatosis type 1 (NF1; von Recklinghausen's disease). This case report describes lumbar foraminal schwannoma as an unusual cause of radiculopathy, presenting clinically as a lumbar disc prolapse. The diagnosis was confirmed on MRI scan. Patient had complete symptomatic recovery following surgical enucleation of the tumour mass from the L5 nerve root. This case report is of particular interest as it highlights the diagnostic confusion, which is bound to arise, because the clinical presentation closely mimics a lumbar PID. This often leads to delay in diagnosis and "failure of conservative treatment."

  1. Facial nerve function after vestibular schwannoma surgery following failed conservative management

    DEFF Research Database (Denmark)

    Kaltoft, Mikkel; Stangerup, Sven-Eric; Cayé-Thomasen, Per

    2012-01-01

    BACKGROUND:: As only a limited proportion of vestibular schwannomas display growth following diagnosis, an increasing number of patients are managed conservatively. Tumor growth during "wait and scan" may, however, necessitate surgery. In these cases, increased tumor size is likely to increase...... diagnosed with a vestibular schwannoma 20mm extrameatal or smaller were included. 419 patients were operated soon after diagnosis and 959 patients were initially managed conservatively. In the latter group, 161 patients were subsequently operated due to tumor growth. RESULTS:: All conservatively managed...... patients allocated primarily to conservative management, good facial function was found in 97%, which was significantly better than the result for primary operation (87%). CONCLUSION:: Overall, conservative management of small to medium-sized vestibular schwannomas is the best option with regard...

  2. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  3. Head and Neck Schwannomas: 20-Year Experience of a Single Institution Excluding Cutaneous and Acoustic Sites.

    Science.gov (United States)

    Butler, Randall T; Patel, Rajiv M; McHugh, Jonathan B

    2016-09-01

    While head and neck sites comprise the most common location of schwannomas, clinicopathologic data regarding those tumors occurring in non-acoustic and non-cutaneous locations are relatively sparse. In this study, therefore, we sought to examine retrospectively the clinical and pathologic features of head and neck schwannomas excised at our institution over a 20-year period. During this period, we identified a total cohort of 85 patients, which included 36 males (42.4 %) and 49 females with average age of 41.3 years, the majority of which presented asymptomatically with a mass. Localized symptoms were, however, associated with all of the schwannomas that arose in the oral cavity and larynx, while tumors within or adjacent to bone were often associated with neurologic complaints (7 of 15 such tumors [46.7 %]). Clinical follow-up data was available in 86.4 % of all cases and demonstrated no recurrences or mortality. Pathologically, the microscopic features were characteristic of those well-described for schwannomas in other sites, including alternating Antoni A and B areas and the presence of degenerative changes. Tumor encapsulation, however, was variable and was completely absent in schwannomas of the nasal cavity, paranasal sinuses, and larynx. Additionally, a significant minority of the tumors (28.2 %) exhibited foci that resembled neurofibroma. Non-acoustic, non-cutaneous schwannomas of the head and neck appear to have clinicopathologic features similar to their soft tissue counterparts with some subsite variation in presentation and/or microscopic features. PMID:26747460

  4. Surgery for Benign Salivary Neoplasms.

    Science.gov (United States)

    Gillespie, M Boyd; Iro, Heinrich

    2016-01-01

    Salivary neoplasms are relatively infrequent entities that account for only 4% of tumors of the head and neck. Although slow-growing lesions of the preauricular area and submandibular space are often confused with sebaceous cysts, lymph nodes, or lipomas by the non-otolaryngologist, otolaryngologists-head and neck surgeons recognize that all preauricular and submandibular masses should be considered a salivary neoplasm until proven otherwise. Surgery remains the treatment of choice for benign salivary gland neoplasms; however, techniques continue to evolve in order to preserve salivary function and reduce surgical morbidity. The goals of management of benign salivary neoplasms include accurate diagnosis of the lesion, complete surgical extirpation, and functional preservation of adjacent cranial nerves. Accurate diagnosis is aided by appropriate preoperative physical examination, imaging, and fine needle aspiration biopsy. Benign neoplasms typically present as slow-growing, painless, mobile masses without adverse features, such as tissue fixation, ulceration, a cranial nerve deficit, or regional lymphadenopathy. Preoperative imaging with ultrasonography, computed tomography, or magnetic resonance imaging reveals well-circumscribed lesions without an infiltrative growth pattern or associated adenopathy. Fine needle aspiration biopsy may favor a benign neoplasm, supporting the clinical presentation. Surgery for a benign or malignant salivary neoplasm is in essence a false dichotomy since the surgeon can never be completely confident of the diagnosis until the specimen is removed. The surgeon must recognize the significant overlap between benign and malignant salivary masses in terms of clinical presentation, imaging, and cytology, which requires the surgeon to remain vigilant and flexible at the time of surgery should tissue characteristics or frozen section analysis suggest a malignant process.

  5. Arachnoid adhesion caused by SURGICEL after operation for ventral spinal schwannoma

    Institute of Scientific and Technical Information of China (English)

    CHEN Sheng-li; ZHANG Gang-li; ZHANG Han-wei; LEI Ting; HU Chang-chen

    2010-01-01

    @@ To the editor: Ventral spinal schwannoma is not a frequently encountered disease and its surgical treatment is difficult.1,2 It has not been reported that the arachnoid adhesions caused by SURGICEL after operation for ventral spinal schwannoma.A 45-year-old man was admitted to our clinic with complaints of intermittent lumbar pain for 12 months. Physical examination: The patient's lower extremity muscle strength was Ⅲ-Ⅳ grade, the bilateral knee tendon reflexes was hyperactive, the bilateral Babinski sign was positive, the sensory dysfunction level was at T11, the anal reflex was positive, the bilateral cremasteric reflex was positive.

  6. Schwannoma Showing Avid Uptake on 68Ga-PSMA-HBED-CC PET/CT.

    Science.gov (United States)

    Kanthan, Gowri L; Izard, Michael A; Emmett, Louise; Hsiao, Edward; Schembri, Geoffrey Paul

    2016-09-01

    Ga prostate-specific membrane antigen (PSMA) PET/CT is a relatively new and highly sensitive imaging modality used in staging metastatic prostate cancer. We report a case of a 65-year-old man with newly diagnosed prostate carcinoma who had a PSMA PET/CT scan for staging of his disease. A PSMA-avid right pelvic mass was identified anterior to the sacrum. Surgical removal and histopathological examination of this lesion revealed the diagnosis of schwannoma. It is important to be aware that schwannoma may also show avid uptake on PSMA PET/CT scan and may potentially lead to an incorrect diagnosis of metastatic prostate carcinoma. PMID:27405039

  7. Schwannoma de nervio mediano en un paciente con neurofibromatosis tipo I

    OpenAIRE

    Romana Ramos-Cárdenas; Ruth Ivonne Acevedo-Estrada; Erick Frank Pineda-Villafuerte

    2014-01-01

    Los tumores neurales periféricos en mano son el 1% de todos los tu - mores. Son benignos y de dos tipos: 1) schwannoma o neurilemoma y 2) neurofibromas. Los schwannomas son tumores benignos encapsu - lados, ovoides, firmes, de crecimiento lento, solitario, asociados o no con una enfermedad neurológica. Se originan de células de Schwann del neurilema de nervios periféricos. Suelen presentarse entre los 30 y 60 años de edad, sin predominio de género o raza; 45% se encuentra en la cabeza/cuello,...

  8. A rare presentation and challenging reconstruction of an extensive cystic orbital Schwannoma

    Directory of Open Access Journals (Sweden)

    Son T. Ho, MD

    2013-04-01

    Full Text Available A 57 year old female presents with an irritated right eye and right-sided enophthalmos for the past year. The patient previously had an extensive right-sided cystic orbital schwannoma removed with reconstruction 5 years ago. Imaging revealed an enlarged right orbit with medial wall collapse and inferior displacement of a floor plate implant. An anterior orbitotomy with placement of an enophthalmos implant and 1mm Medpor sheets was conducted to reconstruct the orbit and corrected the ocular misalignment and right lower lid retraction. We report a successful case of orbital reconstruction in a patient with orbital deformity due to the removal of a massive cystic schwannoma.

  9. A rare presentation and challenging reconstruction of an extensive cystic orbital Schwannoma

    Directory of Open Access Journals (Sweden)

    Son T Ho

    2013-03-01

    Full Text Available A 57 year old female presents with an irritated right eye and right-sided enophthalmos for the past year. The patient previously had an extensive right-sided cystic orbital schwannoma removed with reconstruction 5 years ago. Imaging revealed an enlarged right orbit with medial wall collapse and inferior displacement of a floor plate implant. An anterior orbitotomy with placement of an enophthalmos implant and 1mm Medpor sheets was conducted to reconstruct the orbit and corrected the ocular misalignment and right lower lid retraction. We report a successful case of orbital reconstruction in a patient with orbital deformity due to the removal of a massive cystic schwannoma.

  10. The role of radiology in the diagnosis and management of vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Sriskandan, N., E-mail: neshe@doctors.org.u [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Connor, S.E.J. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Department of Neuroradiology, King' s College Hospital NHS Foundation Trust, London (United Kingdom)

    2011-04-15

    The most frequent lesion identified at the cerebellopontine angle cistern and internal auditory meatus (IAM) is the vestibular schwannoma. Radiological features, the role of imaging in screening and follow-up, therapeutic approaches and appearances following treatment will be discussed. Other cerebellopontine angle lesions will be illustrated and an algorithm presented to help in the imaging differential diagnosis. Whilst lesions other than vestibular schwannomas are rarely isolated to the IAM, the key clinical and radiological features that should raise the possibility of alternative neoplastic and inflammatory diseases will be highlighted.

  11. Is "Benign Childhood Epilepsy with Centrotemporal Spikes” Always Benign?

    Directory of Open Access Journals (Sweden)

    Muhammad SAEED

    2014-07-01

    Full Text Available How to Cite This Article: Saeed M, Azam M, Shabbir N, Qamar ShA. Is "Benign Childhood Epilepsy with Centrotemporal Spikes" Always Benign? Iran J Child Neurol. 2014 Summer;8(3: 39-45.AbstractObjectiveTo determine the prevalence of associated behavioral problems and prognosis with Benign Childhood Epilepsy with CentroTemporal Spikes (BCECTS.Descriptive, Cross Sectional study that was conducted from October 2009 to April 2013 in the Department of Pediatric Neurology, the Children’s Hospital Taif, KSA.Material & MethodsThis study was conducted after approval from the Ethics Committee of the Children’s Hospital Taif, Saudi Arabia. Thirty-two patients from the age of 3 to 10 years old were recruited from the pediatric neurology clinic over a period of 4 years. All the patients were selected based on history, EEGs, and neuropsychological and neurological examinations.EEGs were performed for all the patients while in awake and sleep states. Those who had centrotemporal discharges were included in the study. All the patients also underwent a brain MRI. Only two patients had mild cortical atrophy but developmentally they were normal.ResultsIn our study, prevalence of BRE is 32/430 (7.44%. Among the 32 cases, 24 were male and eight were female. Six cases out of 32 indicated a family history of BRE. Twenty-eight cases had unilateral right sided centrotemporal discharges and four had bilateral discharges.ConclusionIt is possible that for BECTS, a high number of seizures might play an important role in the development of mild cognitive impairment and/or behavior disturbances.ReferencesBradley WG, Daroff RB, Fenichel JM, Jahrovic J. Neurology of clinical practice. 5th Ed. 2009: pp. 1953-1990.Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross H, Van Emde Boas M, et al: Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia. 2010

  12. Vestibular schwannoma in patients with sudden sensorineural hearing loss.

    Science.gov (United States)

    Lee, Jong Dae; Lee, Byung Don; Hwang, Sun Chul

    2011-03-01

    Sudden sensorineural hearing loss (SSNHL) has several etiologies. It may be a presenting symptom of vestibular schwannoma (VS). This study aimed to establish the incidence of VS in patients with SSNHL, and we report several unusual cases among these patients. We reviewed retrospectively the charts and magnetic resonance imaging (MRI) findings of all adult patients who presented with SSNHL between 2002 and 2008. We utilized three-dimensional fast imaging with steady-state acquisition temporal MRI as a screening method. Of the 295 patients with SSNHL, VS was found in 12 (4%). All patients had intrameatal or small to medium-sized tumors. There were three cases with SSNHL in one ear and an incidental finding of intracanalicular VS in the contralateral ear. There were four cases of VS that showed good recovery from SSNHL with corticosteroid treatment. There were two cases that mimicked labyrinthitis with hearing loss and vertigo. A greater number of cases than expected of VS were detected in patients with SSNHL, as a result of increasing widespread use of MRI. Various unusual findings in these patients were identified. MRI would seem to be mandatory in all cases of SSNHL.

  13. A giant plexiform schwannoma of the brachial plexus: case report

    Directory of Open Access Journals (Sweden)

    Kohyama Sho

    2011-11-01

    Full Text Available Abstract We report the case of a patient who noticed muscle weakness in his left arm 5 years earlier. On examination, a biloculate mass was observed in the left supraclavicular area, and Tinel's sign caused paresthesia in his left arm. Magnetic resonance imaging showed a continuous, multinodular, plexiform tumor from the left C5 to C7 nerve root along the course of the brachial plexus to the left brachia. Tumor excision was attempted. The median and musculocutaneous nerves were extremely enlarged by the tumor, which was approximately 40 cm in length, and showed no response to electric stimulation. We resected a part of the musculocutaneous nerve for biopsy and performed latissimus dorsi muscle transposition in order to repair elbow flexion. Morphologically, the tumor consisted of typical Antoni A areas, and immunohistochemistry revealed a Schwann cell origin of the tumor cells moreover, there was no sign of axon differentiation in the tumor. Therefore, the final diagnosis of plexiform Schwannoma was confirmed.

  14. Prediction of Balance Compensation After Vestibular Schwannoma Surgery.

    Science.gov (United States)

    Parietti-Winkler, Cécile; Lion, Alexis; Frère, Julien; Perrin, Philippe P; Beurton, Renaud; Gauchard, Gérome C

    2016-06-01

    Background Balance compensation after vestibular schwannoma (VS) surgery is under the influence of specific preoperative patient and tumor characteristics. Objective To prospectively identify potential prognostic factors for balance recovery, we compared the respective influence of these preoperative characteristics on balance compensation after VS surgery. Methods In 50 patients scheduled for VS surgical ablation, we measured postural control before surgery (BS), 8 (AS8) days after, and 90 (AS90) days after surgery. Based on factors found previously in the literature, we evaluated age, body mass index and preoperative physical activity (PA), tumor grade, vestibular status, and preference for visual cues to control balance as potential prognostic factors using stepwise multiple regression models. Results An asymmetric vestibular function was the sole significant explanatory factor for impaired balance performance BS, whereas the preoperative PA alone significantly contributed to higher performance at AS8. An evaluation of patients' balance recovery over time showed that PA and vestibular status were the 2 significant predictive factors for short-term postural compensation (BS to AS8), whereas none of these preoperative factors was significantly predictive for medium-term postoperative postural recovery (AS8 to AS90). Conclusions We identified specific preoperative patient and vestibular function characteristics that may predict postoperative balance recovery after VS surgery. Better preoperative characterization of these factors in each patient could inform more personalized presurgical and postsurgical management, leading to a better, more rapid balance recovery, earlier return to normal daily activities and work, improved quality of life, and reduced medical and societal costs.

  15. Benign chondroblastoma (a case report)

    OpenAIRE

    Gulman, Birol; Ciray, Mevlut

    2004-01-01

    Chondroblastoma is a rare benign primary bone neoplasm. The clinical symptoms are generally including adjacent joint because of the lesion arises in the epiphysis of long bones. In this report; a case of chondroblastoma is discussed which was considered to be "Tear of Medial Meniscus" clinically.

  16. Benign concentric annular macular dystrophy

    Directory of Open Access Journals (Sweden)

    Luísa Salles de Moura Mendonça

    2015-06-01

    Full Text Available The purpose of the authors is to show clinical findings of a patient with benign concentric annular macular dystrophy, which is an unusual condition, and part of the "bull’s eye" maculopathy differential diagnosis. An ophthalmologic examination with color perception, fluorescein angiography, and ocular electrophysiology was performed.

  17. Familial benign pemphigus atypical localization

    OpenAIRE

    Reyes, Maria Veronica; Halac, Sabina; Mainardi, Claudio; Kurpis, Maria; Ruiz Lascano, Alejandro

    2016-01-01

    We present an atypical case of familial benign pemphigus (Hailey-Hailey disease), which presented as crusted, annular plaques limited to the back without intertriginous involvement. We could not find in the literature another patient with plaques located solely on the back without a prior history of classical disease.

  18. Esotericism Ancient and Modern

    OpenAIRE

    Frazer, Michael

    2006-01-01

    Leo Strauss presents at least two distinct accounts of the idea that the authors in the political-philosophical canon have often masked their true teachings. A weaker account of esotericism, dependent on the contingent fact of persecution, is attributed to the moderns, while a stronger account, stemming from a necessary conflict between philosophy and society, is attributed to the ancients. Although most interpreters agree that Strauss here sides with the ancients, this view fails to consider...

  19. MR imaging differentiation of malignant soft tissue tumors from peripheral schwannomas with large size and heterogeneous signal intensity

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Zhaohui, E-mail: zzh_zs@qq.com [Department of Medical Imaging, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, Guangdong 510080 (China); Deng, Lei [Department of Radiology, Dongguan People' s Hospital, 3 Wandao Road, Dongguan, Guangdong 52300 (China); Ding, Lei; Meng, Quanfei [Department of Medical Imaging, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, Guangdong 510080 (China)

    2015-05-15

    Highlights: • Soft tissue sarcomas can be distinguished from large schwannomas on MR imaging. • Presence of split fat sign and bright rim sign favors the diagnosis of schwannoma. • Absence of lobular shape and extensive edema is also favorable to schwannoma. • Capsule is unreliable in distinguishing soft tissue sarcomas from schwannomas. - Abstract: Objective: To determine the value of MR imaging features at and near the margin of the tumor in differentiating peripheral schwannomas with large size (maximum diameter >5 cm) and heterogeneous appearance from malignant soft tissue tumors (MSTTs). Materials and methods: We retrospectively reviewed MR images of 25 MSTTs and 15 peripheral schwannomas with heterogeneous appearance on MR imaging and maximum diameter ranged from 5 cm to 11 cm. The soft tissue masses were evaluated for split fat sign, bright rim sign, lobular shape (with two or more deep lobulations), peritumoral edema, and capsule. The Fisher's exact test was used to determine whether these imaging features differed significantly between schwannomas and MSTTs. A nonparametric Mann–Whitney test was used to compare the maximal extent of peritumoral edema of schwannomas and MSTTs. The optimal cutoff value of the maximal extent of peritumoral edema was calculated by means of receiver operating characteristic analysis for distinguishing between schwannomas and MSTTs. Interobserver agreement in the assessment of imaging features was evaluated using Cohen κ statistic and percentage agreement. Results: The split fat sign, bright rim sign were more common in schwannomas than in MSTTs (P < 0.001). The incidence of lobular shape was higher for MSTTs than for schwannomas (P < 0.001). The peritumoral edema was present more frequently in MSTTs than in schwannomas (P = 0.001). The median (interquartile range) of the maximal peritumoral edema extent was 13 mm (9.5–17 mm) for schwannomas and 46 mm (24–75.5 mm) for MSTTs, respectively (P < 0.001). The

  20. Immunohistochemical Analysis Supports a Role for INI1/SMARCB1 in Hereditary Forms of Schwannomas, But Not in Solitary, Sporadic Schwannomas

    OpenAIRE

    Patil, Sushama; Perry, Arie; MacCollin, Mia; Dong, Shumin; Betensky, Rebecca A.; Yeh, Tu-Hsueh; Gutmann, David H.; Stemmer-Rachamimov, Anat O

    2008-01-01

    The INI1/SMARCB1 protein product (INI1), a component of a transcription complex, was recently implicated in the pathogenesis of schwannomas in two members of a single family with familial schwannomatosis1. Tumors were found to have both constitutional and somatic mutations of the SMARCB1 gene and showed a mosaic pattern of loss of INI1 expression by immunohistochemistry, suggesting a tumor composition of mixed null and haploinsufficient cells. To determine if this finding could be extended to...

  1. What intervention is best practice for vestibular schwannomas? A systematic review of controlled studies

    NARCIS (Netherlands)

    J.G. Wolbers (John); A.H.G. Dallenga; A.M. Romero; A. van Linge (Anne)

    2013-01-01

    textabstractObjective: Largely, watchful waiting is the initial policy for patients with small-sized or medium-sized vestibular schwannoma, because of slow growth and relatively minor complaints, that do not improve by an intervention. If intervention (microsurgery, radiosurgery or fractionated radi

  2. Two epithelioid malignant schwannomas in a patient with neurofibromatosis : Cytology, histology and DNA-flow-cytometry

    NARCIS (Netherlands)

    Molenaar, W M; Ladde, B E; Koops, H Schraffordt; Dam-Meiring, A

    1989-01-01

    Cytological, histological and DNA-ploidy findings of 2 epithelioid malignant schwannomas arising in a patient with von Recklinghausen's neurofibromatosis are described. In both primary tumors, i.e. in the thigh and in the thoracic wall, origin from a neurofibromatous nerve could be established. With

  3. Expression of Ets-1 proto-oncoprotein in gastrointestinal stromal tumors, leiomyomas and schwannomas

    Institute of Scientific and Technical Information of China (English)

    Toshiyuki Nakayama; Ayumi Yoshizaki; Shinji Naito; Chun Yang Wen; Gabit Alipov; Yuichi Yakata; Ichiro Sekine

    2006-01-01

    AIM: Gastrointestinal stromal tumors (GISTs) are rare. GISTs differ from other mesenchymal tumors of the gastrointestinal tract (e.g. leiomyomas and schwannomas). The purpose of this study was to investigate the role of Ets-1 in the growth and differentiation of GISTs.METHODS: Twenty-eight GISTs, nine leiomyomas and six schwannomas were examined by immunohistochemical staining method for Ets-1 in this study. Specimens were selected from surgical pathology archival tissues at Nagasaki University Hospital.RESULTS: Ets-1 protein was expressed in the cytoplasm of cells in all of these tumors. Immunohistochemical staining revealed that 27 GISTs (96.4%),six leiomyomas (66.7%), and five schwannomas (83.3 %) were positive for Ets-1. Ets-1 expression was statistically different between GISTs and leiomyomas (P<0.005). However, there was no correlation between Ets-1 expression and clinical risk categories.CONCLUSION: Ets-1 plays an important role in the growth and differentiation of GISTs, leiomyomas and schwannomas.

