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Sample records for extracranial hypoglossal schwannoma

  1. CT and MRI diagnosis of intracranial and extracranial dumbbell type hypoglossal schwannoma%颅内外哑铃型舌下神经鞘瘤的CT及MR I诊断

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    晋晖; 程敬亮; 徐红卫

    2015-01-01

    目的:探讨颅内外哑铃型舌下神经鞘瘤的CT及 MRI表现特点。方法对5例经手术病理证实为颅内外哑铃型舌下神经鞘瘤的CT、MRI表现作回顾性分析。结果5例颅内外哑铃型舌下神经鞘瘤均表现为经舌下神经管向颅内外延伸的哑铃状肿块影。CT平扫呈软组织密度,可见舌下神经管扩大和枕骨髁、舌下神经管骨质破坏,增强后病灶一般呈较明显环状或不均强化。MRI平扫病灶T1 WI上呈等或低信号,T2 WI为高信号,并可见舌下神经管扩大,增强后病灶明显均匀或不均强化。舌肌萎缩脂肪变性在T1 WI及T2 WI均呈高信号。结论颅内外哑铃型舌下神经鞘瘤具有特征性的CT及 MRI表现,对临床诊治有重要价值。%Objective To discuss CT and MRI characteristics of intracranial and extracranial dumbbell type hypoglossal schwan-noma.Methods CT and MRI findings of 5 cases with intracranial and extracranial dumbbell type hypoglossal schwannoma verified by operation and pathology were analyzed retrospectively.Results All of 5 cases showed dumbbell shapes along hypoglossal nerve canal with intracranial and extracranial extension.CT revealed soft tissue mass and enlargement and destructino of hypoglossal nerve canal.Marked ring-like or inhomogeneous enhancement was showed after giving contrast media.MRI showed soft tissue mass with isointensity or mild hypointensity on T1 WI and mild hyperintensity on T2 WI as well as presented marked homogeneous or inhomoge-neous enhancement after enhanced scan.Enlargement of hypoglossal nerve canal was also seen on MRI.High signal of hemiatrophy of tongue with fatty replacement was seen on both T1 WI and T2 WI.Conclusion There are characteristic CT and MRI appearances for intracranial and extracranial dumbbell hypoglossal schwannoma,which is valuable in diagnosing and treating hypoglossal schwan-noma.

  2. Plexiform hypoglossal schwannoma of the tongue and the submandibular region.

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    Al-Mahdi, Akmam H; Al-Khurrhi, Luay E; Atto, Ghada Z; Dhaher, Ameer

    2012-09-01

    Hypoglossal schwannomas usually develop in the intracranial portion of the brain. Incidence of hypoglossal schwannomas of the submandibular region is extremely rare. A 27-year-old patient presented to us with hypoglossal schwannoma of the tongue and the submandibular region. The tumor was excised intraorally combined with submandibular approach. Histopathologic examination revealed a plexiform schwannoma (a rare variant).

  