  4. Late malignant transformation of vestibular schwannoma in the absence of irradiation

    DEFF Research Database (Denmark)

    Bashir, Asma; Poulsgaard, Lars; Broholm, Helle;

    2016-01-01

    Late malignant transformation of vestibular schwannoma (VS) following irradiation has previously been reported 29 times in the literature. Here, the authors report the first late malignant transformation of VS unrelated to neurofibromatosis or radiation exposure. After undergoing a near-total exc...

  5. Long-term quality of life and tumour control following gamma knife radiosurgery for vestibular schwannoma

    DEFF Research Database (Denmark)

    Wangerid, Theresa; Bartek, Jiri; Svensson, Mikael;

    2014-01-01

    Gamma knife radiosurgery (GKRS) has for the last decades been an established treatment option for patients with small- or medium-sized vestibular schwannomas (VS), although little data is reported on long-term outcome regarding quality of life (QOL) and tumour control in this patient category...

  6. Clinical and Radiographic Factors Predicting Hearing Preservation Rates in Large Vestibular Schwannomas.

    Science.gov (United States)

    Mendelsohn, Daniel; Westerberg, Brian D; Dong, Charles; Akagami, Ryojo

    2016-06-01

    Objectives Postoperative hearing preservation rates for patients with large vestibular schwannomas range from 0 to 43%. The clinical and radiographic factors predicting hearing preservation in smaller vestibular schwannomas are well described; however, their importance in larger tumors is unclear. We investigated factors predicting hearing preservation in large vestibular schwannomas. Design Retrospective review. Setting Quaternary care academic center. Participants A total of 85 patients with unilateral vestibular schwannomas > 3 cm underwent retrosigmoid resections. Main Outcomes Measures Preoperative and postoperative serviceable hearing rates. Methods Clinical and radiographic data including preoperative and postoperative audiograms, preoperative symptoms, magnetic resonance imaging features, and postoperative facial weakness were analyzed. Results Hearing was preserved in 41% of patients (17 of 42) with preoperative serviceable hearing. Hypertension and diabetes increased the likelihood of preoperative hearing loss. Preoperative tinnitus predicted a lower likelihood of hearing preservation. No radiographic factors predicted hearing preservation; however, larger tumor size, smaller fourth ventricular width, and the presence of a cerebrospinal fluid cleft surrounding the tumor predicted postoperative facial weakness. Conclusion Systemic comorbidities may influence hearing loss preoperatively in patients with large vestibular schwannomas. The absence of tinnitus may reflect hearing reserve and propensity for hearing preservation. Preoperative radiographic features did not predict hearing preservation despite some associations with postoperative facial weakness. PMID:27175312

  7. Pontine extension of a tentorial schwannoma without cranial nerve involvement: a case report

    Directory of Open Access Journals (Sweden)

    D'Urso Pietro

    2011-12-01

    Full Text Available Abstract Introduction Intracranial schwannomas unrelated to the cranial nerves are uncommon. We report a new case of tentorial schwannoma unrelated to the cranial nerves, with extension into the pons. A literature review with discussion of the most relevant pathogenetic aspects is also performed. Case presentation A 42-year-old Caucasian man was admitted with right-sided paresthesias and weakness of his upper and lower extremities. The neurological examination revealed right hemiparesis and hemi-hypoesthesia. A brain magnetic resonance imaging scan revealed a cerebellopontine lesion, arising from the left free edge of the tentorium, and extending into his pons. A piecemeal removal was performed through a retrosigmoid approach. The lesion was not found to be associated with any cranial nerves. The histological examination revealed a schwannoma Antoni type A. His postoperative course was uneventful. At one year follow-up, the patient was neurologically intact and the magnetic resonance imaging of his brain performed at that time showed complete removal without signs of recurrence. Conclusion Tentorial schwannomas are rare clinical entities. Knowledge of their clinical, radiological and anatomical characteristics is very important for the correct diagnosis and management.

  8. The Middle Fossa Approach for the Removal of a Trochlear Schwannoma

    Directory of Open Access Journals (Sweden)

    Andrew B. Boucher

    2014-01-01

    Full Text Available Objectives. Schwannomas originating from the trochlear nerve are extremely rare; only 30 cases have been reported in the literature. Many operative approaches have been utilized for lesion resection, but the advantages of the anterior transpetrosal approach are numerous and include excellent exposure, minimal extradural retraction of the temporal lobe, and minimal cerebrospinal fluid leaks. We report the second case of a trochlear schwannoma resected via the anterior transpetrosal approach. Setting. A 64-year-old male presented with 3-month history of diplopia and headaches. On physical examination, he was found to have a right fourth nerve palsy. Brain magnetic resonance imaging revealed a mass within the right ambient cistern compressing the adjacent midbrain. A right-sided anterior transpetrosal approach was used—which confirmed that the trochlear nerve entered the mass—to achieve gross total resection. Pathological examination confirmed diagnosis of schwannoma. The patient was discharged on postoperative day 3. He experienced a persistent fourth nerve palsy postoperatively with an otherwise normal neurological examination. Follow-up imaging confirmed complete removal of the tumor. Conclusion. The anterior transpetrosal approach is an excellent approach for removal of trochlear schwannomas involving the cisternal course of the trochlear nerve. It affords complete visualization of this anatomical region while introducing minimal morbidity.

  9. Follow-up after gamma knife radiosurgery for vestibular schwannomas: volumetric and axial control rates

    NARCIS (Netherlands)

    Timmer, F.C.A.; Hanssens, P.E.; Haren, A.E. van; Overbeeke, J.J. van; Mulder, J.J.S.; Cremers, C.W.R.J.; Graamans, K.

    2011-01-01

    OBJECTIVES/HYPOTHESIS: A prospective long-term follow-up study was conducted to evaluate the results of gamma knife radiosurgery (GKRS) for vestibular schwannoma (VS) patients. Both axial and volumetric measurements are used to determine tumor size during follow-up. STUDY DESIGN: Individual prospect

  10. Removal of vestibular schwannoma and facial nerve preservation using small suboccipital retrosigmoid craniotomy

    Institute of Scientific and Technical Information of China (English)

    CHEN Ling; CHEN Li-hua; LING Feng; LIU Yun-sheng; Madjid Samii; Amir Samii

    2010-01-01

    Background Vestibular schwannoma, the commonest form of intracranial schwannoma, arises from the Schwann cells investing the vestibular nerve. At present, the surgery for vestibular schwannoma remains one of the most complicated operations demanding for surgical skills in neurosurgery. And the trend of minimal invasion should also be the major influence on the management of patients with vestibular schwannomas. We summarized the microsurgical removal experience in a recent series of vestibular schwannomas and presented the operative technique and cranial nerve preservation in order to improve the rates of total tumor removal and facial nerve preservation.Methods A retrospective analysis was performed in 145 patients over a 7-year period who suffered from vestibular schwannomas that had been microsurgicaily removed by suboccipital retrosigmoid transmeatus approach with small craniotomy. CT thinner scans revealed the tumor size in the internal auditory meatus and the relationship of the posterior wall of the internal acoustic meatus to the bone labyrinths preoperatively. Brain stem evoked potential was monitored intraoperatively. The posterior wall of the internal acoustic meatus was designedly drilled off. Patient records and operative reports, including data from the electrophysiological monitoring, follow-up audiometric examinations, and neuroradiological findings were analyzed.Results Total tumor resection was achieved in 140 cases (96.6%) and subtotal resection in 5 cases. The anatomical integrity of the facial nerve was preserved in 91.0% (132/145) of the cases. Intracranial end-to-end anastomosis of the facial nerve was performed in 7 cases. Functional preservation of the facial nerve was achieved in 115 patients (Grade Ⅰ and Grade Ⅱ, 79.3%). No patient died in this series. Preservation of nerves and vessels were as important as tumor removal dudng the operation. CT thinner scan could show the relationship between the posterior wall of the internal

  11. Current treatment strategy in the management of vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Misra Basant

    2009-01-01

    Full Text Available Background: The changing trends in the management of vestibular schwannoma (VS in our practice over the last two decades as well as the current status are presented here. Materials and Methods: The observations are based on the experience of 559 consecutive cases of VS operated by the first author between 1987 and 2008, 438 of which were operated by microsurgery and 139 by gamma knife radiosurgery (GKR (18 of which were previously operated by the authors. A detailed analysis of microsurgically managed patients in two different periods (100 consecutive patients each before 1993 and 2008 were compared to see the changing trend and document current results. Results and Discussion: In the initial experience (1990s, the emphasis in microsurgery was preserving life, total excision of tumor and preservation of function in that order. In the 21 st century, the emphasis in microsurgery has been all about functional preservation. In 100 consecutive cases of VS (excluding neurofibromatosis-2 that were treated microsurgically between 2005-08, there were four small tumors (< 2 cm, 14 medium-sized tumors (2-3 cm and 82 large tumors (≥3 cm. The total excision rate was 83%. The facial nerve anatomical preservation rate was 96% and function was Grade III House-Brackmann (HB or better in 87%. Both the total excision rate and facial function of Grade II HB or better were 100% in cases with tumor size less than three cm. Functional hearing preservation was achieved in ten cases. There was no operative mortality. Conclusion: Total excision of VS, though aimed at, is no more pursued at the cost of facial function. Moreover, microsurgery, radiosurgery and observation are all valid options in the management of VS and choosing the correct modality helps in achieving optimal outcome.

  12. Enlarging Pancreatic Schwannoma – A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Narjust Duma

    2015-07-01

    Full Text Available Context Schwannomas are rare neoplasms that typically occur in the peripheral nerve of the extremities. Visceral localization of these tumors is particularly rare. We present a unique case of a pancreatic schwannoma presenting as long-lasting dyspepsia and intermittent epigastric pain. Case report Seventy-two-year-old female presented with dyspepsia for 2 years and an incidental mass in the head of the pancreas on abdominal CT scan. Patient had multiple negative endoscopic ultrasound guided biopsies and a non-diagnostic open core biopsy. She was followed up for 3 years with serial imaging until an abdominal CT scan showed an increase in size of the pancreatic mass from 1.9x2.2 cm to 3.1x2.7 cm. Physical examination was unremarkable. Laboratory tests including tumor markers were normal. Given the enlarging size of the mass and its impingement on the portal vein, the consensus was to proceed with surgery. Patient underwent a nonpylorus preserving pancreaticoduodenectomy. Histology revealed a 3.5 cm mass showing a spindle cell neoplasm with mild atypia. The lesion was well defined and nerve tissue was noted at the periphery. On immuno stains, the spindle cells were positive for S-100 protein and negative for pancytokeratin, CD-34, CD-117, smooth muscle actin and Melan A, consistent with the diagnosis of a prancreatic schwannoma. Conclusions Pancreatic schwannomas arise from branches of the vagus nerve which courses through the pancreas. Pre-operative diagnosis of pancreatic schwannomas is difficult even with multiple imaging modalities. The final diagnosis of these tumors is often made only after operative excision and histological studies.

  13. Long-Term Results for Trigeminal Schwannomas Treated With Gamma Knife Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Toshinori, E-mail: h-toshi@komakihp.gr.jp; Kato, Takenori; Iizuka, Hiroshi; Kida, Yoshihisa

    2013-12-01

    Purpose: Surgical resection is considered the desirable curative treatment for trigeminal schwannomas. However, complete resection without any complications remains challenging. During the last several decades, stereotactic radiosurgery (SRS) has emerged as a minimally invasive treatment modality. Information regarding long-term outcomes of SRS for patients harboring trigeminal schwannomas is limited because of the rarity of this tumor. The aim of this study was to evaluate long-term tumor control and functional outcomes in patients harboring trigeminal schwannomas treated with SRS, specifically with gamma knife surgery (GKS). Methods and Materials: Fifty-three patients harboring trigeminal schwannomas treated with GKS were evaluated. Of these, 2 patients (4%) had partial irradiation of the tumor, and 34 patients (64%) underwent GKS as the initial treatment. The median tumor volume was 6.0 cm{sup 3}. The median maximum and marginal doses were 28 Gy and 14 Gy, respectively. Results: The median follow-up period was 98 months. On the last follow-up image, 7 patients (13%) had tumor enlargement, including the 2 patients who had partial treatment. Excluding the 2 patients who had partial treatment, the actuarial 5- and 10-year progression-free survival (PFS) rates were 90% and 82%, respectively. Patients with tumors compressing the brainstem with deviation of the fourth ventricle had significantly lower PFS rates. If those patients with tumors compressing the brainstem with deviation of the fourth ventricle are excluded, the actuarial 5- and 10-year PFS rates increased to 95% and 90%, respectively. Ten percent of patients had worsened facial numbness or pain in spite of no tumor progression, indicating adverse radiation effect. Conclusions: GKS can be an acceptable alternative to surgical resection in patients with trigeminal schwannomas. However, large tumors that compress the brainstem with deviation of the fourth ventricle should be surgically removed first and then

  14. Long-Term Results for Trigeminal Schwannomas Treated With Gamma Knife Surgery

    International Nuclear Information System (INIS)

    Purpose: Surgical resection is considered the desirable curative treatment for trigeminal schwannomas. However, complete resection without any complications remains challenging. During the last several decades, stereotactic radiosurgery (SRS) has emerged as a minimally invasive treatment modality. Information regarding long-term outcomes of SRS for patients harboring trigeminal schwannomas is limited because of the rarity of this tumor. The aim of this study was to evaluate long-term tumor control and functional outcomes in patients harboring trigeminal schwannomas treated with SRS, specifically with gamma knife surgery (GKS). Methods and Materials: Fifty-three patients harboring trigeminal schwannomas treated with GKS were evaluated. Of these, 2 patients (4%) had partial irradiation of the tumor, and 34 patients (64%) underwent GKS as the initial treatment. The median tumor volume was 6.0 cm3. The median maximum and marginal doses were 28 Gy and 14 Gy, respectively. Results: The median follow-up period was 98 months. On the last follow-up image, 7 patients (13%) had tumor enlargement, including the 2 patients who had partial treatment. Excluding the 2 patients who had partial treatment, the actuarial 5- and 10-year progression-free survival (PFS) rates were 90% and 82%, respectively. Patients with tumors compressing the brainstem with deviation of the fourth ventricle had significantly lower PFS rates. If those patients with tumors compressing the brainstem with deviation of the fourth ventricle are excluded, the actuarial 5- and 10-year PFS rates increased to 95% and 90%, respectively. Ten percent of patients had worsened facial numbness or pain in spite of no tumor progression, indicating adverse radiation effect. Conclusions: GKS can be an acceptable alternative to surgical resection in patients with trigeminal schwannomas. However, large tumors that compress the brainstem with deviation of the fourth ventricle should be surgically removed first and then

  15. Multiple chronic benign pulmonary nodules.

    Science.gov (United States)

    Kalifa, L G; Schimmel, D H; Gamsu, G

    1976-11-01

    Four cases are discussed in which were found unusual multiple chronic pulmonary nodules: leiomyomatous hamartomas, rheumatoid nodules, multiple histoplasmomas, and possible multiple plasma cell granulomas (hyalinizing pulmonary nodules). In each case the initial impression of metastic malignancy was countered by more than 2 years' observation, during which time the lesions appeared to be benign. Histologic examination is necessary to exclude malignancy, although a definitive diagnosis may be difficult to establish. PMID:981596

  16. Benign chondroblastoma - malignant radiological appearances

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, K.; Treugut, H.; Mueller, G.E.

    1980-04-01

    The very rare benign chondroblastoma occasionally invades soft tissues and may grow beyond the epiphysis into the metaphysis. In the present case such a tumour did not show the typical radiological appearances, but presented malignant features both on plain films and on the angiogram. The importance of biopsy of tumours which cannot be identified with certainty must be stressed before radical surgery is carried out.

  17. Benign Pediatric Salivary Gland Lesions.

    Science.gov (United States)

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions.

  18. BENIGN PROSTATIC HYPERPLASIA: UPDATED REVIEW

    OpenAIRE

    Praveen.R

    2013-01-01

    Benign Prostatic Hyperplasia (BPH) is one of the commonest medical conditions affecting the geriatric male population. The enlargement of prostate can lead to various clinical symptoms like difficulty in voiding, urinary retention etc. The symptoms are varied depending on the size of enlargement. The International Prostatic Symptom Score (IPSS) is the gold standard and first step in understanding and diagnosing the disease clinically, but in the recent past there are various other newer tools...

  19. Hearing outcomes of vestibular schwannoma patients managed with 'wait and scan': predictive value of hearing level at diagnosis

    DEFF Research Database (Denmark)

    Stangerup, S-E; Tos, M; Thomsen, J;

    2010-01-01

    This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma....

  20. Benign tumours of the vulva

    International Nuclear Information System (INIS)

    Objective: To present clinicopathological analysis of benign tumours of the vulva. Patients and Methods: Thirty cases of benign tumours of vulva were studied during 2 years research period. Detailed history along with complete local and general physical examination followed by all necessary pre-operative investigations were carried out. Excision surgery was the treatment of choice in majority of cases while marsupialization was done for Bartholin's cyst. Histopathology of tumours specimen was also collected. Results: A total of 30 cases were studied. Twenty-two were cystic and 8 were solid tumours. Aggressive angiomyxoma was 10% of solid tumours and Bartholin's cyst was 46.6% of cystic tumours. Most of the patients were multipara and between 21-30 years of age. The main site of tumour was labium majus. Excision surgery for all cases and marsupialization for Bartholin's cyst was treatment of choice. Conclusion: Aggressive angiomyxoma is the commonest solid benign vulval tumour. It should be considered in the differential diagnosis of vulval mass in women of reproductive age. (author)

  1. Schwannoma vestibular: involução tumoral espontânea Vestibular Schwannoma: spontaneous tumor involution

    Directory of Open Access Journals (Sweden)

    Norma de Oliveira Penido

    2007-12-01

    Full Text Available A história natural dos schwannomas vestibulares ainda não está totalmente elucidada, mas sua maioria tende a apresentar crescimento lento, muitos permanecendo sem sintomas durante toda a vida do paciente. Cerca de 69% deste tipo de tumor diagnosticados não apresentam crescimento e, destes, 16% chegam a apresentar regressão tumoral. Considerando os tumores que apresentam crescimento, cerca de 70% crescem menos de 2 mm ao ano. O avanço nos métodos de diagnóstico por imagem, particularmente à ressonância magnética com contraste de gadolínio, permite o diagnóstico cada vez mais de lesões com sintomas mínimos e tamanhos menores. O tratamento de escolha para estes tumores ainda é a ressecção completa do tumor. As técnicas cirúrgicas apresentaram grande avanço nas últimas décadas, o que possibilitou diminuição da mortalidade. Assim, a cirurgia, que antes tinha como objetivo apenas a ressecção completa do tumor, agora visa também à preservação da audição e da função do nervo facial. Considerações finais: Considerando-se sua história natural, abre-se a possibilidade de uma conduta conservadora já que o ritmo de crescimento no primeiro ano após o diagnóstico prediz o comportamento do tumor nos próximos anos. A conduta conservadora não implica em repúdio à cirurgia, devendo ser utilizada em casos de aumento tumoral, piora dos sintomas ou desejo do paciente. Além disso, em relatos de literatura não há diferença estatisticamente significante entre os pacientes submetidos à cirurgia logo após o diagnóstico ou após conduta conservadora inicial, no que diz respeito às seqüelas pós-operatórias.The natural history of Vestibular Schwannomas (VS is yet not totally known, but most of them have the tendency to slow growth, sometimes without any kind of symptoms during the individual’s entire time. About 69% of diagnosed VS do not grow at all and 16% of these can even regress. Considering tumors that grow

  2. Epithelioid Malignant Peripheral Nerve Sheath Tumor Arising in a Schwannoma, in a Patient with “Neuroblastoma-like” Schwannomatosis and a Novel Germline SMARCB1 mutation

    OpenAIRE

    Carter, Jodi M.; O'Hara, Carolyn; Dundas, George; Gilchrist, Dawna; Collins, Mark S.; Eaton, Katherine; Judkins, Alexander R.; Biegel, Jaclyn A.; Folpe, Andrew L.

    2012-01-01

    Epithelioid malignant peripheral nerve sheath tumors arising in pre-existing schwannomas are extremely rare. We report an unusual example occurring in a patient with multiple schwannomas (schwannomatosis), all but one of which showed “neuroblastoma-like” histology. By immunohistochemistry, both the epithelioid malignant peripheral nerve sheath tumor and the schwannomas showed a complete loss of the Smarcb1 protein. Subsequent genetic evaluation revealed the presence of a novel germline mutati...

  3. Evaluation of CT findings for the differentiation of benign from malignant primary retroperitoneal tumors

    Institute of Scientific and Technical Information of China (English)

    Zhu Zheng; Zhao Xinming; Zhao Yanfeng; Yang Lei; Zhao Jing; Dai Jingrui; Zhou Chunwu

    2014-01-01

    Background Benign and malignant primary retroperitoneal tumors (RT) have different pathological manifestations,and overlapping imaging characteristics.This study aimed to evaluate the value of computed tomography (CT) for differentiating benign from malignant RT.Methods One hundred and ninety-four patients with clinical and radiographic data were evaluated retrospectively following surgical resection of primary RT.There were 38.1% (n=74) benign lesions and 61.9% (n=120) malignant lesions.Categorical variables were tested with a chi-square test or Fisher's exact test for the diagnostic indexes and sensitivity and specificity of CT characteristics.Results In univariate analysis,the differences in ill-defined margins,irregular surfaces,long diameter >6.75 cm,short diameter >6.25 cm,and solid or mixed texture had statistical significance; the sensitivity and specificity were 44.2% and 91.9%,70.0% and 62.2%,68.8% and 60.7%,59.7% and 74.2%,87.5% and 35.1%,respectively.In multivariate analysis,a combination of all the above indexes was the best model for differentiating malignant tumors,resulting in the most accurate diagnosis of malignancies with a sensitivity of 77.2% and a specificity of 81.1% (P<0.0001) when the score was 4.The differences in other findings including CT attenuation,number,and calcification had no statistical significance.The unique characteristics included the spotted enhancement (mottled high density)in schwannoma (P<0.0001),adipose tissue in liposarcoma (P<0.0001)and paravertebral location in neurogenic tumors (P<0.0001).Conclusions More accurate differential diagnosis of primary RT can be made through comprehensive analysis of the combined diagnostic indexes of CT.Some specific characteristics of CT can assist in preoperative planning.

  4. Segmental neurofibromatosis type 2: discriminating two hit from four hit in a patient presenting multiple schwannomas confined to one limb

    OpenAIRE

    Castellanos, Elisabeth; Bielsa, Isabel; Carrato, Cristina; Rosas, Imma; Solanes, Ares; Hostalot, Cristina; Amilibia, Emilio; Prades, José; Roca-Ribas, Francesc; Lázaro, Conxi; Blanco, Ignacio; Serra, Eduard; ,

    2015-01-01

    Background A clinical overlap exists between mosaic Neurofibromatosis Type 2 and sporadic Schwannomatosis conditions. In these cases a molecular analysis of tumors is recommended for a proper genetic diagnostics. This analysis is challenged by the fact that schwannomas in both conditions bear a somatic double inactivation of the NF2 gene. However, SMARCB1-associated schwannomas follow a four-hit, three-step model, in which both alleles of SMARCB1 and NF2 genes are inactivated in the tumor, wi...

  5. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    OpenAIRE

    Harun Kütahya; Ali Güleç; Yunus Güzel; Burkay Kacira; Serdar Toker

    2013-01-01

    Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the ...

  6. Trochlear Nerve Schwannoma Treated with Gamma Knife after Excision: A Case Report and Review of the Literature

    OpenAIRE

    Inoue, Takuro; Shima, Ayako; HIRAI, Hisao; Suzuki, Fumio; MATSUDA, MASAYUKI

    2015-01-01

    Trochlear nerve schwannomas are extremely rare. We present a surgically excised case of trochlear nerve schwannoma followed by Gamma Knife (ELEKTA, Stockholm, Sweden) after histologic confirmation. A 52-year-old man presented with diplopia, gait disturbance, and sensory disturbance. Magnetic resonance imaging demonstrated a large cystic mass at ambient cistern on the right side. Subtotal excision followed by Gamma Knife surgery was undertaken. His neurologic symptoms disappeared with radiolog...

  7. Hearing outcomes of vestibular schwannoma patients managed with 'wait and scan': predictive value of hearing level at diagnosis

    DEFF Research Database (Denmark)

    Stangerup, S-E; Tos, M; Thomsen, J;

    2010-01-01

    This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma.......This study aimed to evaluate the predictive value of both hearing level (at various frequencies) and speech discrimination for forecasting hearing outcome after a period of observation, in patients with vestibular schwannoma....

  8. 胃神经鞘瘤超声内镜下被误诊为胃间质瘤4例并文献复习%4 cases of gastric schwannoma misdiagnosed as gastric stromal tumors by endoscopic ultrasonography and literature review

    Institute of Scientific and Technical Information of China (English)

    卢光荣; 符竣惠; 钟金伟; 蔡振寨; 吴昊; 申苏建; 薛战雄; 黄智铭

    2016-01-01

    Objective To improve detectable rate of gastric schwannoma by endoscopic ultrasonography (EUS). Method Clinical data and endoscopic ultrasonography (EUS) imaging features of 4 cases were retrospectively ana-lyzed which diagnosed as gastric schwannoma pathologically and immunohistochemically while diagnosed as gastric stromal tumor by EUS from May 2008 to June 2015 and reviewed the literature. Results 4 cases of gastric schwan-nomas are female and benign, all 4 lesions are solitary, 3 in gastric body, and 1 in fundus by endoscopic. By EUS, all lesions are originated from muscularis propria, hypoechoic change, even echoes and clear board without calcifica-tion or cystic changes. 2 cases have halo artifacts around the lesion. Literature review found that gastric schwannoma tended to occur in female, halo artifacts could be the feature of gastric schwannoma, calcification or cystic changes were rare in gastric schwannoma which were common in gastric stromal tumors. Conclusion It was difficult to distin-guish gastric schwannoma and gastric stromal tumors that originated from muscularis propria by EUS. For female patients with lesions originated from muscularis propria, originated from muscularis propria and occurred in gastric body, it was necessary to observe lesions whether there was being calcification or cystic and halo artifacts. Integrated all these performance, we should be in consideration of gastric stromal tumors, meanwhile, excluding the possibility of gastric schwannoma.%目的:为了提高超声内镜(EUS)对胃神经鞘瘤的检出率。方法回顾分析2008年5月-2015年6月温州医科大学附属第一、第二医院和台州市第一人民医院4例病理及免疫组化确诊为胃神经鞘瘤但经EUS误诊为胃间质瘤的临床资料及EUS的影像特征并文献复习。结果4例胃神经鞘瘤均为女性且均为良性,胃镜下4例病灶均为单发,有3例位于胃体,1例位于胃底;EUS下病灶均

  9. [Psychiatry in ancient Mexico].

    Science.gov (United States)

    Calderón Narváez, G

    1992-12-01

    Using studies on prehispanic and early post-conquest documents of Ancient Mexico--such as the Badianus Manuscript, also known as Libellus de Medicinalibus Indorum Herbis, and Brother Bernardino de Sahagún's famous work History of the Things of the New Spain, a description of some existing medical and psychiatric problems, and treatments Ancient Aztecs resorted to, is presented. The structure of the Aztec family, their problems with the excessive ingestion of alcoholic beverages, and the punishments native authorities had implemented in order to check alcoholism up are also described. PMID:1341125

  10. Adoption in ancient times

    OpenAIRE

    Bisha Eugena

    2015-01-01

    Since in ancient times, in all human cultures, children transfered from biological parents to parents that want them to create family, for political alliances, for inheritance, for a future marriage, or to care for elderly parents. The practice of adoption was fairly common in different places and periods. Adoption is mention on Bible and Quran. Greeks, Romans, Egyptians and Babylonians had adoption systems.

  11. Ancient ports of Kalinga

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    which plied between Kalinga and south east Asian countries. Nanda Raja, is said to have attacked Kalinga with the intention of getting access to the sea for the landlocked Kingdom of Magadha (Bihar). The ancient texa Artha Sastra (3rd-4th century B...

  12. Ancient deforestation revisited.

    Science.gov (United States)

    Hughes, J Donald

    2011-01-01

    The image of the classical Mediterranean environment of the Greeks and Romans had a formative influence on the art, literature, and historical perception of modern Europe and America. How closely does is this image congruent with the ancient environment as it in reality existed? In particular, how forested was the ancient Mediterranean world, was there deforestation, and if so, what were its effects? The consensus of historians, geographers, and other scholars from the mid-nineteenth century through the first three quarters of the twentieth century was that human activities had depleted the forests to a major extent and caused severe erosion. My research confirmed this general picture. Since then, revisionist historians have questioned these conclusions, maintaining instead that little environmental damage was done to forests and soils in ancient Greco-Roman times. In a reconsideration of the question, this paper looks at recent scientific work providing proxy evidence for the condition of forests at various times in ancient history. I look at three scientific methodologies, namely anthracology, palynology, and computer modeling. Each of these avenues of research offers support for the concept of forest change, both in abundance and species composition, and episodes of deforestation and erosion, and confirms my earlier work.

  13. Printing Ancient Terracotta Warriors

    Science.gov (United States)

    Gadecki, Victoria L.

    2010-01-01

    Standing in awe in Xian, China, at the Terra Cotta warrior archaeological site, the author thought of sharing this experience and excitement with her sixth-grade students. She decided to let her students carve patterns of the ancient soldiers to understand their place in Chinese history. They would make block prints and print multiple soldiers on…

  14. Creative Ventures: Ancient Civilizations.

    Science.gov (United States)

    Stark, Rebecca

    The open-ended activities in this book are designed to extend the imagination and creativity of students and encourage students to examine their feelings and values about historic eras. Civilizations addressed include ancient Egypt, Greece, Rome, Mayan, Stonehenge, and Mesopotamia. The activities focus upon the cognitive and affective pupil…

  15. Ancient Egyptian surgical heritage.

    Science.gov (United States)

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  16. Ancient Egypt: History 380.

    Science.gov (United States)

    Turk, Laraine D.

    "Ancient Egypt," an upper-division, non-required history course covering Egypt from pre-dynastic time through the Roman domination is described. General descriptive information is presented first, including the method of grading, expectation of student success rate, long-range course objectives, procedures for revising the course, major course…

  17. Ancient Egypt: Personal Perspectives.

    Science.gov (United States)

    Wolinski, Arelene

    This teacher resource book provides information on ancient Egypt via short essays, photographs, maps, charts, and drawings. Egyptian social and religious life, including writing, art, architecture, and even the practice of mummification, is conveniently summarized for the teacher or other practitioner in a series of one to three page articles with…

  18. A Vibrant Ancient City

    Institute of Scientific and Technical Information of China (English)

    WANGTONG

    2004-01-01

    LIJIANG is a small city onthe Yunnan-Guizhou Plateau in southern Chinawith an 800-year history.Word of its ancient language and music, and unique natural scenery has spread over the decades, and Lijiang is now known throughout the world. It was added

  19. Taking it to the next level: lumbar radiculopathy from thoracic nerve schwannoma

    Directory of Open Access Journals (Sweden)

    Anene Ukaigwe

    2015-02-01

    Full Text Available Compression or irritation of the sciatic nerve and its branches, the common fibular and tibial nerves, causes sciatica which is a common syndrome characterized most often by radiating pain from the lower back down the legs and also manifesting as sensory and motor deficits. Sciatica is a common presentation of lumbosacral disc prolapse and degenerative disease of the lumbar spine in ambulatory settings. Schwannomas rarely cause sciatica; hence, it is seldom considered in evaluation of a patient with radiculopathy. Our patient presented with lumbar radiculopathy, mild degenerative changes on lumbar magnetic resonance imaging (MRI scan, and failed conservative treatment. Myelopathy was confirmed with electromyogram (EMG. Thoracolumbar spine MRI revealed the schwannoma in the thoracic region. He recovered neurologic function after tumor excision. This case highlights the diagnostic challenge that may arise in evaluating a patient with lumbar radiculopathy, negative lumbosacral spine imaging, and failure of conservative therapy.

  20. Giant Primary Schwannoma of the Left Nasal Cavity and Ethmoid Sinus

    Directory of Open Access Journals (Sweden)

    Eugene Wong

    2016-01-01

    Full Text Available A unilateral tumour in the nasal cavity or paranasal sinuses is commonly caused by polyps, cysts, and mucoceles, as well as invasive tumours such as papillomas and squamous cell carcinomas. Schwannomas, in contrast, are rare lesions in this area (Minhas et al., 2013. We present a case of a 52-year-old female who presented with a 4-year progressive history of mucous hypersecretion, nasal obstruction, pain, and fullness. Imaging of the paranasal sinuses showed complete opacification of the entire left nasal cavity and sinuses by a tumour causing subsequent obstruction of the frontal and maxillary sinuses. The tumour was completely excised endoscopically. Histopathology was consistent with that of a schwannoma.

  1. Giant Primary Schwannoma of the Left Nasal Cavity and Ethmoid Sinus.

    Science.gov (United States)

    Wong, Eugene; Kong, Justin; Oh, Lawrence; Cox, Daniel; Forer, Martin

    2016-01-01

    A unilateral tumour in the nasal cavity or paranasal sinuses is commonly caused by polyps, cysts, and mucoceles, as well as invasive tumours such as papillomas and squamous cell carcinomas. Schwannomas, in contrast, are rare lesions in this area (Minhas et al., 2013). We present a case of a 52-year-old female who presented with a 4-year progressive history of mucous hypersecretion, nasal obstruction, pain, and fullness. Imaging of the paranasal sinuses showed complete opacification of the entire left nasal cavity and sinuses by a tumour causing subsequent obstruction of the frontal and maxillary sinuses. The tumour was completely excised endoscopically. Histopathology was consistent with that of a schwannoma. PMID:27379190

  2. Facial demyelinating neuropathy caused by previous stereotactic irradiation to a vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Makoto; Kurita, Hiroki; Sasaki, Tomio [Tokyo Univ. (Japan). Faculty of Medicine

    1997-12-01

    This is a report of a vestibular schwannoma patient who received surgical treatment 8 months after stereotactic gamma knife irradiation. The previous irradiation caused facial demyelinating neuropathy of the facial nerve, and it made the identification and preservation of the nerve during subsequent microsurgery difficult. In the affected nerve segments, stimulation even to the exposed facial nerve evoked only attenuated response or no responses in electromyography. As a result, the flattened facial nerve located behind the tumor was indistinguishable. In order to prevent damage of the facial nerve, subcapsular tumor removal had to be performed at the demyelinated segments. This sequela of stereotactic irradiation should be considered when the irradiation is planned as a primary treatment modality of a vestibular schwannoma, in particular in young patients who will eventually receive another surgery afterwards. (author)

  3. Malignant schwannoma of the upper mediastinum originating from the vagus nerve

    Directory of Open Access Journals (Sweden)

    Nishiyama Kenichi

    2005-10-01

    Full Text Available Abstract Background Malignant schwannoma of the upper mediastinum originating from the vagus nerve is extremely rare. Case presentation A 46-year-old female was admitted for a left cervical mass which was associated with both hoarseness and Horner's syndrome. Chest computed tomography showed a mass extending from the left upper mediastinum to the left supraclavicular area. A fine needle aspiration cytological examination suggested primary lung cancer stage IIIB large cell carcinoma. After administering induction chemo-radiotherapy, a complete surgical resection was performed. The tumor was found to involve both the left vagus nerve and the left sympathetic nerve. Histological examination of the resected specimen revealed the tumor to be malignant schwannoma. Conclusion Despite incorrect preoperative diagnosis, the multimodality treatment administered in this case, including induction chemo-radiotherapy and surgery, proved to be effective.

  4. A report of three cases of surgical removal of esophageal schwannomas.

    Science.gov (United States)

    Chen, Xiankai; Li, Yin; Liu, Xianben; Fu, Huaiping; Sun, Haibo; Zhang, Ruixiang; Wang, Zongfei; Zheng, Yan

    2016-05-01

    Esophageal schwannomas are rarely observed, and the most frequent presenting symptom is dysphagia. In such cases, esophageal endoscopy shows a mucosal protrusion with normal esophageal mucosa. Esophagography shows a protruding smooth mass in the middle thoracic esophagus. Both fluorodeoxyglucose (FDG) positron emission tomography (PET) and endoscopic ultrasonography-fine needle aspiration (EUS-FNA) are limited for diagnosing the case. Diagnosis of this condition before surgery is difficult. The most common and effective treatment is enucleation through surgery or endoscopy. Thoracoscopic surgery is gradually becoming used more often, and the prognosis is particularly good. In comparison, thoracoscopy surgery is less invasive, with a shorter length of hospital stay, and reduced pain at the surgical wound site. Extended lymph node dissection was not performed. The positive expression of S-100 on immunohistochemistry examination indicates the nature of the schwannoma. In the present cases, the postoperative course was uneventful, and no evidence of recurrence has been noted. PMID:27162699

  5. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Gürel

    2012-12-01

    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  6. Repeated delayed onset cerebellar radiation injuries after linear accelerator-based stereotactic radiosurgery for vestibular schwannoma

    OpenAIRE

    Ujifuku, Kenta; Matsuo, Takayuki; Toyoda, Keisuke; Baba, Shiro; Okunaga, Tomohiro; Hayashi, Yukishige; Kamada, Kensaku; MORIKAWA, Minoru; Suyama, Kazuhiko; Nagata, Izumi; Hayashi, Nobuyuki

    2012-01-01

    A 63-year-old woman presented with right hearing disturbance and vertigo. Magnetic resonance (MR) imaging revealed the presence of right vestibular schwannoma (VS). Stereotactic radiosurgery (SRS) was performed with a tumor marginal dose of 14 Gy using two isocenters. She was followed up clinically and neuroradiologically using three-dimensional spoiled gradient-echo MR imaging. She experienced temporal neurological deterioration due to peritumoral edema in her right cerebellar peduncle and p...

  7. Mixed tumour of schwannoma and meningioma in a patient with neurofibromatosis-2 : a case report.

    Directory of Open Access Journals (Sweden)

    Elizabeth J

    2001-10-01

    Full Text Available The co-existence of schwannoma and meningioma as a mixed intracranial tumour is uncommon and so far only eight cases have been published in the literature. Because of rarity, we report a unique case of mixed tumour having schwann cell and meningeal components, in a patient with neurofibromatosis type -2 (NF-2. The possible mechanisms for the occurrence of these mixed tumours are discussed.

  8. Value of endoscopy of the internal auditory canal for microsurgery of intracanalicular vestibular schwannoma

    OpenAIRE

    Song, Shiwei

    2014-01-01

    Objective: The objective of this study was to evaluate the feasibility and efficiency of the endoscope-assisted technique in the surgical treatment of intracanalicular vestibular schwannoma (IVS). Methods: From May 2011 to October 2013, endoscope-assisted microneurosurgery (EAM) was applied on 24 patients undergoing IVS surgery via the retrosigmoid suboccipital approach. Bayonet rigid endoscopes with 0-, 30-and 70- degree lenses were used to inspect and guide the tumor dissection in the c...

  9. Expectant Management of Vestibular Schwannoma: A Retrospective Multivariate Analysis of Tumor Growth and Outcome

    OpenAIRE

    Hughes, Mark; Skilbeck, Christopher; Saeed, Shakeel; Bradford, Robert

    2011-01-01

    We conducted a retrospective observational study to assess the consequences of conservative management of vestibular schwannoma (VS). Data were collected from tertiary neuro-otological referral units in United Kingdom. The study included 59 patients who were managed conservatively with radiological diagnosis of VS. The main outcome measures were growth rate and rate of failure of conservative management. Multivariate analysis sought correlation between tumor growth and (i) demographic feature...

  10. Criteria of objectification diagnostics and indicators of quality of vestibular schwannoma surgical treatment

    OpenAIRE

    Pedachenko, Eugene; Skobska, Oksana; Malysheva, Aleksandra

    2016-01-01

    The article is sanctified to the problem of standardization and objectification diagnosis and the development of indicators of the quality of surgical treatment of patients with vestibular schwannomas (VS).Purpose. Objectification and standardization of diagnostic criteria and indicators of the quality of surgical treatment of patients with VS accordance to international standards.Materials and methods. Locations retro prospective analysis of complex examination results and treatment of 227 p...

  11. Asymmetry of balance responses to monaural galvanic vestibular stimulation in subjects with vestibular schwannoma

    OpenAIRE

    Welgampola, M. S.; Ramsay, E.; Gleeson, M. J.; Day, B. L.

    2013-01-01

    Objective We investigated the potential of galvanic vestibular stimulation (GVS) to quantify lateralised asymmetry of the vestibulospinal pathways by measuring balance responses to monaural GVS in 10 subjects with vestibular schwannoma and 22 healthy control subjects. Methods Subjects standing without vision were stimulated with 3 s, 1 mA direct current stimuli delivered monaurally. The mean magnitude and direction of the evoked balance responses in the horizontal plane were measured from gro...

  12. Vestibular function and quality of life in vestibular schwannoma: does size matter?

    Directory of Open Access Journals (Sweden)

    Judith eWagner

    2011-08-01

    Full Text Available Objectives. Patients with vestibular schwannoma (VS frequently suffer from disabling vestibular symptoms. This prospective follow-up study evaluates vestibular and auditory function and impairment of quality of life due to vertigo, dizziness and imbalance in patients with unilateral vestibular schwannoma of different sizes before/ after microsurgical or radiosurgical treatment. Methods. 38 patients with unilateral vestibular schwannoma were included. 22 received microsurgery, 16 cyberknife radiosurgery. Two follow-ups took place after a median of 50 and 186.5 days. Patients received a standardized neuro-ophthalmological examination, electronystagmography with bithermal caloric testing, and pure-tone audiometry. Quality of life was evaluated with the Dizziness Handicap Inventory (DHI. Patient data was grouped and analyzed according to the size of the VS (group 1: < 20mm vs group 2: ≥ 20mm. Results. In group 1, the median loss of vestibular function was +10.5% as calculated by Jongkees Formula (range –43;+52; group 2: median + 36%, range –56; +90. The median change of DHI scores was –9 in group 1 (range –68;30 and +2 in group 2 (–54;+20. Median loss of hearing was 4dB (-42;93 in group 1 and 12dB in group 2 (5;42.Conclusions. Loss of vestibular function in vestibular schwannoma clearly correlates with tumor size. However, loss of vestibular function was not strictly associated with a long-term deterioration of quality of life. This may be due to central compensation of vestibular deficits in long-standing large tumors. Loss of hearing before treatment was significantly influenced by the age of the patient but not by tumor size. At follow-up 1 and 2, hearing was significantly worse in those patients with a large VS and after microsurgical treatment.

  13. SU-E-T-536: Inhomogeneity Correction in Planning of Gamma Knife Treatments for Acoustic Schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Lu, L [Ohio State Univ, Columbus, OH (United States); Gupta, N [Ohio State University, Columbus, OH (United States); Hessler, J [University of Cincinnati, Cincinnati, OH (United States); Liu, A [Upper Arlington High School, Columbus, OH (United States); Weldon, M [Ohio State University, Columbus, OH (United States); McGregor, J [Ohio State University, Columbus, OH (United States); Ammirati, M [Ohio State University, Columbus, OH (United States); Guiou, M [Ohio State University, Columbus, OH (United States); Xia, F [Ohio State University, Columbus, OH (United States); Grecula, J [Ohio State University, Columbus, OH (United States)

    2014-06-01

    Purpose: To find out the dose difference on targets and organs at risk for the treatment of acoustic schwannoma if the inhomogeneity correction (Convolution algorithm) is applied. Methods: Images of patients treated for acoustic schwannoma with Gamma Knife using TMR 10 algorithm were retrieved from database and replanned with Convolution and TMR 10 algorithm respectively. These patients were treated using a preplan scheme in following: (1) Before the actual treatment day, using the MRI image that was taken without a head frame on the patient's skull, a pre-treatment plan was made based on the default skull coordinates in the Gamma Knife treatment planning system (LGP); (2) then on treatment day, a head frame was placed on the patient's skull, and a CT image was taken. The CT image with head frame was registered and fused with the completed preplan; (3) the treatment plan was finalized and the treatment was delivered. To find out the dosimetry impact of inhomogeneity correction, we used the retrieved CT images to replan the treatment using Convolution algorithm in LGP software version 10.1.1. The dose distributions and the dose volume histograms for targets and OARs were compared for these two dose calculation algorithms. Results: The dose calculated with the Convolution algorithm in general is slightly lower than the one from TMR 10 around the boney area. The effect from the inhomogeneity correction is observable but not significant, and varies with the location of the tumor. Conclusion: Inhomogeneity correction slightly improve the dose accuracy for acoustic schwannoma Gamma Knife treatments although the correction may not be very significant. Our Result provides evidence for dose prescription adjustment to treat acoustic schwannoma. The actual clinical outcome of switching from using TMR10 to using Convolution needs to be further investigated.

  14. Melanotic Schwannoma of the Cervical Spine Progressing With Pulmonary Metastasis: Case Report

    OpenAIRE

    Faria, Mário Henrique Girão; Dória-Netto, Ricardo Henrique; Osugue, Gustavo Jun; Queiroz, Luciano Souza; Chaddad-Neto, Feres Eduardo

    2013-01-01

    Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm. Only 10% of these tumors will undergo malignant degeneration, with exceedingly rare reported metastasis. We present a 32-year-old woman with a 6-month history of cervical pain and left arm progressive weakness. Neurological examination showed a left upper limb radicular pain, with pyramidal syndrome at C5 level. The magnetic resonance imaging (MRI) study highlighted an intradural extramedullary heterogeneous mass along ...

  15. The clinical characteristics and treatment for sudden sensorineural hearing loss with vestibular schwannoma.

    Science.gov (United States)

    Lin, Chang; Gong, Qilin; Zuo, Wenjing; Zhang, Rong; Zhou, Aidong

    2015-04-01

    The aim of this study is to analyze the clinical characteristics and treatment of sudden sensorineural hearing loss (SSNHL) patients with vestibular schwannoma (VS). The clinical features of the VS patients were explored by retrospectively analyzing the clinical data from 542 cases of SSNHL patients between January 2008 and March 2013. There were 10 cases (10 ears) diagnosed with VS in 542 cases of SSNHL patients (10 ears, 1.85 %), 3 males, 7 females, with a range of 28-57 years. Among all the cases, eight patients with abnormal ABR, ten with ear ipsilateral stapedius reflexes which were completely not elicited and seven patients with healthy ear contralateral stapedius reflexes which were completely not elicited. Neuromas were classified by Koos grades according to size (8 of grade I, 1 of grade II, 1 of grade IV). Eight small VS  patients were taken waiting and MRI therapy strategies. Meanwhile, we used glucocorticoid treatment and timely and short-term medication to improve the microcirculation of the inner ear for these patients. And four cases' hearing was improved. Some vestibular schwannomas have SSNHL as initial symptoms, especially the small ones in internal auditory canal. To prevent misdiagnosis or leak-diagnosis, MRI should be performed as a routine test for SSNHL, and ABR is sometimes necessary for SSNHL patients. It is also necessary to give appropriate treatment to protect hearing of the small vestibular schwannoma patients whose first symptoms are diagnosed as SSNHL in acute phase.

  16. Schwannoma of the 6th nerve: case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Xin Li; Jingjun Li; Jing Li; Zhen Wu

    2015-01-01

    Introduction: Schwannomas of the 6th nerve are extremely rare.Only 22 cases of intracranial schwannomas of the 6th cranial nerve pathologically confirmed have been reported.Case Presentation: Here, we report a case of a 14-year-old girl who presented with isolated progressive 6th nerve palsy.A cisternal type of schwannomawas found from neuro-imaging.Subtotal removal of the tumor was performed by a routine left subtemporal craniotomy with an petrosectomy.The attachment to the 6th nerve was found.After surgery, the patient's 6th nerve palsy remained.Histological images revealed a cellular schwannoma.Then the classification, clinical presentation, diagnosis, operation, stereotactic radiosurgery are reviewed.Conclusions: The location and the attachment to the 6th nerve is the key for diagnosis.Most cases are treated surgically.It looks like it is not easy to completely remove for CA type because of invasion of the cavernous sinus or firm adherence to the nerves.The 6th nerve function seldom completely recovered postoperatively.The direction of further research is to improve the diagnosis and therapy to have better nerve recovery.

  17. Detection of Spontaneous Schwannomas by MRI in a Transgenic Murine Model of Neurofibromatosis Type 2

    Directory of Open Access Journals (Sweden)

    S.M. Messerli

    2002-01-01

    Full Text Available Spontaneous schwannomas were detected by magnetic resonance imaging (MRI in a transgenic murine model of neurofibromatosis type 2 (NF2 expressing a dominant mutant form of merlin under the Schwann cell-specific PO promoter. Approximately 85% of the investigated mice showed putative tumors by 24 months of age. Specifically, 21% of the mice showed tumors in the intercostal muscles, 14% in the limb muscles, 7% in the spinal cord and spinal ganglia, 7% in the external ear, 14% in the muscle of the abdominal region, and 7% in the intestine; 66% of the female mice had uterine tumors. Multiple tumors were detected by MRI in 21% of mice. The tumors were isointense with muscle by T1-weighted MRI, showed strong enhancement following administration of gadolinium-DTPA, and were markedly hyperintense by T2-weighted MRI, all hallmarks of the clinical manifestation. Hematoxylin and eosin staining and immunohistochemistry indicated that the tumors consisted of schwannomas and Schwann cell hyperplasias. The lesions stained positively for S-100 protein and a marker antigen for the mutated transgenic NF2 protein, confirming that the imaged tumors and areas of hyperplasia were of Schwann cell origin and expressed the mutated NF2 protein. Tumors were highly infectable with a recombinant herpes simplex virus type 1 vector, hrR3, which contains the reporter gene, lacZ. The ability to develop schwannoma growth with a noninvasive imaging technique will allow assessment of therapeutic interventions.

  18. Comets in ancient India

    CERN Document Server

    Gupta, Patrick Das

    2014-01-01

    The Indo-aryans of ancient India observed stars and constellations for ascertaining auspicious times for sacrificial rites ordained by vedas. It is but natural that they would have recounted in the vedic texts about comets. In Rigveda ($\\sim $ 1700 - 1500 BC) and Atharvaveda ($\\sim $ 1150 BC), there are references to dhumaketus and ketus, which stand for comets in Sanskrit. Varahamihira in 550 AD and Ballala Sena ($\\sim $ 1100 - 1200 AD) have described a large number of comets recorded by ancient seers such as Parashara, Vriddha Garga, Narada, Garga, etc. In this article, I conjecture that an episode narrated in Mahabharata of a radiant king, Nahusha, ruling the heavens, and later turning into a serpent after he had kicked the seer Agastya (also the star Canopus), is a mythological retelling of a cometary event.

  19. Ancient human microbiomes

    Science.gov (United States)

    Warinner, Christina; Speller, Camilla; Collins, Matthew J.; Lewis, Cecil M.

    2015-01-01

    Very recently, we discovered a vast new microbial self: the human microbiome. Our native microbiota interface with our biology and culture to influence our health, behavior, and quality of life, and yet we know very little about their origin, evolution, or ecology. With the advent of industrialization, globalization, and modern sanitation, it is intuitive that we have changed our relationship with microbes, but we have little information about the ancestral state of our microbiome, and therefore, we lack a foundation for characterizing this change. High-throughput sequencing has opened up new opportunities in the field of paleomicrobiology, allowing us to investigate the evolution of the complex microbial ecologies that inhabit our bodies. By focusing on recent coprolite and dental calculus research, we explore how emerging research on ancient human microbiomes is changing the way we think about ancient disease and how archaeological studies can contribute to a medical understanding of health and nutrition today. PMID:25559298

  20. Premature termination of SMARCB1 translation may be followed by reinitiation in schwannomatosis-associated schwannomas, but results in absence of SMARCB1 expression in rhabdoid tumors

    NARCIS (Netherlands)

    Hulsebos, T.J.M.; Kenter, S.; Verhagen, W.I.; Baas, F.; Flucke, U.E.; Wesseling, P.

    2014-01-01

    In schwannomatosis, germline SMARCB1 mutations predispose to the development of multiple schwannomas, but not vestibular schwannomas. Many of these are missense or splice-site mutations or in-frame deletions, which are presumed to result in the synthesis of altered SMARCB1 proteins. However, also no

  1. Benign paroxysmal torticollis in infancy

    Directory of Open Access Journals (Sweden)

    Dimitrijević Lidija

    2006-01-01

    Full Text Available Background. Benign paroxysmal torticollis (BPT is an episodic functional disorder of unknown etiology, characterized by the periods of torticollic posturing of the head, that occurs in the early months of life in healthy children. Case report. We reported two patients with BPT. In the first patient the symptoms were observed at the age of day 20, and disappeared at the age of 3 years. There were 10 episodes, of which 2 were followed by vomiting, pallor, irritability and the abnormal trunk posture. In the second patient, a 12-month-old girl, BPT started from day 15. She had 4 episodes followed by vomiting in the first year. Both girls had the normal psychomotor development. All diagnostical tests were normal. Conclusion. The recognition of BPT, as well as its clinical course may help to avoid not only unnecessary tests and the treatment, but also the anxiety of the parents.

  2. Benign fibroxanthoma of the mandible

    Directory of Open Access Journals (Sweden)

    L Zouloumis

    2011-01-01

    Full Text Available Histiocytomas constitute a large group of tumors, the classification of which created a lot of confusion in the past. For this reason, various attempts were carried out during the last years so that a widely accepted classification system could be defined. Fibroxanthomas, according to contemporary data, are classified into benign histiocytomas and they are mostly located at the skin of extremities. They are rarely localized in the area of the head and neck, where they are found commonly in soft tissue. Fibroxanthomas located at the bones of oral and maxillofacial region are extremely rare. The purpose of this paper is to present a case of a fibroxanthoma located at the mandible as well as to analyze the histological findings of the lesion on which the diagnosis and differential diagnosis were based.

  3. Benign communicating hydrocephalus in children

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, B.; Holland, I.

    1981-03-01

    A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have mengalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.

  4. Design of environmentally benign processes

    DEFF Research Database (Denmark)

    Hostrup, Martin; Harper, Peter Mathias; Gani, Rafiqul

    1999-01-01

    This paper presents a hybrid method for design of environmentally benign processes. The hybrid method integrates mathematical modelling with heuristic approaches to solving the optimisation problems related to separation process synthesis and solvent design and selection. A structured method...... of solution, which employs thermodynamic insights to reduce the complexity and size of the mathematical problem by eliminating redundant alternatives, has been developed for the hybrid method. Separation process synthesis and design problems related to the removal of a chemical species from process streams...... because of environmental constraints are particularly suited for solution with the hybrid method. Application of the hybrid method is highlighted through two illustrative examples. The first example involves the determination of an optimal flowsheet for the removal of a chemical species from an azeotropic...

  5. [HYPOFRACTIONATED RADIOSURGERY FOR BENIGN BRAIN LESIONS--THE BEST OF ALL WORLDS].

    Science.gov (United States)

    Cohen-Inbar, Or

    2016-05-01

    Despite advances in neurosurgical technique, postoperative morbidity continues to taint open complete removal of many benign cranial base tumors (meningioma, pituitary adenomas, schwannomas). The incidence of temporary and permanent cranial nerve deficits is reported to be as high as 44% and 56% respectively, with postoperative mortality rates as high as 9%. As a consequence, many neurosurgeons choose to perform partial resections in order to preserve neurological functions. Progression rates after partial removal of a meningioma with no radiosurgery have been reported to be as high as 70%, compared to > 90% post-radiosurgical progression free survival rates. This resulted in a change of paradigms from an attempted radical resection to a combined neurosurgical-radiosurgical approach due to the high surgical morbidity the former entails. Radiosurgery has traditionally been used to treat lesions dose to the tumor while maintaining a tolerable dose to the optic apparatus. Fractionated Radiosurgery (Temporal or spatial fractionation) may help overcome these limitations associated with larger volume target and dose fall-off. It should be considered in patients with sellar, parasellar or para-acoustic tumors involving major vasculature or when there is broad contact with the optic apparatus or cranial nerves. Fractionated radiosurgery offers a substantial reduction in radiation-related toxicity and with maintaining high tumor control rates. PMID:27526562

  6. Foramen magnum schwannoma: review of the literature and report of a case; Schwannoma do forame magno: revisao e relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Nacif, Marcelo Souto; Caiado, Stella; Oliveira, Nidia di Paula Silva; Paula Neto, Walter Teixeira de [Fundacao Educacional Serra dos Orgaos, Teresopolis, RJ (Brazil). Centro de Ciencias Biomedicas. Faculdade de Medicina de Teresopolis]. E-mail: marcelonacif30@hotmail.com; Mello, Ricardo Andrade Fernandes de [Universidade Federal, Rio de Janeiro, RJ (brazil). Faculdade de Medicina. Dept. de Radiologia; Jauregui, Gustavo Federico [Hospital Geral de Bonsucesso, Rio de Janeiro, RJ (Brazil); Campos, Flavio do Amaral [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Servico de Radiologia; Santos, Alair Augusto Sarmet Moreira Damas dos [Instituto de Pos-graduacao Medica Carlos Chagas (IPGMCC), Niteroi, RJ (Brazil). Curso de Pos-graduacao em Radiologia

    2001-02-01

    The authors report an unusual presentation of a voluminous neck schwannoma in a 53-year-old female that presented with a three-year history of progressive weakness associated with impaired movement of the limbs. Neurological examination revealed postural instability, unstable and paraparetic gait, tetraparesis and dyspnea. A preoperative magnetic resonance imaging of the neck revealed an expansive, extradural, well-circumscribed lesion, with soft-tissue attenuation, at the level of C1-C2 vertebral bodies. During surgery, the tumor was found to be extradural, lateral to the cervical spinal cord, attached to the C1 left nerve root and extending upwards through the foramen magnum. Histopathological analysis of the resected specimen confirmed the diagnosis of schwannoma. The patient showed a favorable outcome with progressive improvement of the symptoms. Magnetic resonance imaging proved to be valuable in the detection and evaluation of the lesion, although the definite diagnosis was achieved only after histopathological studies. We concluded that magnetic resonance imaging for early diagnosis and prompt surgical resection seems to be the best approach to achieve good prognosis. (author)

  7. Suicide in ancient Greece.

    Science.gov (United States)

    Laios, K; Tsoukalas, G; Kontaxaki, M-I; Karamanou, M; Androutsos, G

    2014-01-01

    The theme of suicide appears several times in ancient Greek literature. However, each such reference acquires special significance depending on the field from which it originates. Most of the information found in mythology, but the suicide in a mythological tale, although in terms of motivation and mental situation of heroes may be in imitation of similar incidents of real life, in fact is linked with the principles of the ancient Greek religion. In ancient drama and mainly in tragedies suicide conduces to the tragic hypostasis of the heroes and to the evolution of the plot and also is a tool in order to be presented the ideas of poets for the relations of the gods, the relation among gods and men and the relation among the men. In ancient Greek philosophy there were the deniers of suicide, who were more concerned about the impact of suicide on society and also these who accepted it, recognizing the right of the individual to put an end to his life, in order to avoid personal misfortunes. Real suicides will be found mostly from historical sources, but most of them concern leading figures of the ancient world. Closer to the problem of suicide in the everyday life of antiquity are ancient Greek medicines, who studied the phenomenon more general without references to specific incidents. Doctors did not approve in principal the suicide and dealt with it as insane behavior in the development of the mental diseases, of melancholia and mania. They considered that the discrepancy of humors in the organ of logic in the human body will cause malfunction, which will lead to the absurdity and consequently to suicide, either due to excessive concentration of black bile in melancholia or due to yellow bile in mania. They believed that greater risk to commit suicide had women, young people and the elderly. As therapy they used the drugs of their time with the intention to induce calm and repression in the ill person, therefore they mainly used mandragora. In general, we would say

  8. Suicide in ancient Greece.

    Science.gov (United States)

    Laios, K; Tsoukalas, G; Kontaxaki, M-I; Karamanou, M; Androutsos, G

    2014-01-01

    The theme of suicide appears several times in ancient Greek literature. However, each such reference acquires special significance depending on the field from which it originates. Most of the information found in mythology, but the suicide in a mythological tale, although in terms of motivation and mental situation of heroes may be in imitation of similar incidents of real life, in fact is linked with the principles of the ancient Greek religion. In ancient drama and mainly in tragedies suicide conduces to the tragic hypostasis of the heroes and to the evolution of the plot and also is a tool in order to be presented the ideas of poets for the relations of the gods, the relation among gods and men and the relation among the men. In ancient Greek philosophy there were the deniers of suicide, who were more concerned about the impact of suicide on society and also these who accepted it, recognizing the right of the individual to put an end to his life, in order to avoid personal misfortunes. Real suicides will be found mostly from historical sources, but most of them concern leading figures of the ancient world. Closer to the problem of suicide in the everyday life of antiquity are ancient Greek medicines, who studied the phenomenon more general without references to specific incidents. Doctors did not approve in principal the suicide and dealt with it as insane behavior in the development of the mental diseases, of melancholia and mania. They considered that the discrepancy of humors in the organ of logic in the human body will cause malfunction, which will lead to the absurdity and consequently to suicide, either due to excessive concentration of black bile in melancholia or due to yellow bile in mania. They believed that greater risk to commit suicide had women, young people and the elderly. As therapy they used the drugs of their time with the intention to induce calm and repression in the ill person, therefore they mainly used mandragora. In general, we would say

  9. Benign paroxysmal positional vertigo in Parkinson's disease

    NARCIS (Netherlands)

    Wensen, E. van; Leeuwen, R.B. van; Zaag-Loonen, H.J. van der; Masius-Olthof, S.; Bloem, B.R.

    2013-01-01

    BACKGROUND: Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. AIM: To assess the prevalence of benign paroxysmal

  10. Dance in Ancient Greek Culture

    OpenAIRE

    Spalva, Rita

    2015-01-01

    The greatness and harmony of ancient Greece has had an impact upon the development of the Western European culture to this day. The ancient Greek culture has influenced contemporary literature genres and systems of philosophy, principles of architecture, sculpture and drama and has formed basis for such sciences as astronomy and mathematics. The art of ancient Greece with its penchant for beauty and clarity has been the example of the humanity’s search for an aesthetic ideal. Despite only bei...

  11. Climate and Ancient Societies

    DEFF Research Database (Denmark)

    Climate, and human responses to it, have a strongly interconnected relationship. This when climate change occurs, the result of either natural or human causes, societies should react and adapt to these. But do they? If so, what is the nature of that change, and are the responses positive...... or negative for the long-term survival of social groups? In this volume, scholars from diverse disciplines including archaeology, geology and climate sciences explore scientific and material evidence for climate changes in the past, their causes, their effects on ancient societies and how those societies...

  12. Mathematics in ancient Greece

    CERN Document Server

    Dantzig, Tobias

    2006-01-01

    More than a history of mathematics, this lively book traces mathematical ideas and processes to their sources, stressing the methods used by the masters of the ancient world. Author Tobias Dantzig portrays the human story behind mathematics, showing how flashes of insight in the minds of certain gifted individuals helped mathematics take enormous forward strides. Dantzig demonstrates how the Greeks organized their precursors' melange of geometric maxims into an elegantly abstract deductive system. He also explains the ways in which some of the famous mathematical brainteasers of antiquity led

  13. Ancient concrete works

    CERN Document Server

    Sparavigna, Amelia Carolina

    2011-01-01

    It is commonly believed that the ancient Romans were the first to create and use concrete. This is not true, as we can easily learn from the Latin literature itself. For sure, Romans were able to prepare high-quality hydraulic cements, comparable with the modern Portland cements. In this paper, we will see that the use of concrete is quite older, ranging back to the Homeric times. For instance, it was used for the floors of some courts and galleries of the Mycenaean palace at Tiryns

  14. Recurrent Benign Salivary Gland Neoplasms.

    Science.gov (United States)

    Witt, Robert Lee; Nicolai, Piero

    2016-01-01

    The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions. However, surgery alone may be inadequate for controlling RPA over the long term. There is growing evidence from retrospective series that postoperative radiotherapy results in significantly better local control. A high percentage of RPAs are incurable. All patients should therefore be informed about the possibility of needing multiple treatment procedures, with possible impairment of facial nerve function, and radiation therapy for RPA. Reappearance of Warthin tumor is a metachronous occurrence of a new focus or residual incomplete excision of all primary multicentric foci of Warthin tumor. Selected cases can be observed. Conservative surgical management can include partial superficial parotidectomy or extracapsular dissection. Not uncommonly, other major and minor salivary gland neoplasms, including myoepithelioma, basal cell adenoma, oncocytoma, canalicular adenoma, cystadenoma, and ductal papilloma, follow an indolent course after surgical resection, with rare cases of recurrence.

  15. Nocturia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Laketić Darko

    2008-01-01

    Full Text Available Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH. The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.

  16. Exploring Ancient Skies A Survey of Ancient and Cultural Astronomy

    CERN Document Server

    Kelley, David H

    2011-01-01

    Exploring Ancient Skies brings together the methods of archaeology and the insights of modern astronomy to explore the science of astronomy as it was practiced in various cultures prior to the invention of the telescope. The book reviews an enormous and growing body of literature on the cultures of the ancient Mediterranean, the Far East, and the New World (particularly Mesoamerica), putting the ancient astronomical materials into their archaeological and cultural contexts. The authors begin with an overview of the field and proceed to essential aspects of naked-eye astronomy, followed by an examination of specific cultures. The book concludes by taking into account the purposes of ancient astronomy: astrology, navigation, calendar regulation, and (not least) the understanding of our place and role in the universe. Skies are recreated to display critical events as they would have appeared to ancient observers—events such as the supernova of 1054 A.D., the "lion horoscope," and the Star of Bethlehem. Explori...

  17. A Case of Action-Induced Clonus that Mimicked Action Tremors and was Associated with Cervical Schwannoma

    Directory of Open Access Journals (Sweden)

    Young-Hee Sung

    2010-10-01

    Full Text Available Clonus is the rhythmic muscle contraction which usually occurs in patients with lesions involving descending motor pathways. Sometimes, rhythmic oscillation of action induced clonus could be confused to action tremor. We report a case of action induced clonus associated with cervical schwannoma which was misdiagnosed as essential tremor. The patient had spasticity in all limbs with exaggerated tendon reflexes, and passive stretch-induced clonus. Imaging and histological examinations revealed a schwannoma extending from C2 to C7. The lesion was partially removed by surgery. Even though essential tremor is a common disease, clinician have to do sufficient neurologic examination considering differential diagnosis.

  18. [Benign prostatic hyperplasia: background and diagnosis].

    Science.gov (United States)

    Gratzke, C; Schlenker, B; Weidlich, P; Seitz, M; Reich, O; Stief, C G

    2007-08-16

    Lower UrinaryTracts Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) represent an increasing prevalent condition in ageing men. Patients often seek primarily consultation at their general practitioner. Aetiology and natural history of LUTS due to BPH have not been completely clarified. The development of symptomatic LUTS is age-dependent and determined to varying degrees by the presence of Benign Prostatic Hyperplasia (BPH), Benign Prostatic Enlargement (BPE) as well as Bladder Outlet Obstruction (BOO). A causal relationship does not always exist. Basis for a specific medical or surgical treatment in the individual patient with LUTS due to BPH is an exact diagnosis by the practising urologist. PMID:17912862

  19. Horizontal Canal Benign Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  20. Authenticity in ancient DNA studies

    DEFF Research Database (Denmark)

    Gilbert, M Thomas P; Willerslev, Eske

    2006-01-01

    Ancient DNA studies represent a powerful tool that can be used to obtain genetic insights into the past. However, despite the publication of large numbers of apparently successful ancient DNA studies, a number of problems exist with the field that are often ignored. Therefore, questions exist as ...

  1. Tamil merchant in ancient Mesopotamia.

    Directory of Open Access Journals (Sweden)

    Malliya Gounder Palanichamy

    Full Text Available Recent analyses of ancient Mesopotamian mitochondrial genomes have suggested a genetic link between the Indian subcontinent and Mesopotamian civilization. There is no consensus on the origin of the ancient Mesopotamians. They may be descendants of migrants, who founded regional Mesopotamian groups like that of Terqa or they may be merchants who were involved in trans Mesopotamia trade. To identify the Indian source population showing linkage to the ancient Mesopotamians, we screened a total of 15,751 mitochondrial DNAs (11,432 from the literature and 4,319 from this study representing all major populations of India. Our results although suggest that south India (Tamil Nadu and northeast India served as the source of the ancient Mesopotamian mtDNA gene pool, mtDNA of these ancient Mesopotamians probably contributed by Tamil merchants who were involved in the Indo-Roman trade.

  2. Tamil merchant in ancient Mesopotamia.

    Science.gov (United States)

    Palanichamy, Malliya Gounder; Mitra, Bikash; Debnath, Monojit; Agrawal, Suraksha; Chaudhuri, Tapas Kumar; Zhang, Ya-Ping

    2014-01-01

    Recent analyses of ancient Mesopotamian mitochondrial genomes have suggested a genetic link between the Indian subcontinent and Mesopotamian civilization. There is no consensus on the origin of the ancient Mesopotamians. They may be descendants of migrants, who founded regional Mesopotamian groups like that of Terqa or they may be merchants who were involved in trans Mesopotamia trade. To identify the Indian source population showing linkage to the ancient Mesopotamians, we screened a total of 15,751 mitochondrial DNAs (11,432 from the literature and 4,319 from this study) representing all major populations of India. Our results although suggest that south India (Tamil Nadu) and northeast India served as the source of the ancient Mesopotamian mtDNA gene pool, mtDNA of these ancient Mesopotamians probably contributed by Tamil merchants who were involved in the Indo-Roman trade. PMID:25299580

  3. Schwannoma de plexo braquial en el diagnóstico diferencial del hombro doloroso: Diferential diagnostic in the shoulder pain Brachial plexus schwannoma

    OpenAIRE

    Cortés, S.; A. Orts; R. García-Rayo; F. Pérez-Cerdá; J. Gómez de Tojeiro

    2006-01-01

    Los schwannomas son tumores derivados de las células de Schwann, infrecuentes y generalmente de comportamiento benigno. El dolor y la radiculopatía son los síntomas iniciales más frecuentes. El diagnóstico se realiza mediante resonancia magnética y la resección quirúrgica es el tratamiento de elección. Presentamos el caso de una paciente de 50 años con omalgia atraumática izquierda de 5 años de evolución, durante los cuáles fue valorada por diferentes especialistas que incluían traumatólogos,...

  4. Schwannoma do forame magno: revisão e relato de caso Foramen magnum schwannoma: review of the literature and report of a case

    Directory of Open Access Journals (Sweden)

    Marcelo Souto Nacif

    2005-02-01

    Full Text Available Os autores relatam um volumoso schwannoma cervical de apresentação incomum, numa paciente do sexo feminino, 53 anos de idade, que em fevereiro de 2002 apresentou queixa de fraqueza progressiva, iniciada há três anos, com dificuldade de mobilização das pernas e braços. Antes da cirurgia foi realizada ressonância magnética da região cervical. No exame físico apresentava postura com aumento da base de sustentação, marcha instável e paraparética, além de diminuição da força nos quatro membros, maior à esquerda, associada a dispnéia. Na ressonância magnética cervical evidenciou-se lesão expansiva extramedular de limites bem definidos, na altura de C1 e C2. Na cirurgia, o volumoso tumor encontrava-se ântero-lateralmente à medula, aderido à raiz esquerda de C1, estendendo-se superiormente através do forame magno, com localização extradural. O diagnóstico de schwannoma foi confirmado pela histopatologia. A paciente evoluiu satisfatoriamente, com melhora progressiva da hemiparesia e hemiparestesia esquerda. A ressonância magnética possibilita a detecção e avaliação da lesão, porém o diagnóstico definitivo só é feito com o exame histopatológico. Dessa forma, o diagnóstico precoce através da ressonância magnética e a exérese cirúrgica tornam-se a melhor forma de abordagem, com bom prognóstico.The authors report an unusual presentation of a voluminous neck schwannoma in a 53-year-old female that presented with a three-year history of progressive weakness associated with impaired movement of the limbs. Neurological examination revealed postural instability, unstable and paraparetic gait, tetraparesis and dyspnea. A preoperative magnetic resonance imaging of the neck revealed an expansive, extradural, well-circumscribed lesion, with soft-tissue attenuation, at the level of C1-C2 vertebral bodies. During surgery, the tumor was found to be extradural, lateral to the cervical spinal cord, attached to the C1 left

  5. Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States.

    Science.gov (United States)

    Carlson, Matthew L; Glasgow, Amy E; Grossardt, Brandon R; Habermann, Elizabeth B; Link, Michael J

    2016-09-01

    The management of small- to medium-sized vestibular schwannoma (VS) remains controversial. Despite a lack of compelling evidence supporting one treatment modality over others, many providers and institutions remain highly biased toward one particular therapy-microsurgery, radiation, or primary observation. The objective of the current study was to estimate the impact of geography on disease presentation and initial treatment of VS in the United States. An analysis of the Surveillance, Epidemiology, and End Results (SEER) database identified 9761 patients with VS that were managed across the 16 SEER geographic registry areas. Univariate analyses demonstrated strong associations between geographic location and tumor size at diagnosis (P therapy over others, multidisciplinary consultation with a minimum of a neurotologist, neurosurgeon, and radiation oncologist or radiosurgeon should be offered in order to provide balanced counseling and accurate informed consent. PMID:27334903

  6. Vestibular schwannoma (acoustic neuroma mimicking temporomandibular disorders: a case report Schwannoma vestibular (neurinoma do acústico imitando desordens temporomandibulares: um relato de caso

    Directory of Open Access Journals (Sweden)

    Maurício A. Bisi

    2006-12-01

    Full Text Available Approximately 6 to 16% of patients with trigeminal neuralgia symptoms present intracranial tumors, the most common being the vestibular schwannoma (acoustic neuroma. Some symptoms reported by patients include hearing loss, tinnitus, headaches, vertigo and trigeminal disturbances. An increased muscle response in the surrounding head and neck musculature may also be observed, which mimics signs and symptoms of temporomandibular disorders. In these cases, magnetic resonance imaging (MRI has proved to be a useful tool in tumor diagnosis. The differential diagnosis between myofascial and neuralgic pain is important, as both may present similar characteristics, while being of different origin, and demanding special treatment approaches. The purpose of this paper is to demonstrate the relationship among trigeminal neuralgia symptoms, intracranial tumors and temporomandibular dysfunction by presenting a clinical case.Aproximadamente 6 a 16% dos pacientes com sintomas de neuralgia trigeminal apresentam tumores intracranianos, sendo mais comum o schwannoma vestibular (neurinoma do acústico. Alguns sintomas relatados pelos pacientes são perda da audição, zumbido, dores de cabeça, vertigens e distúrbios trigeminais. Uma resposta muscular aumentada na musculatura associada da cabeça e do pescoço também pode ser observada, o que pode mimetizar sinais e sintomas de desordens temporomandibulares. Nestes casos é de grande valia o uso de imagem de ressonância magnética (IRM para detecção de tumores. É importante, também, a diferenciação de dores miofasciais e neurálgicas, pois ambas podem apresentar características semelhantes, mas com origens e tratamentos diferentes. O objetivo desse trabalho foi demonstrar através de relato de caso clínico a associação entre sintomas de neuralgia trigeminal, tumores intracranianos e disfunção temporomandibular.

  7. Benign Lesions of The Vocal Fold

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  8. Intra-abdominal benign multicystic peritoneal mesothelioma.

    Science.gov (United States)

    Jouvin, I; Dohan, A; Gergi, P; Pocard, M

    2014-04-01

    Benign multicystic peritoneal mesotheliomas are rare: pre-operative diagnosis relies on proper imaging. The differential diagnosis includes pseudomyxoma peritonei and other peritoneal cysts. Absence of previous surgical resection offers the best chance of success when complete resection is performed in a specialized center. We report the case of a 43 year-old man with benign multicystic peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. PMID:24433857

  9. Current treatment of benign biliary strictures

    OpenAIRE

    Costamagna, Guido; Boškoski, Ivo

    2013-01-01

    Endoscopy is a widely used approach for the treatment of benign biliary strictures. Most common benign biliary strictures amandable to endoscopic treatment are post-cholecystectomy, dominant biliary strictures due to primary sclerosing cholangitis, biliary anastomotic strictures occurring after liver transplantation, and common bile duct strictures due to chronic pancreatitis. Surgery is a valid option in cases of complete transection or ligation of the common bile duct, in selected patients ...

  10. Sciatica from a Foraminal Lumbar Root Schwannoma: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2012-01-01

    This case report describes lumbar foraminal schwannoma as an unusual cause of radiculopathy, presenting clinically as a lumbar disc prolapse. The diagnosis was confirmed on MRI scan. Patient had complete symptomatic recovery following surgical enucleation of the tumour mass from the L5 nerve root. This case report is of particular interest as it highlights the diagnostic confusion, which is bound to arise, because the clinical presentation closely mimics a lumbar PID. This often leads to delay in diagnosis and “failure of conservative treatment.”

  11. Schwannoma del nervio facial intraparotídeo. Un dilema terapéutico

    Directory of Open Access Journals (Sweden)

    Paula Barba-Recreo

    2015-07-01

    Full Text Available Los schwannomas del nervio facial intraparotídeos son tumores benignos poco frecuentes, suponiendo frecuentemente un reto diagnóstico y terapéutico. La mayoría de los pacientes presentan una masa parotídea asintomática y las pruebas de imagen y la punción con aguja fina no suelen ser concluyentes en el diagnóstico. Tras la revisión de la literatura a propósito de un caso, pretendemos proporcionar cierta guía para el tratamiento de esta rara patología.

  12. Stereotactic radiosurgery in the management of vestibular schwannoma and glomus jugulare: indications, techniques, and results.

    Science.gov (United States)

    Jacob, Jeffrey T; Pollock, Bruce E; Carlson, Matthew L; Driscoll, Colin L W; Link, Michael J

    2015-06-01

    Gamma Knife stereotactic radiosurgery (GKS) has become an important management strategy for an increasing number of patients with skull base tumors. For select patients with lateral skull base disorders, given the proximity to sensitive critical structures such as the brainstem, cranial nerves, and cochlea, this technology has emerged as a first-line treatment to achieve the paramount goals of long-term tumor control and maintenance of existing neurologic function. This article reviews the indications, technique, and results of GKS for the treatment of vestibular schwannoma and glomus jugulare tumors, and highlights our experience in treating these tumors at the Mayo Clinic. PMID:25873444

  13. Ancient Chinese Sundials

    Science.gov (United States)

    Deng, Kehui

    Timekeeping was essential in the agricultural society of ancient China. The use of sundials for timekeeping was associated with the use of the gnomon, which had its origin in remote antiquity. This chapter studies three sundials (guiyi 晷仪) from the Qin and Han dynasties, the shorter shadow plane sundial (duanying ping yi 短影平仪) invented by Yuan Chong in the Sui Dynasty, and the sundial chart (guiyingtu 晷影图) invented by Zeng Minxing in the Southern Song dynasty. This chapter also introduces Guo Shoujing's hemispherical sundial (yang yi 仰仪). A circular stone sundial discovered at the Small Wild Goose Pagoda in Xi'an is also mentioned. It is dated from the Sui and Tang dynasties. A brief survey of sundials from the Qing dynasty shows various types of sundials.

  14. Predictors of future growth of sporadic vestibular schwannomas obtained by history and radiologic assessment of the tumor.

    NARCIS (Netherlands)

    Artz, J.C.; Timmer, F.C.A.; Mulder, J.J.S.; Cremers, C.W.R.J.; Graamans, K.

    2009-01-01

    Management of a sporadic vestibular schwannoma (VS) is still a subject of controversy, mainly due to distinct and unpredictable growth patterns. To embark on an appropriate therapy it is necessary to dispose of a reliable prediction about tumor progression. This study aims to design a risk profile w

  15. Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient's perspective.

    NARCIS (Netherlands)

    Timmer, F.C.A.; Haren, A.E. van; Mulder, J.J.S.; Hanssens, P.E.; Overbeeke, J.J. van; Cremers, C.W.R.J.; Graamans, K.

    2010-01-01

    This study evaluates the impact of gamma knife radiosurgery (GKRS) on the quality of life (QOL) of patients with a sporadic vestibular schwannoma (VS). This study pertains to 108 VS patients who had GKRS in the years 2003 through 2007. Two different QOL questionnaires were used: medical outcome stud

  16. The effect of bevacizumab on vestibular schwannoma tumour size and hearing in patients with neurofibromatosis type 2

    DEFF Research Database (Denmark)

    Alanin, Mikkel Christian; Klausen, Camilla; Caye-Thomasen, Per;

    2015-01-01

    The hallmark of neurofibromatosis type 2 (NF2) is bilateral vestibular schwannomas (VS) and severe hearing loss is common in NF2 patients. Vascular endothelial growth factor (VEGF) expression level in NF2 correlates with tumour growth rate and bevacizumab, a VEGF-binding antibody, has previously...

  17. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Harun Kütahya

    2013-01-01

    Full Text Available Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%. They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography, MRI (magnetic resonance imagination, and USG (ultrasound are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.

  18. A Giant Intrathoracic Malignant Schwannoma Causing Respiratory Failure in a Patient without von Recklinghausen’s Disease

    OpenAIRE

    Angelopoulos, Epameinondas; Eleftheriou, Konstantinos; Kyriakopoulos, Georgios; Athanassiadi, Kalliopi; Rontogianni, Dimitra; Routsi, Christina

    2016-01-01

    We report an unusual case of a thoracic opacity due to a huge mediastinal malignant schwannoma which compressed the whole left lung and the mediastinum causing respiratory failure in a 73-year-old woman without von Recklinghausen's disease. Although the tumor was resected, the patient failed to wean from mechanical ventilation and died one month later because of multiple organ dysfunction syndrome.

  19. Germline loss-of-function mutations in LZTR1 predispose to an inherited disorder of multiple schwannomas.

    Science.gov (United States)

    Piotrowski, Arkadiusz; Xie, Jing; Liu, Ying F; Poplawski, Andrzej B; Gomes, Alicia R; Madanecki, Piotr; Fu, Chuanhua; Crowley, Michael R; Crossman, David K; Armstrong, Linlea; Babovic-Vuksanovic, Dusica; Bergner, Amanda; Blakeley, Jaishri O; Blumenthal, Andrea L; Daniels, Molly S; Feit, Howard; Gardner, Kathy; Hurst, Stephanie; Kobelka, Christine; Lee, Chung; Nagy, Rebecca; Rauen, Katherine A; Slopis, John M; Suwannarat, Pim; Westman, Judith A; Zanko, Andrea; Korf, Bruce R; Messiaen, Ludwine M

    2014-02-01

    Constitutional SMARCB1 mutations at 22q11.23 have been found in ∼50% of familial and schwannomatosis cases. We sequenced highly conserved regions along 22q from eight individuals with schwannomatosis whose schwannomas involved somatic loss of one copy of 22q, encompassing SMARCB1 and NF2, with a different somatic mutation of the other NF2 allele in every schwannoma but no mutation of the remaining SMARCB1 allele in blood and tumor samples. LZTR1 germline mutations were identified in seven of the eight cases. LZTR1 sequencing in 12 further cases with the same molecular signature identified 9 additional germline mutations. Loss of heterozygosity with retention of an LZTR1 mutation was present in all 25 schwannomas studied. Mutations segregated with disease in all available affected first-degree relatives, although four asymptomatic parents also carried an LZTR1 mutation. Our findings identify LZTR1 as a gene predisposing to an autosomal dominant inherited disorder of multiple schwannomas in ∼80% of 22q-related schwannomatosis cases lacking mutation in SMARCB1. PMID:24362817

  20. Gamma knife radiosurgery for vestibular schwannomas: results of hearing preservation in relation to the cochlear radiation dose.

    NARCIS (Netherlands)

    Timmer, F.C.A.; Hanssens, P.E.; Haren, A.E. van; Mulder, J.J.S.; Cremers, C.W.R.J.; Beynon, A.J.; Overbeeke, J.J. van; Graamans, K.

    2009-01-01

    OBJECTIVES/HYPOTHESIS: This study was designed to evaluate hearing preservation after gamma knife radiosurgery (GKRS) and to determine the relation between hearing preservation and cochlear radiation dose in patients with a sporadic vestibular schwannoma (VS). METHODS: Prospective study involving pa

  1. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease.

    Science.gov (United States)

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-05-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status.

  2. Long-term mobile phone use and the risk of vestibular schwannoma: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Schüz, Joachim; Steding-Jessen, Marianne; Hansen, Søren;

    2011-01-01

    Vestibular schwannomas grow in the region within the brain where most of the energy by radiofrequency electromagnetic fields from using mobile phones is absorbed. The authors used 2 Danish nationwide cohort studies, one a study of all adult Danes subscribing for a mobile phone in 1995 or earlier ...

  3. Thallium chloride 201Tl combined with single photon emission computed tomography (SPECT) in the evaluation of vestibular schwannoma growth

    DEFF Research Database (Denmark)

    Charabi, Samih Ahmed; Lassen, N A; Thomsen, J;

    1997-01-01

    Thallium chloride 201Tl combined with SPECT was performed in a series of 29 patients with neuroradiological evidence of vestibular schwannoma (VS). The relative tumor uptake (U) and relative tumor concentration (C) of the radiotracer 201Tl was determined, and the cerebellum served as a reference....

  4. Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study.

    NARCIS (Netherlands)

    Meijer, O.W.M.; Vandertop, W.P.; Baayen, J.C.; Slotman, B.J.

    2003-01-01

    PURPOSE: In this single-institution trial, we investigated whether fractionated stereotactic radiation therapy is superior to single-fraction linac-based radiosurgery with respect to treatment-related toxicity and local control in patients with vestibular schwannoma. METHODS AND MATERIALS: All 129 v

  5. Did the ancient Egyptians migrate to ancient Nigeria?

    OpenAIRE

    Jock M. Agai

    2014-01-01

    Literatures concerning the history of West African peoples published from 1900 to 1970 debate�the possible migrations of the Egyptians into West Africa. Writers like Samuel Johnson and�Lucas Olumide believe that the ancient Egyptians penetrated through ancient Nigeria but Leo�Frobenius and Geoffrey Parrinder frowned at this opinion. Using the works of these early�20th century writers of West African history together with a Yoruba legend which teaches�about the origin of their earliest ancesto...

  6. Does Attempt at Hearing Preservation Microsurgery of Vestibular Schwannoma Affect Postoperative Tinnitus?

    Directory of Open Access Journals (Sweden)

    Martin Chovanec

    2015-01-01

    Full Text Available Background. The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome. Material and Methods. A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed. Results. Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively. Conclusions. Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.

  7. Unilateral tinnitus as a single symptom of unusually large vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Komazec Zoran

    2014-01-01

    Full Text Available Introduction. Vestibular schwannomas are relatively rare tumors whose symptoms are based on its location and as the tumor grows, the symptoms usually advance. Case Report. An 18-year old patient was examined by an otolaryngologist due to buzzing in her right ear that had lasted for about 1 month. Her pure-tone audiometry findings showed slight asymmetry; a slight ascendant type sensorineural hearing loss was found in the right ear (25 dB HL at 125 Hz, 20 dB HL at 250 Hz, and 10 dB HL at other frequencies, while the threshold in the left ear was 15 dBHL at 125 Hz and 10 dB HL at other frequencies. Electronystagmography, otoacoustic emissions and auditory brain-stem responses suggested retrocochlear etiology of tinnitus. Magnetic resonance imaging examination revealed a large right cerebellopontine angle tumor, measuring 5 x 3 x 3 cm, which had shifted the brain stem laterally. Conclusion. Every case of unilateral tinnitus, asymmetric sensorineural hearing loss, or hypotonia of labyrinth not strictly accompanied by vertigo, needs to be further evaluated using a battery of audiologic tests whose findings may be normal. Audiologic tests should be repeated in cases of persistent symptoms and accompanied by cranial magnetic resonance imaging, which is today considered the gold standard for diagnosis of vestibular schwannoma.

  8. Magnetic resonance cisternography using the fast spin echo method for the evaluation of vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Nishizawa, Shigeru; Yokoyama, Tetsuo; Uemura, Kenichi [Hamamatsu Univ. School of Medicine, Shizuoka (Japan)

    1999-04-01

    Neuroimaging of vestibular schwannoma was performed with the fat-suppression spoiled gradient recalled acquisition in the steady state (SPGR) method and magnetic resonance (MR) cisternography, which is a fast spin echo method using a long echo train length, for the preoperative evaluation of the lateral extension of the tumor in the internal auditory canal, and the anatomical identification of the posterior semicircular canal and the nerves in the canal distal to the tumor. The SPGR method overestimated the lateral extension in eight cases, probably because of enhancement of the nerves adjacent to the tumor in the canal. The posterior semicircular canal could not be clearly identified, and the cranial nerves in the canal were shown only as a nerve bundle. In contrast, MR cisternography showed clear images of the lateral extension of the tumor and the facial and cochlear nerves adjacent to the tumor in the internal auditory canal. The anatomical location of the posterior semicircular canal was also clearly shown. These preoperative findings are very useful to plan the extent to which the internal auditory canal can be opened, and for intraoperative identification of the nerves in the canal. MR cisternography is less invasive since no contrast material or radiation is required, as with thin-slice high-resolution computed tomography (CT). MR cisternography should replace high-resolution CT for the preoperative neuroradiological evaluation of vestibular schwannoma. (author)

  9. Tissue-Specific Ablation of Prkar1a Causes Schwannomas by Suppressing Neurofibromatosis Protein Production

    Directory of Open Access Journals (Sweden)

    Georgette N. Jones

    2008-11-01

    Full Text Available Signaling events leading to Schwann cell tumor initiation have been extensively characterized in the context of neurofibromatosis (NF. Similar tumors are also observed in patients with the endocrine neoplasia syndrome Carney complex, which results from inactivating mutations in PRKAR1A. Loss of PRKAR1A causes enhanced protein kinase A activity, although the pathways leading to tumorigenesis are not well characterized. Tissue-specific ablation of Prkar1a in neural crest precursor cells (TEC3KO mice causes schwannomas with nearly 80% penetrance by 10 months. These heterogeneous neoplasms were clinically characterized as genetically engineered mouse schwannomas, grades II and III. At the molecular level, analysis of the tumors revealed almost complete loss of both NF proteins, despite the fact that transcript levels were increased, implying posttranscriptional regulation. Although Erk and Akt signaling are typically enhanced in NF-associated tumors, we observed no activation of either of these pathways in TEC3KO tumors. Furthermore, the small G proteins Ras, Rac1, and RhoA are all known to be involved with NF signaling. In TEC3KO tumors, all three molecules showed modest increases in total protein, but only Rac1 showed significant activation. These data suggest that dysregulated protein kinase A activation causes tumorigenesis through pathways that overlap but are distinct from those described in NF tumorigenesis.

  10. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas.

    Science.gov (United States)

    Carney, J A

    1995-06-01

    The complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas (the Carney complex) is a multisystem tumorous disorder that is transmitted as a mendelian autosomal dominant trait. Approximately 150 affected patients are known worldwide. The myxomas, which tend to be multiple in the involved organ, affect the heart, skin and breast. Typical sites for the skin myxomas are the eyelids, external ear canal, and nipples. The lesions commonly recur after excision. The spotty skin pigmentation includes lentigines and blue nevi, but ephelides and junctional and compound nevi also occur. The lentigines are widespread and typically involve the centrofacial area, including the vermilion border of the lips, and the conjunctiva, especially the lacrimal caruncle and the conjunctival semilunar fold. One or more intraoral pigmented spots are seen occasionally. The blue nevi occur on the face, trunk, and limbs, but not the hands and feet. Endocrine overactivity includes Cushing's syndrome (caused by primary pigmented nodular adrenocortical disease), acromegaly (caused by growth hormone-producing pituitary adenoma), and sexual precocity (caused by large-cell calcifying Sertoli cell tumor). The schwannomas are a special histological type, featuring psammoma bodies and melanin. Most commonly, they affect the upper gastrointestinal tract and sympathetic nerve chains, but a few have occurred in the skin. The most serious component of the Carney complex is cardiac myxoma. Patients suspected of having the syndrome (and their primary relatives) should be examined for this neoplasm.

  11. [Ancient Egyptian Odontology].

    Science.gov (United States)

    Berghult, B

    1999-01-01

    In ancient Egypt during the reign of Pharaoh Djoser, circa 2650 BC, the Step Pyramid was constructed by Imhotep. He was later worshiped as the God of Medicine. One of his contemporaries was the powerful writer Hesy who is reproduced on a panel showing a rebus of a swallow, a tusk and an arrow. He is therefore looked upon as being the first depicted odontologist. The art of writing begun in Egypt in about 3100 BC and the medical texts we know from different papyri were copied with hieratic signs around 1900-1100 BC. One of the most famous is the Papyrus Ebers. It was purchased by professor Ebers on a research travel to Luxor in 1873. Two years later a beautiful facsimile in color was published and the best translation came in 1958 in German. The text includes 870 remedies and some of them are related to teeth and oral troubles like pain in the mouth, gingivitis, periodontitis and cavities in the teeth. The most common oral pain was probably pulpitis caused by extreme attrition due to the high consumption of bread contaminated with soil and/or quern minerals. Another text is the Papyrus Edwin Smith with four surgical cases of dental interest. The "toothworms" that were presumed to bring about decayed teeth have not been identified in the medical texts. It was not until 1889 W.D. Miller presented a scientific explanation that cavities were caused by bacteria. In spite of extensive research only a few evidence of prosthetic and invasive treatments have been found and these dental artifacts have probably been made post mortem. Some of the 150 identified doctors were associated with treatments of disorders of the mouth. The stele of Seneb from Sa'is during the 26th dynasty of Psamtik, 664-525 BC, shows a young man who probably was a dental healer well known to Pharaoh and his court. Clement of Alexandria mentions circa 200 AD that the written knowledge of the old Egyptians was gathered in 42 collections of papyri. Number 37-42 contained the medical writings. The

  12. Triological Society Thesis Preclinical Validation of AR42, a Novel Histone Deacetylase Inhibitor, as Treatment for Vestibular Schwannomas

    Science.gov (United States)

    Jacob, Abraham; Oblinger, Janet; Bush, Matthew L.; Brendel, Victoria; Santarelli, Griffin; Chaudhury, Abhik R.; Kulp, Samuel; La Perle, Krista M. D.; Chen, Ching-Shih; Chang, Long-Sheng; Welling, D. Bradley

    2012-01-01

    Objective/Hypothesis Recent studies indicate that vestibular schwannomas (VS) rely on PI3-kinase/AKT activation to promote cell proliferation and survival; therefore, targeting AKT may provide new therapeutic options. We have previously shown that AR42, a novel histone deacetylase inhibitor, potently suppresses VS growth in vitro at doses correlating with AKT inactivation. The objectives of the current study were translational: 1) to examine the end biologic effects of AR42 on tumor growth in vivo, 2) to validate AKT as its in vivo molecular target, 3) to determine whether AR42 penetrates the blood brain barrier (BBB), and 4) to study AR42’s pharmacotoxicity profile. Study Design In vivo mouse studies Methods AR42 was dosed orally in murine schwannoma allografts and human vestibular schwannoma xenografts. MRI was used to quantify changes in tumor volume while intracellular molecular targets were analyzed using immunohistochemistry. Blood-brain barrier (BBB) penetration was assayed, and both blood chemistry measurements and histology studies were used to evaluate toxicity. Results Growth of schwannoma implants was dramatically decreased by AR42 at doses correlating with AKT dephosphorylation, cell cycle arrest, and apoptosis. AR42 penetrated the BBB, and wild-type mice fed AR42 for 6-months behaved normally and gained weight appropriately. Blood chemistry studies and organ histology performed after 3- and 6-months of AR42 treatment demonstrated no clinically significant abnormalities. Conclusions AR42 suppresses schwannoma growth at doses correlating with AKT pathway inhibition. This orally bioavailable drug penetrates the BBB, is well tolerated, and represents a novel candidate for translation to human VS clinical trials. PMID:22109824

  13. A case series of two cases of juxta-adrenal schwannoma presenting as adrenal mass lesion and review of the literature

    Directory of Open Access Journals (Sweden)

    Shivashankar Damodaran

    2015-01-01

    Full Text Available Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a very hyperintense lesion in another, in T2-weighted images, mimicking a adrenocortical malignancy and a pheochromocytoma respectively. Both cases were treated by surgical excision. Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining. Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors. We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

  14. A case series of two cases of juxta-adrenal schwannoma presenting as adrenal mass lesion and review of the literature.

    Science.gov (United States)

    Damodaran, Shivashankar; Mahimairaj, Griffin; Velaichamy, Kamaraj

    2015-01-01

    Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a very hyperintense lesion in another, in T2-weighted images, mimicking a adrenocortical malignancy and a pheochromocytoma respectively. Both cases were treated by surgical excision. Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining. Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors. We report a unique imaging characteristic, which helps in preoperative identification these rare lesions. PMID:25837378

  15. Ancient Astronomical Monuments of Athens

    Science.gov (United States)

    Theodossiou, E.; Manimanis, V. N.

    2010-07-01

    In this work, four ancient monuments of astronomical significance found in Athens and still kept in the same city in good condition are presented. The first one is the conical sundial on the southern slope of the Acropolis. The second one is the Tower of the Winds and its vertical sundials in the Roman Forum of Athens, a small octagonal marble tower with sundials on all 8 of its sides, plus a water-clock inside the tower. The third monument-instrument is the ancient clepsydra of Athens, one of the findings from the Ancient Agora of Athens, a unique water-clock dated from 400 B.C. Finally, the fourth one is the carved ancient Athenian calendar over the main entrance of the small Byzantine temple of the 8th Century, St. Eleftherios, located to the south of the temple of the Annunciation of Virgin Mary, the modern Cathedral of the city of Athens.

  16. Layout of Ancient Maya Cities

    Science.gov (United States)

    Aylesworth, Grant R.

    Although there is little doubt that the ancient Maya of Mesoamerica laid their cities out based, in part, on astronomical considerations, the proliferation of "cosmograms" in contemporary scholarly discourse has complicated matters for the acceptance of rigorous archaeoastronomical research.

  17. Reconstructing ancient genomes and epigenomes

    DEFF Research Database (Denmark)

    Orlando, Ludovic Antoine Alexandre; Gilbert, M. Thomas P.; Willerslev, Eske

    2015-01-01

    DNA studies have now progressed to whole-genome sequencing for an increasing number of ancient individuals and extinct species, as well as to epigenomic characterization. Such advances have enabled the sequencing of specimens of up to 1 million years old, which, owing to their extensive DNA damage and...... contamination, were previously not amenable to genetic analyses. In this Review, we discuss these varied technical challenges and solutions for sequencing ancient genomes and epigenomes....

  18. Orthopedic surgery in ancient Egypt

    OpenAIRE

    Blomstedt, Patric

    2014-01-01

    Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentra...

  19. A case series of two cases of juxta-adrenal schwannoma presenting as adrenal mass lesion and review of the literature

    OpenAIRE

    Shivashankar Damodaran; Griffin Mahimairaj; Kamaraj Velaichamy

    2015-01-01

    Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a ver...

  20. Benign multicystic peritoneal mesothelioma: a case report

    Directory of Open Access Journals (Sweden)

    Papapaulou Leonidas

    2010-11-01

    Full Text Available Abstract Introduction We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. Case presentation A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Conclusions Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

  1. Pharmacological treatment of the benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. The etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5α-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the aα1 -adrenoceptors (ADR). The pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5aα-reductase inhibitors, the aα1-adrenoreceptor blockers, their combined therapy and the phytotherapy. This paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. To this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. Natural products were included as lipid extracts from Serenoa repens and Pygeum africanum as well as D-004, a lipid extract from Roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. D-004 is a prostatic 5a-reductase inhibitor, an aα1-adrenoceptor antagonist, aα 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. The results achieved till now indicate that D-004 is a safe and well-tolerated product

  2. Diagnostik og behandling af benigne levertumorer

    DEFF Research Database (Denmark)

    Eriksen, Peter Lykke; Schultz, Nicolai Aagaard; Larsen, Lars Peter;

    2016-01-01

    Due to the expanding use of diagnostic imaging, an increasing number of liver tumours are discovered. Benign tumours are very common; they rarely cause symptoms and often they do not require any treatment. However, because of differences in the natural history including risk of complications and...... malignant transformation exact diagnosis is important. Dedicated radiological examinations serve as important diagnostic tools reducing the need for biopsy. In this review we provide an update on the diagnosis and treatment of benign liver tumours adding to existing recommendations on hepatocellular...

  3. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  4. Benign cephalic histiocytosis: report of four cases.

    Science.gov (United States)

    de Luna, M L; Glikin, I; Golberg, J; Stringa, S; Schroh, R; Casas, J

    1989-09-01

    We cared for four patients with benign cephalic histiocytosis, a self-healing non-X, nonlipid cutaneous histiocytosis of children. The age of onset of the disease was 5 to 9 months, with papules and erythematous macules involving the head (mainly the cheeks), and posterior spread to the trunk and limbs in three patients. Microscopic examination of skin biopsies revealed a histiocytic infiltrate in the superficial dermis that was S100 protein-negative by immunoperoxidase (PAP method). One patient showed comma-shaped bodies and desmosomelike junctions on electron microscopy. No Birbeck's granules were present. Benign cephalic histiocytosis is a self-limiting condition that requires no treatment.

  5. Did the ancient Egyptians migrate to ancient Nigeria?

    Directory of Open Access Journals (Sweden)

    Jock M. Agai

    2014-01-01

    Full Text Available Literatures concerning the history of West African peoples published from 1900 to 1970 debate�the possible migrations of the Egyptians into West Africa. Writers like Samuel Johnson and�Lucas Olumide believe that the ancient Egyptians penetrated through ancient Nigeria but Leo�Frobenius and Geoffrey Parrinder frowned at this opinion. Using the works of these early�20th century writers of West African history together with a Yoruba legend which teaches�about the origin of their earliest ancestor(s, this researcher investigates the theories that the�ancient Egyptians had contact with the ancient Nigerians and particularly with the Yorubas.Intradisciplinary and/or interdisciplinary implications: There is an existing ideology�amongst the Yorubas and other writers of Yoruba history that the original ancestors of�the Yorubas originated in ancient Egypt hence there was migration between Egypt and�Yorubaland. This researcher contends that even if there was migration between Egypt and�Nigeria, such migration did not take place during the predynastic and dynastic period as�speculated by some scholars. The subject is open for further research.

  6. Schwannoma intralaberíntico. Descripción de un caso

    Directory of Open Access Journals (Sweden)

    José Antonio CÁMARA-ARNAZ

    2016-03-01

    Full Text Available Introducción y objetivos: El schwannoma intralaberíntico es un tumor benigno muy infrecuente, de lento crecimiento extradural, localizado primariamente en el laberinto membranoso. A través de un caso clínico presentamos las características de su evolución, intentamos ofrecer una explicación fisiopatológica de la sintomatología y de los hallazgos audio-vestibulares y describimos finalmente, las diferentes opciones terapéuticas. Descripción: Se trata de una mujer de 59 años, que comienza con síntomas inespecíficos del oído izquierdo a los que posteriormente se añade una pérdida auditiva. Al confirmar que se trata de una hipoacusia unilateral no justificada, solicitamos una RM que pone de manifiesto la presencia de un pequeño tumor de 2-3 mm intravestibular, al que revisaremos periódicamente. Discusión: El origen y la prevalencia del schwannoma intralaberíntico son desconocidos. Aunque la clínica se confunde con la de otros procesos otológicos más frecuentes, la realización de RM incrementaría el número de casos diagnosticados. En función del paciente, de su sintomatología, de la evolución y de las características tumorales, se decide el tipo de tratamiento Conclusión: El schwannoma intralaberíntico debe formar parte del diagnóstico diferencial en pacientes con síntomas audio-vestibulares unilaterales y solicitar una RM de alta resolución para obtener el diagnóstico definitivo. Presentando un pronóstico excelente, la observación es considerada como la mejor opción terapéutica.

  7. Repositioning chairs in benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    West, Niels; Hansen, Søren; Møller, Martin Nue;

    2016-01-01

    The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo...

  8. Benign prostatic hyperplasia: symptoms and objective interpretation

    DEFF Research Database (Denmark)

    Andersen, J T

    1991-01-01

    Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been...

  9. Benign solitary solid cold thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Karstrup, Steen;

    2002-01-01

    PURPOSE: To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS: ILP was performed in 16 patients with normal thyroid function and a solid...... solitary solid cold thyroid nodule in patients who cannot or will not undergo surgery....

  10. Urodynamic implications of benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Jensen, K M; Andersen, J T

    1990-01-01

    By the age of 60, about 70% of men have developed benign prostatic hyperplasia (BPH), and 85%-95% of these have symptomatic dysfunction of the lower urinary tract, 10%-20% undergoing prostatectomy. Although transurethral resection of the prostate is generally considered to be a safe and effective...

  11. CT and MRI appearance of schwannoma in the sinonasal region%鼻腔鼻窦神经鞘瘤的CT和MRI表现

    Institute of Scientific and Technical Information of China (English)

    杨本涛; 王振常; 刘莎; 鲜军舫; 陈青华; 刘中林; 兰宝森

    2008-01-01

    Objective To study the CT and MRI findings of schwannoma in tIle sinonasal region and evaluate their clinical application.Methods All 12 cases of schwannoma locating in the sinonasal region were verified by pathology.r111e CT images in all 12 cases and MRI findings in 10 cases were analyzed retrospectively.Results Of the 12 cases of schwannoma in the sinonasal cavity.11 were benign and l was malignant.The tumors located in the nasoethmoid region in 4 cases.in the maxillary sinus in 3 cases and in the maxillary.ethmoid and sphenoid sinuses in 2 cases.The lesion of the remaining 3 cases involved maxillary sinus and hasal cavity,sphenoid sinus and choana respectively.The lesions with well-defined margin showed elliptic shape in 4 cases,irregular shape in 8 cases.On CT,the lesion resulted in dilatation of the affected sinonasal cavity with remodeling,thinning and displacement of the bony wall.In addition.local bony absorption was detected in 8 cases and bony destruction was found in 1 case.The lesions revealed homogeneous density in 10 cases and inhomogeneous in 2 on precontrast CT.Two cases showed heterogeneous enhancement on postcontrast CT. On MR T1WI,schwannoma in the sinonasal region demonstrated isointense signal compared to brain in 10 cases with patchy and nodular low signal intensity in 3 cases and patchy hish signal intensity in 2 cases.On T2 WI.the lesion showed heterogeneous isointense singal in 7 cases and slightly hyperintense signal in 3 cases.Stippled and patchy hyperintense signal was seen in 9 cases and well-defined and regular nedular high intense signal in 6 cases.Patchy low signal intensity was found in 2 cases corresponding to the high signal intensity on MR Tl WI.In addition,liquid-iquid level was identified in one case.The lesion displayed rooderate to marked inhomogeneous enhancement on contrast-enhanced MR images in 9 cases and marked homogeneous enhancement in one case.The time.intensity curve of dynamic contrast enhancement of MRI showed

  12. Natural history of benign prostate hyperplasia

    Institute of Scientific and Technical Information of China (English)

    WU Shi-liang; LI Ning-chen; XIAO Yun-xiang; JIN Jie; QIU Shao-peng; YE Zhang-qun; KONG Chui-ze; SUN Guang; NA Yan-qun

    2006-01-01

    Background Benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.Methods One hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.Results All patients were visited after 6 months, the mean volume of transitional zone was found to haveincreased by 1.6 ml (P<0.01), International Prostate Symptom Score was increased by 0.8 (P<0.01) and Quality of Life was increased by 0.2 (P<0.01), and there was no statistical change in other data. Among these patients,17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).Conclusions After one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

  13. Ancient DNA in Greece. Problems and prospects

    International Nuclear Information System (INIS)

    The promise associated with early 'ancient DNA' results has not been translated into routine techniques of value to archaeologists. The reasons for this are partly technical - ancient DNA analysis is an extremely difficult technique - and partly practical - ancient DNA analysis is often an 'after thought' to an archaeological project. In this paper ancient human DNA analysis is briefly reviewed paying particular attention to specimens originating from Greek archaeological contexts. Problems commonly encountered during ancient DNA research are summarised and recommendations for future strategies in the application of ancient DNA in archaeology are proposed. (author)

  14. Need for facial reanimation after operations for vestibular schwannoma: patients perspective

    DEFF Research Database (Denmark)

    Tos, Tina; Caye-Thomasen, Per; Stangerup, Sven-Eric;

    2003-01-01

    A total of 779 patients operated on for vestibular schwannoma mostly by the translabyrinthine approach in Denmark during the period 1976-2000 answered a questionnaire about various postoperative consequences. In this paper we describe the patients' facial function evaluated by professionals one...... (15%) of 779 patients considered their facial palsy to be a big problem and 125 patients (16%) were interested in surgical treatment for the sequelae of facial palsy. Seventy-eight (10%) had already had some kind of operation, usually the VII-XII coaptation. Thirty-three of 61 patients who had already...... been operated on for facial palsy were interested in further surgical treatment. One hundred and ninety-five patients (25%) had some kind of operation on the eye, mostly (88%) a tarsorrhaphy. Reanimation procedures such as a palpebral gold weight or a spring, apparently still have a small place...

  15. Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.;

    2008-01-01

    surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7......: At the time of diagnosis, 334 patients (53 per cent) had good hearing and speech discrimination of better than 70 per cent; at the end of the 10-year observation period, this latter percentage was 31 per cent. In 17 per cent of the patients, speech discrimination at diagnosis was 100 per cent; of these, 88...... per cent still had good hearing at the end of the observation period. However, in patients with even a small initial speech discrimination loss, only 55 per cent maintained good hearing at the end of the observation period. Conclusion: After comparing the hearing results of hearing preservation...

  16. The extracisternal approach in vestibular schwannoma surgery and facial nerve preservation

    Directory of Open Access Journals (Sweden)

    Eduardo A. S. Vellutini

    2014-12-01

    Full Text Available The classical surgical technique for the resection of vestibular schwannomas (VS has emphasized the microsurgical anatomy of cranial nerves. We believe that the focus on preservation of the arachnoid membrane may serve as a safe guide for tumor removal. Method The extracisternal approach is described in detail. We reviewed charts from 120 patients treated with this technique between 2006 and 2012. Surgical results were evaluated based on the extension of resection, tumor relapse, and facial nerve function. Results Overall gross total resection was achieved in 81% of the patients. The overall postoperative facial nerve function House-Brackmann grades I-II at one year was 93%. There was no recurrence in 4.2 years mean follow up. Conclusion The extracisternal technique differs from other surgical descriptions on the treatment of VS by not requiring the identification of the facial nerve, as long as we preserve the arachnoid envelope in the total circumference of the tumor.

  17. Endo-biliary stents for benign disease: not always benign after all!

    Directory of Open Access Journals (Sweden)

    Jo-Etienne Abela

    2011-11-01

    Full Text Available This case report describes the presentation, management and treatment of a patient who suffered small bowel perforation due to the migration of his biliary stent which had been inserted for benign disease.

  18. Predicting Nonauditory Adverse Radiation Effects Following Radiosurgery for Vestibular Schwannoma: A Volume and Dosimetric Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hayhurst, Caroline; Monsalves, Eric; Bernstein, Mark; Gentili, Fred [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada); Heydarian, Mostafa; Tsao, May [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Schwartz, Michael [Radiation Oncology Program and Division of Neurosurgery, Sunnybrook Hospital, Toronto (Canada); Prooijen, Monique van [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Millar, Barbara-Ann; Menard, Cynthia [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Kulkarni, Abhaya V. [Division of Neurosurgery, Hospital for Sick Children, University of Toronto (Canada); Laperriere, Norm [Radiation Oncology Program, Princess Margaret Hospital, Toronto (Canada); Zadeh, Gelareh, E-mail: Gelareh.Zadeh@uhn.on.ca [Gamma Knife Unit, Division of Neurosurgery, University Health Network, Toronto (Canada)

    2012-04-01

    Purpose: To define clinical and dosimetric predictors of nonauditory adverse radiation effects after radiosurgery for vestibular schwannoma treated with a 12 Gy prescription dose. Methods: We retrospectively reviewed our experience of vestibular schwannoma patients treated between September 2005 and December 2009. Two hundred patients were treated at a 12 Gy prescription dose; 80 had complete clinical and radiological follow-up for at least 24 months (median, 28.5 months). All treatment plans were reviewed for target volume and dosimetry characteristics; gradient index; homogeneity index, defined as the maximum dose in the treatment volume divided by the prescription dose; conformity index; brainstem; and trigeminal nerve dose. All adverse radiation effects (ARE) were recorded. Because the intent of our study was to focus on the nonauditory adverse effects, hearing outcome was not evaluated in this study. Results: Twenty-seven (33.8%) patients developed ARE, 5 (6%) developed hydrocephalus, 10 (12.5%) reported new ataxia, 17 (21%) developed trigeminal dysfunction, 3 (3.75%) had facial weakness, and 1 patient developed hemifacial spasm. The development of edema within the pons was significantly associated with ARE (p = 0.001). On multivariate analysis, only target volume is a significant predictor of ARE (p = 0.001). There is a target volume threshold of 5 cm3, above which ARE are more likely. The treatment plan dosimetric characteristics are not associated with ARE, although the maximum dose to the 5th nerve is a significant predictor of trigeminal dysfunction, with a threshold of 9 Gy. The overall 2-year tumor control rate was 96%. Conclusions: Target volume is the most important predictor of adverse radiation effects, and we identified the significant treatment volume threshold to be 5 cm3. We also established through our series that the maximum tolerable dose to the 5th nerve is 9 Gy.

  19. Night blindness and ancient remedy

    Directory of Open Access Journals (Sweden)

    H.A. Hajar Al Binali

    2014-01-01

    Full Text Available The aim of this article is to briefly review the history of night blindness and its treatment from ancient times until the present. The old Egyptians, the Babylonians, the Greeks and the Arabs used animal liver for treatment and successfully cured the disease. The author had the opportunity to observe the application of the old remedy to a patient. Now we know what the ancients did not know, that night blindness is caused by Vitamin A deficiency and the animal liver is the store house for Vitamin A.

  20. Cervical sympathetic chain schwannoma masquerading as a carotid body tumour with a postoperative complication of first-bite syndrome.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-01-31

    Carotid body tumours (CBT) are the most common tumours at the carotid bifurcation. Widening of the bifurcation is usually demonstrated on conventional angiography. This sign may also be produced by a schwannoma of the cervical sympathetic plexus. A 45-year-old patient presented with a neck mass. Investigations included contrast-enhanced CT, MRI and magnetic resonance arteriography with contrast enhancement. Radiologically, the mass was considered to be a CBT due to vascular enhancement and splaying of the internal and external carotid arteries. Intraoperatively, it was determined to be a cervical sympathetic chain schwannoma (CSCS). The patient had a postoperative complication of first-bite syndrome (FBS).Although rare, CSCS should be considered in the differential diagnosis for tumours at the carotid bifurcation. Damage to the sympathetic innervation to the parotid gland can result in severe postoperative pain characterised by FBS and should be considered in all patients undergoing surgery involving the parapharyngeal space.

  1. Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review

    Science.gov (United States)

    Yoon, Sun; Park, Hunho; Lee, Kyu-Sung; Park, Seoung Woo

    2016-01-01

    Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions. We removed the tumor with a left lateral suboccipital craniectomy with laminectomy only at C1 and without any subsequent surgery-related neurologic deficits. However, this technique requires meticulous preoperative evaluation on existence of Cerebrospinal fluid (CSF) cleft between the tumor and spinal cord on magnetic resonance imaging, of tumor origin located at the upper cervical root, and of detachment of tumor from the origin site.

  2. Tuberculosis in ancient times

    Directory of Open Access Journals (Sweden)

    Louise Cilliers

    2008-09-01

    Full Text Available In spite of an array of effective antibiotics, tuberculosis is still very common in developing countries where overcrowding, malnutrition and poor hygienic conditions prevail. Over the past 30 years associated HIV infection has worsened the situation by increasing the infection rate and mortality of tuberculosis. Of those diseases caused by a single organism only HIV causes more deaths internationally than tuberculosis. The tubercle bacillus probably first infected man in Neolithic times, and then via infected cattle, but the causative Mycobacteriacea have been in existence for 300 million years. Droplet infection is the most common way of acquiring tuberculosis, although ingestion (e.g. of infected cows’ milk may occur. Tuberculosis probably originated in Africa. The earliest path gnomonic evidence of human tuberculosis in man was found in osteo-archaeological findings of bone tuberculosis (Pott’s disease of the spine in the skeleton of anEgyptian priest from the 21st Dynasty (approximately 1 000 BC. Suggestive but not conclusiveevidence of tuberculotic lesions had been found in even earlier skeletons from Egypt and Europe. Medical hieroglyphics from ancient Egypt are silent on the disease, which could be tuberculosis,as do early Indian and Chinese writings. The Old Testament refers to the disease schachapeth, translated as phthisis in the Greek Septuagint. Although the Bible is not specific about this condition, tuberculosis is still called schachapeth in modern Hebrew. In pre-Hippocratic Greece Homer did not mention phthisis, a word meaning non-specific wasting of the body. However. Alexander of Tralles (6th century BC seemed to narrow the concept down to a specific disease, and in the Hippocratic Corpus (5th-4th centuries BC phthisis can be recognised as tuberculosis. It was predominantly a respiratory disease commonly seen and considered to be caused by an imbalance of bodily humours. It was commonest in autumn, winter and spring

  3. Benign Prostatic Hyperstatic Hyperplasia (BPH) (Beyond the Basics)

    Science.gov (United States)

    ... names for benign prostatic hyperplasia include benign prostatic hypertrophy, an enlarged prostate, and BPH. BPH occurs only ... prostatic hyperplasia" .) Alpha blockers — These medications relax the muscle of the prostate and bladder neck, which allows ...

  4. The research progress of cystic vestibular schwannoma%囊性听神经瘤的研究进展

    Institute of Scientific and Technical Information of China (English)

    玄鹏; 张新中

    2014-01-01

    Cystic vestibular schwannoma presents a therapeutic dilemma.Observation and radiotherapy are not recommended for these tumors.As to surgery,cystic vestibular schwannoma also has worse prognosis because of the difficulty in preserving an adequate subarachnoid dissection plane.But the results of other recent studies have not supported above conclusions.Some studies found a subset of cystic vestibular schwannoma presented with fluid-fluid level,indicating intratumoral hemorrhage.Here,we reviewed the studies on cystic vestibular schwannoma and discussed its surgical outcomes and the possible mechanism of peritumoral adhesion and formation of fluid-fluid level,and its implication for surgical strategy.%目前囊性听神经瘤的治疗存在困境。单纯观察和放射治疗都不是推荐的治疗方法,至于手术治疗,由于囊性听神经瘤的蛛网膜界面保留困难使其预后较差。但是,最近的一些研究并不支持上述结论。其中有研究发现部分囊变的囊性听神经瘤带有液-液平面表明有瘤内出血。通过回顾有关囊性听神经瘤的研究进展的相关文献,探讨外科手术治疗效果,瘤周粘连及液-液平面形成的可能机制以及对外科手术治疗策略的意义。

  5. Vitamin D deficiency and benign paroxysmal positioning vertigo

    OpenAIRE

    Büki, Bela; Ecker, Michael; Jünger, Heinz; Lundberg, Yunxia Wang

    2012-01-01

    Benign paroxysmal positional vertigo is a common cause of disabling vertigo with a high rate of recurrence. Although connections between vitamin D deficiency and osteoporosis, as well as between osteoporosis and benign paroxysmal positional vertigo have been suggested respectively in the literature, we are not aware of any publication linking vitamin D and benign paroxysmal positional vertigo. As a hypothesis, we suggest that there is a relation between insufficient vitamin D level and benign...

  6. Understanding Malaria: Fighting an Ancient Scourge

    Science.gov (United States)

    Understanding Malaria Fighting an Ancient Scourge U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases Understanding Malaria Fighting an Ancient Scourge U.S. DEPARTMENT OF HEALTH ...

  7. Phylogenetic estimation of timescales using ancient DNA

    DEFF Research Database (Denmark)

    Molak, Martyna; Lorenzen, Eline; Shapiro, Beth;

    2013-01-01

    In recent years, ancient DNA has increasingly been used for estimating molecular timescales, particularly in studies of substitution rates and demographic histories. Molecular clocks can be calibrated using temporal information from ancient DNA sequences. This information comes from the ages...

  8. The eye and its diseases in Ancient Egypt

    DEFF Research Database (Denmark)

    Andersen, S. Ry

    1997-01-01

    Ophthalmology, History of ophthalmology, eyes in the Ancient Egypt, eye disease in Ancient Egypt, porotic hyperostosis, mummification......Ophthalmology, History of ophthalmology, eyes in the Ancient Egypt, eye disease in Ancient Egypt, porotic hyperostosis, mummification...

  9. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  10. Skeletal scintigraphy in benign and malignant disease

    International Nuclear Information System (INIS)

    This paper begins with a discussion of the technical factors in skeletal scintigraphy, including collimation, the use of three-phase bone scan, and single-photon emission computed tomography. Skeletal scintigraphy for benign conditions is commonly indicated for the patient presenting with pain (trauma, sports-related injury, posttraumatic pain syndrome, painful orthopedic prosthesis) and for the patient with abnormal laboratory test results (metabolic bone disease, Paget disease). For malignant conditions, the bone scan is useful in the evaluation of metastases in patients with extraosseous malignancies and primary bone tumors. The discussion addresses the various scan patterns seen in the more common tumors, such as prostate carcinoma, breast carcinoma, and lung carcinoma. Bone scintigraphy is an exquisitely sensitive modality. With some understanding of the techniques necessary for obtaining the optimal bone scan, and of the patterns that can be seen in various clinical conditions, the radiologist will find the bone scan a very specific tool for evaluating both benign and malignant diseases

  11. Idiopathic benign retroperitoneal cyst: a case report

    Directory of Open Access Journals (Sweden)

    Alzaraa Ahmed

    2008-02-01

    Full Text Available Abstract Introduction Retroperitoneal cysts are uncommon, with an estimated incidence of 1/5750 to 1/250,000. Case presentation A male patient was admitted with an abdominal pain, jaundice and fever. Clinical examination and investigations confirmed an idiopathic benign retroperitoneal cyst. He underwent surgery and was discharged after making good recovery. Conclusion Retroperitoneal cysts are very rare, and most of the time they are discovered incidentally. Patients may be asymptomatic or present with abdominal pain, referred pain to the legs or weight loss. Imaging may help diagnose these lesions, but surgery is the keystone in confirming the diagnosis. This case is very rare and very educational as it highlights an unusual presentation of a benign retroperitoneal cyst. In our patient, the course of the disease was unique as the patient presented with jaundice.

  12. Characteristics of benign lymphoadenosis of oral mucosa

    Institute of Scientific and Technical Information of China (English)

    Shu-Xia Li; Shi-Feng Yu; Kai-Hua Sun

    2005-01-01

    AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

  13. Endoscopic therapy of benign biliary strictures

    Institute of Scientific and Technical Information of China (English)

    Joel R Judah; Peter V Draganov

    2007-01-01

    Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of postliver transplant anastomotic strictures and distal (Bismuth Ⅰ and Ⅱ) post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat,and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.

  14. Wisdom of an Ancient City

    Institute of Scientific and Technical Information of China (English)

    GE JIANXIONG

    2010-01-01

    @@ The famous painting,Along the River During Qingming Festival,impresses visitors at the China Pavilion not iust because of the animated figures in the electronic version of the painting but because it shows a prosperous view of Kaifeng,capital of the Northern Song Dynasty (960-1127).It also showcases the wisdom of city planning in ancient China.

  15. The ancient art of memory.

    Science.gov (United States)

    Hobson, Allan

    2013-12-01

    Revision of Freud's theory requires a new way of seeking dream meaning. With the idea of elaborative encoding, Sue Llewellyn has provided a method of dream interpretation that takes into account both modern sleep science and the ancient art of memory. Her synthesis is elegant and compelling. But is her hypothesis testable? PMID:24304762

  16. Ancient medicine--a review.

    Science.gov (United States)

    Zuskin, Eugenija; Lipozencić, Jasna; Pucarin-Cvetković, Jasna; Mustajbegović, Jadranka; Schachter, Neil; Mucić-Pucić, Branka; Neralić-Meniga, Inja

    2008-01-01

    Different aspects of medicine and/or healing in several societies are presented. In the ancient times as well as today medicine has been closely related to magic, science and religion. Various ancient societies and cultures had developed different views of medicine. It was believed that a human being has two bodies: a visible body that belongs to the earth and an invisible body of heaven. In the earliest prehistoric days, a different kind of medicine was practiced in countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and others. In those countries, "medicine people" practiced medicine from the magic to modern physical practices. Medicine was magical and mythological, and diseases were attributed mostly to the supernatural forces. The foundation of modern medicine can be traced back to ancient Greeks. Tibetan culture, for instance, even today, combines spiritual and practical medicine. Chinese medicine developed as a concept of yin and yang, acupuncture and acupressure, and it has even been used in the modern medicine. During medieval Europe, major universities and medical schools were established. In the ancient time, before hospitals had developed, patients were treated mostly in temples. PMID:18812066

  17. The Echoes of Ancient Humans

    Science.gov (United States)

    Watzman, Haim

    2006-01-01

    Several artifacts found at the Gesher Benot Ya'aqov, or Daughters of Jacob Bridge, archaeological site in Israel provide a picture of ancient human ancestors that is different from the once accepted by most scholars. The discoveries by Israeli archaeologist Naama Goren-Inbar suggest that humans developed language and other key abilities far…

  18. Adult Reading of Ancient Languages.

    Science.gov (United States)

    Casler, Frederick H.

    Traditionally, students of ancient languages have been taught to translate rather than read. The four most popular current approaches to language instruction--the grammar-translation method, the direct-reading or inductive approach, the audiolingual method, and the structural approach--all have inherent deficiencies that are magnified when applied…

  19. Large Penile Mass With Unusual Benign Histopathology.

    Science.gov (United States)

    Johnson, Nate; Voznesensky, Maria; VerLee, Graham

    2015-09-01

    Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance. PMID:26793536

  20. Large Penile Mass With Unusual Benign Histopathology

    Directory of Open Access Journals (Sweden)

    Nate Johnson

    2015-09-01

    Full Text Available Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance.

  1. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail: martin.kocher@seznam.cz; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)

    2007-05-15

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  2. Environmentally benign silicon solar cell manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Tsuo, Y.S. [National Renewable Energy Lab., Golden, CO (United States); Gee, J.M. [Sandia National Labs., Albuquerque, NM (United States); Menna, P. [National Agency for New Technologies Energy and Environment, Portici (Italy); Strebkov, D.S.; Pinov, A.; Zadde, V. [Intersolarcenter, Moscow (Russian Federation)

    1998-09-01

    The manufacturing of silicon devices--from polysilicon production, crystal growth, ingot slicing, wafer cleaning, device processing, to encapsulation--requires many steps that are energy intensive and use large amounts of water and toxic chemicals. In the past two years, the silicon integrated-circuit (IC) industry has initiated several programs to promote environmentally benign manufacturing, i.e., manufacturing practices that recover, recycle, and reuse materials resources with a minimal consumption of energy. Crystalline-silicon solar photovoltaic (PV) modules, which accounted for 87% of the worldwide module shipments in 1997, are large-area devices with many manufacturing steps similar to those used in the IC industry. Obviously, there are significant opportunities for the PV industry to implement more environmentally benign manufacturing approaches. Such approaches often have the potential for significant cost reduction by reducing energy use and/or the purchase volume of new chemicals and by cutting the amount of used chemicals that must be discarded. This paper will review recent accomplishments of the IC industry initiatives and discuss new processes for environmentally benign silicon solar-cell manufacturing.

  3. CLINICAL PROFILE AND SURGICAL OUTCOME OF VESTIBULAR SCHWANNOMAS: AN INSTITUTIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Madhukar T

    2015-03-01

    Full Text Available AIMS & OBJECTIVES : Vestibular schwannomas manifest with very serious deficits of hearing, facial expression, lower cranial nerve, cerebellar and brain stem functions either preoperatively or as a consequence of surgical intervention. Our objective was to analyse the symptomatology and clinical signs and try to correlate with postoperative outcome and complications in the setting of limited infrastructure, the rapeutic and monitoring aids and multi - surgeon involvement with varied spectrum of surgical expertise in a single large tertiary teaching institute. METHODS : We retrieved 110 patients with Vestibular schwannomas from the Discharge Summary records of the De partment Of Neurosurgery, Nizam’s Institute Of Medical Sciences, and Hyderabad from January 2004 to April 2010. The mean age/sex distribution, clinical symptomatology, presenting signs were documented. The operative and clinical findings were evaluated. Data w ere obtained regarding presenting clinical features, histopathological data after surgical resection, surgical morbidity, mortality and clinical outcome (follow up of 6 - 12 months. Clinical features and surgical outcome were analysed. RESULTS : The mean tum or size was 4.4 cm. Giant tumours [>4 cm] constituted 74 % of patients. All patients had significant hearing loss which was the most common initial symptom. In 80 % of cases, gross total tumor resection was achieved. In 20 % of cases, deliberate subtotal r esections were performed. These were due to adhesions to brain stem in 4 % cases and for facial nerve preservation in 5% cases. Anatomic facial nerve preservation was achieved in 84 % in tumours < 3 cm size. The overall anatomic facial nerve preservation r ate was 33.6 %. The rate of functional facial nerve preservation [ H - B Grade 1 - 2] was 67.2 % in cases of small tumors (< 30 mm. The overall functional facial nerve preservation [ H - B Grade 1 - 2] was 28.2 %. Overall mortality was 5.4 % [6 cases] out of which 4

  4. Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients.

    Science.gov (United States)

    Zhang, Z; Nguyen, Y; De Seta, D; Russo, F Y; Rey, A; Kalamarides, M; Sterkers, O; Bernardeschi, D

    2016-09-06

    La gestione dello schwannoma vestibolare (SV) sporadico si è gradualmente evoluta negli ultimi decenni. Lo scopo di questo studio è di analizzare l’evoluzione negli esiti chirurgici dell’exeresi di queste lesioni, realizzata da un team neurotologico tra il 1990 e il 2006, attraverso differenti approcci. È stata eseguita una revisione retrospettica monocentrica dei dati clinici di 1006 pazienti. Al fine di valutare eventuali modifiche e progressi, il periodo di 17 anni è stato diviso in tre periodi, ciascuno comprendente rispettivamente 268 SV (1990- 1996), 299 SV (1997-2001), e 439 SV (2002-2006). Il follow-up medio è stato di 5,9 ± 2,4 anni. Complessivamente l’asportazione totale è stata ottenuta nel 99,4% dei casi. Il tasso di mortalità è stato dello 0,3%, la meningite e la perdita di liquido cefalo rachidiano (LCR) sono stati osservati nel 1,2% e il 9% dei casi, rispettivamente. La frequenza della perdita di LCR è diminuita dal 11,6% al 7,1% tra il primo e dell’ultimo periodo (p stata osservata nel 85,1% dei pazienti (I e II grado House- Brackmann), con una variazione tra il primo e l’ultimo periodo che andava dal 78,4% al 87,6% (p stata ottenuta nel 61,6% dei pazienti, passando dal 50,9% del primo periodo, al 69,0% del periodo piú recente (p < 0,05) (classe A + B + C dalla classificazione AAO-HNS). L’udito utile (classe A + B) è stato conservato nel 33,5% dei casi complessivamente, con percentuali comprese tra il 21,8% e 42% nel primo e nell’ultimo periodo rispettivamente (p < 0,01). Gli esiti chirurgici dell’asportazion dello schwannoma vestibolare sporadico sono migliorati negli anni per quanto riguarda i risultati funzionali del nervo facciale, la conservazione dell’udito, le perdite di liquido cefalorachidiano, principalmente grazie all’esperienza del team neurotologico. I risultati funzionali dopo la rimozione microchirurgica completa SV di grandi dimensioni dipendono dall’ esperienza maturata sulle lesioni di piccole

  5. Models of ancient sound vases

    Science.gov (United States)

    Bruel, Per V.

    2002-11-01

    Models were made of vases described by Vitruvius in Rome in about the year 70 A.D. and of sound vases (lydpotter) placed in Danish churches from 1100-1300 A.D. Measurements of vase's resonant frequencies and damping (reradiation) verified that the model vases obeyed expected physical rules. It was concluded that the excellent acoustical quality of many ancient Greek and Roman theaters cannot be ascribed to the vases placed under their seats. This study also found that sound vases placed in Nordic churches could not have shortened the reverberation time because there are far too few of them. Moreover, they could not have covered a broad frequency range. It remains a mystery why vases were installed under the seats of ancient Greek theaters and why, 1000 years later, Danes placed vases in their churches.

  6. Mitogenomic analyses from ancient DNA

    DEFF Research Database (Denmark)

    Paijmans, Johanna L.A.; Gilbert, M Thomas P; Hofreiter, Michael

    2013-01-01

    analyses (whether using modern or ancient DNA) were largely restricted to the analysis of short fragments of the mitochondrial genome. However, due to many technological advances during the past decade, a growing number of studies have explored the power of complete mitochondrial genome sequences...... (mitogenomes). Such studies were initially limited to analyses of extant organisms, but developments in both DNA sequencing technologies and general methodological aspects related to working with degraded DNA have resulted in complete mitogenomes becoming increasingly popular for ancient DNA studies as well....... To date, at least 124 partially or fully assembled mitogenomes from more than 20 species have been obtained, and, given the rapid progress in sequencing technology, this number is likely to dramatically increase in the future. The increased information content offered by analysing full mitogenomes has...

  7. Molecular analysis of ancient caries.

    Science.gov (United States)

    Simón, Marc; Montiel, Rafael; Smerling, Andrea; Solórzano, Eduvigis; Díaz, Nancy; Álvarez-Sandoval, Brenda A; Jiménez-Marín, Andrea R; Malgosa, Assumpció

    2014-09-01

    An 84 base pair sequence of the Streptococcus mutans virulence factor, known as dextranase, has been obtained from 10 individuals from the Bronze Age to the Modern Era in Europe and from before and after the colonization in America. Modern samples show four polymorphic sites that have not been found in the ancient samples studied so far. The nucleotide and haplotype diversity of this region have increased over time, which could be reflecting the footprint of a population expansion. While this segment has apparently evolved according to neutral evolution, we have been able to detect one site that is under positive selection pressure both in present and past populations. This study is a first step to study the evolution of this microorganism, analysed using direct evidence obtained from ancient remains.

  8. ANCIENT BREAD STAMPS FROM JORDAN

    OpenAIRE

    Kakish, Randa

    2014-01-01

    Marking bread was an old practice performed in different parts of the old world. It was done for religious, magical, economic and identification purposes. Bread stamps differ from other groups of stamps. Accordingly, the aim of this article is to identify such stamps, displayed or stored, in a number of Jordanian Archaeological Museums. A col-lection of twelve ancient bread stamps were identified and studied. Two of the stamps were of unknown provenance while the others came from al-Shuneh, D...

  9. Ancient Technology in Contemporary Surgery

    OpenAIRE

    Buck, Bruce A.

    1982-01-01

    Archaeologists have shown that ancient man developed the ability to produce cutting blades of an extreme degree of sharpness from volcanic glass. The finest of these prismatic blades were produced in Mesoamerica about 2,500 years ago. The technique of production of these blades was rediscovered 12 years ago by Dr. Don Crabtree, who suggested possible uses for the blades in modern surgery. Blades produced by Dr. Crabtree have been used in experimental microsurgery with excellent results. Anima...

  10. Splendid Arts Fram Ancient Capitals

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    IT was in the golden autumn in Beijing, when the sky was high and the air clear, that I hurried to Zhongshan Park to witness the display of the songs and dances of the seven Chinese ancient capitals. The flower beds arranged for the celebration of National Day were still there and the colorful blooms looked especially bright in the sunshine. The seven cities which have served as capitals in Chinese history are Beijing,

  11. Psychiatric Thoughts in Ancient India

    Directory of Open Access Journals (Sweden)

    Ravi Abhyankar

    2015-01-01

    Full Text Available A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

  12. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-01-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting. PMID:3225588

  13. Laser Applications for Benign Prostate Hyperplasia

    Directory of Open Access Journals (Sweden)

    Akyüz O.

    2012-02-01

    Full Text Available Transurethral prostate resection is still accepted as golden standard treatment modality for the management of benign prostate hyperplasia (BPH. Laser represents the most promising option among the minimal invasive alternatives. Laser with different wavelengths can provide coagulation, enucleation or vaporization on the target tissues. The significant advantages of laser applications are lesser complication rates of mainly retrograde ejaculation and erectile dysfunction, shorter hospitalization and catheterization times, and applicability in patients on anticoagulant treatment. However, further randomized multicenter trials are certainly required for laser to become a candidate for golden standard treatment for BPH.

  14. Endoscopic management of benign biliary strictures

    Institute of Scientific and Technical Information of China (English)

    Kavel; H; Visrodia; James; H; Tabibian; Todd; H; Baron

    2015-01-01

    Endoscopic management of biliary obstruction has evolved tremendously since the introduction of flexible fiberoptic endoscopes over 50 years ago. For the last several decades, endoscopic retrograde cholangiopancreatography(ERCP) has become established as the mainstay for definitively diagnosing and relieving biliary obstruction. In addition, and more recently, endoscopic ultrasonography(EUS) has gained increasing favor as an auxiliary diagnostic and therapeutic modality in facilitating decompression of the biliary tree. Here, we provide a review of the current and continually evolving role of gastrointestinal endoscopy, including both ERCP and EUS, in the management of biliary obstruction with a focus on benign biliary strictures.

  15. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-10-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting.

  16. Benign symmetric lipomatosis of the knees

    Institute of Scientific and Technical Information of China (English)

    Zhiqiang Yin; Di Wu; Yixin Ge; Meihua Zhang; Zhigang Bi; Dan Luo

    2008-01-01

    Benign symmetric lipomatosis(BSL) is a rare disease characterized by the presence of multiple, symmetric and nonencapsulated fat masses in the face, neck and other areas. It is commonly seen in middle-aged Caucasian Mediterranean males, while its etiology is still not clear. The majority of the patients with BSL have a history of alcohol abuse and hepatopathy. BSL of the limbs is very rare. This article reports a unique case of a 60-year-old Chinese woman with involvement of the knees confirmed by the results of magnetic resonance imaging(MRI) and histopathology, which was not described previously in published literatures.

  17. Clarithromycin Culprit of Benign Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Habib Rehman Khan

    2015-01-01

    Full Text Available Benign intracranial hypertension is characterized with increase in CSF opening pressure with no specific etiology. It is predominantly found in women of child bearing age and particularly in individuals with obesity. Visual disturbances or loss and associated headaches are common and can lead to blindness if left untreated. Diagnosis can be achieved once other causes of visual loss, headaches and high opening pressures are excluded. Management consists of serial optic disc assessments although no specific treatment is available despite recent trials using carbonic anhydrase inhibitors. Diet modification and weight management can help in therapy.

  18. Benign intracranial hypertension diagnosed with bilateral papilloedema

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  19. OTC tamsulosin for benign prostatic hyperplasia.

    Science.gov (United States)

    2010-10-01

    Earlier this year, tamsulosin, an alpha blocker previously only available on prescription, became available for sale by pharmacists as a treatment for functional symptoms of benign prostatic hyperplasia (BPH) in men aged 45-75 years (Flomax Relief MR - Boehringer Ingelheim). A television advert for the over-the-counter (OTC) product claims that it is a "simple and effective" treatment that can relieve symptoms within 1 week, allowing the user to "take control of your annoying pee problems".¹ Here we review the evidence on tamsulosin and assess whether its availability as an OTC product confers worthwhile advantages. PMID:20926447

  20. Analysis of Ancient DNA in Microbial Ecology.

    Science.gov (United States)

    Gorgé, Olivier; Bennett, E Andrew; Massilani, Diyendo; Daligault, Julien; Pruvost, Melanie; Geigl, Eva-Maria; Grange, Thierry

    2016-01-01

    The development of next-generation sequencing has led to a breakthrough in the analysis of ancient genomes, and the subsequent genomic analyses of the skeletal remains of ancient humans have revolutionized the knowledge of the evolution of our species, including the discovery of a new hominin, and demonstrated admixtures with more distantly related archaic populations such as Neandertals and Denisovans. Moreover, it has also yielded novel insights into the evolution of ancient pathogens. The analysis of ancient microbial genomes allows the study of their recent evolution, presently over the last several millennia. These spectacular results have been attained despite the degradation of DNA after the death of the host, which results in very short DNA molecules that become increasingly damaged, only low quantities of which remain. The low quantity of ancient DNA molecules renders their analysis difficult and prone to contamination with modern DNA molecules, in particular via contamination from the reagents used in DNA purification and downstream analysis steps. Finally, the rare ancient molecules are diluted in environmental DNA originating from the soil microorganisms that colonize bones and teeth. Thus, ancient skeletal remains can share DNA profiles with environmental samples and identifying ancient microbial genomes among the more recent, presently poorly characterized, environmental microbiome is particularly challenging. Here, we describe the methods developed and/or in use in our laboratory to produce reliable and reproducible paleogenomic results from ancient skeletal remains that can be used to identify the presence of ancient microbiota. PMID:26791510

  1. Flow ghost artifact in slice-encoding direction mimicking vestibular schwannoma in contrast-enhanced 3D spoiled gradient-echo sequence

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, S.; Koshikawa, T.; Fukatsu, H.; Ishigaki, T.; Aoki, I. [Nagoya Univ. (Japan). Dept. of Radiology

    2004-03-01

    The value of MR imaging by post-contrast T1-weighted 3D spoiled gradient-echo (3D SPGR) is well established for the detection of small vestibular schwannomas in the cerebellopontine angle region. We describe a case in which a flow ghost artifact in the slice-encoding direction mimicked a vestibular schwannoma and heavily T2-weighted MR cisternography and multiplanar reconstruction images helped us to reach the correct diagnosis. In addition, we conducted a volunteer study to demonstrate that changing the k-space trajectory can reduce this artifact in post-contrast 3D SPGR images.

  2. An investigation into the ancient abortion laws: comparing ancient Persia with ancient Greece and Rome.

    Science.gov (United States)

    Yarmohammadi, Hassan; Zargaran, Arman; Vatanpour, Azadeh; Abedini, Ehsan; Adhami, Siamak

    2013-01-01

    Since the dawn of medicine, medical rights and ethics have always been one of mankind's concerns. In any civilisation, attention paid to medical laws and ethics depends on the progress of human values and the advancement of medical science. The history of various civilisations teaches that each had its own views on medical ethics, but most had something in common. Ancient civilisations such as Greece, Rome, or Assyria did not consider the foetus to be alive and therefore to have human rights. In contrast, ancient Persians valued the foetus as a living person equal to others. Accordingly, they brought laws against abortion, even in cases of sexual abuse. Furthermore, abortion was considered to be a murder and punishments were meted out to the mother, father, and the person performing it. PMID:24304111

  3. Benign cementoblastoma (true cementoma in a cat

    Directory of Open Access Journals (Sweden)

    Lenin A Villamizar-Martinez

    2016-01-01

    Full Text Available Case summary A 10-year-old castrated male domestic shorthair cat was presented for assessment of a gingival mass surrounding the left maxillary third and fourth premolar teeth. The mass was surgically removed by means of a marginal rim excision, and the tissue was submitted for histological assessment. It was identified as a benign cementoblastoma (true cementoma. There was proliferation of mineralized eosinophilic material with multiple irregularly placed lacunae and reversal lines, reminiscent of cementum. The cat recovered uneventfully from the anesthesia, and there was no evidence of tumor recurrence 6 months after surgery. Relevance and novel information Cementoblastomas (true cementomas in domestic animals are rare, with just a few reports in ruminants, monogastric herbivores and rodents. Cementoblastoma is considered a benign tumor that arises from the tooth root. The slow, expansive and constant growth that characterizes these masses may be accompanied by signs of oral discomfort and dysphagia. This case report is intended to increase knowledge regarding this tumor in cats and also highlights the importance of complete excision of the neoplasm. To our knowledge, there are no previous reports in the literature of cementoblastoma in the cat.

  4. Histiocytic sarcoma that mimics benign histiocytosis.

    Science.gov (United States)

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge. PMID:8793665

  5. Histiocytic sarcoma that mimics benign histiocytosis.

    Science.gov (United States)

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge.

  6. Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study

    International Nuclear Information System (INIS)

    Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68) and −13.1 years (95% confidence intervals, −111.0 to −6.94), respectively. Tumor control, defined as a post-GKRS growth rate ≤0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected by treatment, but quality of life was improved.

  7. Clinical Evaluation of CyberKnife in the Treatment of Vestibular Schwannomas

    Directory of Open Access Journals (Sweden)

    Jo-Ting Tsai

    2013-01-01

    Full Text Available Objective. This study assessed the posttreatment tumor control and auditory function of vestibular schwannoma (VS patients after CyberKnife (CK and analyzed the possible prognostic factors of hearing loss. Methods. We retrospectively studied 117 VS patients, with Gardner-Robertson (GR classification grades I to IV, who underwent CK between 2006 and 2012. Data including radiosurgery treatment parameters, pre- and postoperative tumor size, and auditory function were collected and examined. Results. With CK, 117 patients had excellent tumor control rates (99.1%, with a mean imaging followup of 61.1 months. Excluding 52 patients (GR III-IV pretreatment, 53 (81.5% of the remaining 65 patients (initial GR I-II maintained GR I or II hearing after CK, with a mean audiometric followup of 64.5 months. Twelve patients experienced hearing degradation (91.6% were GR II pretreatment; they appeared to have significantly larger tumor sizes, significantly smaller cochlear sizes, and higher prescribed cochlear doses, compared to the patients with preserved hearing. Conclusion. Our data showed that CK treatment provided an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Patients with pretreatment GR II hearing levels, larger tumor volumes, smaller cochlear sizes, and higher prescribed cochlear doses may have poor hearing prognoses.

  8. Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com [Institute of Surgical Sciences, University of Bergen, Bergen (Norway); Wentzel-Larsen, Tore [Centre for Clinical Research, Haukeland University Hospital, Bergen (Norway); Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo (Norway); Norwegian Centre for Violence and Traumatic Stress Studies, Oslo (Norway); Pedersen, Paal-Henning [Institute of Surgical Sciences, University of Bergen, Bergen (Norway); Department of Neurosurgery, Haukeland University Hospital, Bergen (Norway); Mahesparan, Ruby [Department of Neurosurgery, Haukeland University Hospital, Bergen (Norway); Lund-Johansen, Morten [Institute of Surgical Sciences, University of Bergen, Bergen (Norway); Department of Neurosurgery, Haukeland University Hospital, Bergen (Norway)

    2012-10-01

    Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68) and -13.1 years (95% confidence intervals, -111.0 to -6.94), respectively. Tumor control, defined as a post-GKRS growth rate {<=}0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected by treatment, but quality of life was improved.

  9. Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

    International Nuclear Information System (INIS)

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  10. Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience

    Directory of Open Access Journals (Sweden)

    Prakash Nair

    2014-01-01

    Full Text Available Aim: The aim of the following study is to analyze the outcome following surgery in 169 patients with large vestibular schwannoma (VS and to evaluate hydrocephalus as a prognostic factor in patients of the VSs. Subjects and Methods: Retrospective analysis of all cases of VSs admitted to our tertiary neurosurgical center from January 2005 to December 2010 was performed. Comparison of patients who underwent pre-operative cerebrospinal fluid (CSF diversion and those who underwent primary surgery was carried out for post-operative complications and delayed hydrocephalus. Results: A total of 169 patients of VS were seen. The mean age at presentation was 39.03 years (12-72 years. The most common symptom was hearing loss seen in 161 (95.2% cases. Giant VS was seen in 130 (75.5% and hydrocephalus was present in 110 (63.9%. Pre-operative CSF diversion was done in 23 (13.1% patients; 8 (4.6% patients developed gradually symptomatic hydrocephalus following surgery and underwent ventriculoperitoneal shunt. Total surgical excision was done in 92.9% patients and subtotal excision was done in 7% patients. Conclusions: Hydrocephalus occurs in longstanding untreated cases of VS. Hydrocephalus causes no statistically significant increase in post-operative complications like CSF leak and post-operative hematoma. Patients with hydrocephalus presenting with acute symptoms of raised intracranial pressure benefit from CSF diversion. In most patients, tumor resection will restore patency of the CSF pathway and CSF diversion can be avoided.

  11. Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

    Science.gov (United States)

    Scheich, Matthias; Ginzkey, Christian; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Hagen, Rudolf

    2016-10-01

    Microsurgery is one of the primary current standard options for the treatment of vestibular schwannoma (VS). Especially the middle cranial fossa (MCF) approach is a safe and efficacious technique for the preservation of hearing and facial nerve function in small VS. Postoperative complications are rare, although a leakage of cerebrospinal fluid (CSF) is common. The aim of this study was to analyze postoperative CSF leaks and to describe strategies for postoperative treatment. Between October 2005 and May 2012, 148 patients suffering from VS and selected for microsurgery via the MCF approach were treated in our department. Postoperative CSF leakage occurred in 19 patients. We found a leakage via the Eustachian tube into the nasopharynx in 18 patients and one case of incisional leakage. In 13 cases leaking stopped within 5 days by conservative management including bed rest and intravenous (i.v) antibiotics. Five patients needed lumbar drainage (LD) and only two patients had to undergo revision surgery to seal and pack the mastoid. Analyzed risk factors were age, gender, tumor size and pneumatization of the mastoid. Only the latter showed a significant influence on CSF leakage. We could demonstrate that a stepwise strategy is needed for successful treatment of CSF leaks. PMID:26749560

  12. Hearing Outcomes After Stereotactic Radiosurgery for Unilateral Intracanalicular Vestibular Schwannomas: Implication of Transient Volume Expansion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young-Hoon [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.kr [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Jung Ho [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chung, Hyun-Tai; Kim, In Kyung; Song, Sang Woo [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Jeong-Hoon [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Wook; Kim, Yong Hwy; Park, Chul-Kee [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Chae-Yong [Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Paek, Sun Ha; Jung, Hee-Won [Department of Neurosurgery, Seoul National University Hospital, Seoul (Korea, Republic of); Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-01-01

    Purpose: We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials: Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 {+-} 0.03 cm{sup 3} (range, 0.03-1.00 cm{sup 3}), and the mean marginal dose was 12.2 {+-} 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results: The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of {>=}20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average {>=}20 dB) (odds ratio = 7.638; 95% confidence interval, 2.317-25.181; P=.001 and odds ratio = 3.507; 95% confidence interval, 1.228-10.018; P=.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions: Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

  13. Benign Paroxysmal Positional Vertigo After Nonotologic Surgery: Case Series

    OpenAIRE

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2012-01-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe thr...

  14. Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

    Science.gov (United States)

    Linskey, Mark E

    2013-12-01

    By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image--targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the

  15. The Ancient Greece's roots of Olimpism

    Directory of Open Access Journals (Sweden)

    Bubka Sergej Nazarovich

    2011-10-01

    Full Text Available The paper focused on the phenomena of sport in Ancient Greece along with history, traditions, religion, education, culture and art. Economic and political conditions are analysed which promote or hamper development of Olympic Games in Ancient Greece. Exceptional stability of Ancient Olympic games during more than eleven centuries are noted as well as their influence on the life of Greek polices of those days. Hellenistic period needs of individual consideration.

  16. Benign and malignant tumors of the foot and ankle

    International Nuclear Information System (INIS)

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  17. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Adam D.; Datir, Abhijit; Langley, Travis [Emory University Hospital, Department of Radiology, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Tresley, Jonathan [University of Wisconsin, Department of Radiology, Madison, WI (United States); Clifford, Paul D.; Jose, Jean; Subhawong, Ty K. [University of Miami, Department of Radiology, Miami, FL (United States)

    2016-03-15

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  18. Clustered microcalcifications without mass on mammography : benignancy vs. malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yoon Hee; Do, Young Soo; Oh, Hoon Il; Kim, Ki Hwan; Chin, Soo Yil [Korean Cancer Center Hostpital, Seoul (Korea, Republic of); Cho, Byung Jae [Chung Dam Radiologic Clinics, Seoul (Korea, Republic of); Han, Heon [Chungang Gil Hospital, Seoul (Korea, Republic of); Choi, Yeun Hyeun; Han, Boo Kyung [Sam Sung Medical Center, Seoul (Korea, Republic of); Park, Jung Mi [Asan Medical Center, Seoul (Korea, Republic of)

    1996-11-01

    The purpose of this study is to evaluate the accuracy of differentiation between benign and malignant clustered microcalcifications without mass on mammogram. Fourty six mammograms of 44 patients showing clustered microcalcifications without mass were interpreted blindly by five independent observers majoring in breast imaging from different institutions. Twenty two were malignant (10 infiltrating ductal carcinomas, 12 intraductal carcinomas) and 24 were benign (all fibrocystic disease). The observers judge benignancy or malignancy of microcalcifications. The authors assess the accuracy of differential diagnosis of clustered microcalcifications. Of 24 cases proved benign microcalcifications, five radiologists correctly interpreted 20 on average as benign and of malignant 22 cases, 16 on average were correctly interpreted as malignant. The diagnostic accuracy of malignant microcalcifications was 71.8% on average(63.6%{approx}81.8%) and the diagnostic accuracy for benign microcalcifications was 83% on average(71%{approx}92%). It was 9 among total 46 cases that were misinterpreted by more than three radiologists. Among these 9 cases, malignant microcalcifications that had been misinterpreted as benign were seven, benign microcalcifications misinterpreted as malignant were two. The diagnostic accuracy of clustered malignant microcalcifications(71.8%) without mass on mammogram was lower than that of benign microcalcifications(83.3%). So, in case of suspected malignant microcalcification on mammogram, it is preferable that along with magnification view, histopathologic confirmation by core biopsy must be obtained.

  19. Management of benign prostatic hyperplasia with silodosin

    Directory of Open Access Journals (Sweden)

    Tomonori Yamanishi

    2009-08-01

    Full Text Available Tomonori Yamanishi1, Tomoya Mizuno1, Takao Kamai1, Ken-ichiro Yoshida1, Ryuji Sakakibara2, Tomoyuki Uchiyama31Department of Urology, Dokkyo Medical University, Tochigi, Japan; 2Department of Neurology, Sakura Hospital, Toho University, Toho, Japan; 3Department of Neurology, Chiba University, Chiba, JapanAbstract: It has been reported that blockade of α1A-adrenoceptor (AR relieves bladder outlet obstruction, while blockade of α1D-AR is believed to alleviate storage symptoms due to detrusor overactivity. Silodosin, (--1-(3-hydroxypropyl-5-[(2R-2-({2-[2-(2,2,2trifluoroethoxy phenoxy]ethyl}aminopropyl]-2,3-dihydro-1H-indole-7- carboxamide, is a new α1A-AR selective antagonist. Silodosin is highly selective for the α1A-AR subtype, showing an affinity for the α1A-AR that is 583- and 55.5-fold higher than its affinity for the α1B- and α1D-ARs, respectively. In randomized, double-blind, placebo-controlled phase III studies performed in Japan and the United States, silodosin has been shown to be effective for both storage and voiding symptoms associated with benign prostatic hyperplasia. Early effects of silodosin (after 2–6 hours or day 1 on lower urinary tract symptoms have also been reported. In urodynamic studies, detrusor overactivity disappeared in 40% and improved in 35% of patients after administration. In pressure flow studies, the grade of obstruction on the International Continence Society nomogram showed improvement in 56% of patients. The rate of adverse events in the silodosin, tamsulosin and placebo groups was 88.6%, 82.3%, and 71.6%, respectively. The most common adverse event was (mostly mild abnormal ejaculation (28.1%. However, few patients (2.8% discontinued silodosin because of abnormal ejaculation. Orthostatic hypotension showed a similar incidence in the silodosin (2.6% and placebo (1.5% groups. In conclusion, silodosin improves detrusor overactivity and obstruction and thus may be effective for both storage and voiding

  20. P13.26LINEAR ACCELERATOR RADIOSURGERY FOR THE TREATMENT OF NEUROFIBROMATOSIS TYPE 2 RELATED VESTIBULAR SCHWANNOMAS

    OpenAIRE

    Zemskova, O.; Chuvashova, O.

    2014-01-01

    BACKGROUND: Approaches in management of neurofibromatosis type 2 related vestibular schwannomas (VS-NF2) are still controversial. All modern treatment options are less effective in controlling VS-NF2 than sporadic VS. Stereotactic radiosurgery (SRS) can be an alternative to surgery for VS-NF2. We analyzed the efficacy and side effects of SRS in treatment of patients with VS-NF2. MATERIALS AND METHODS: From 2010 till 2013 SRS was applied in twelve patients with 15 VS-NF2. Two patients were pre...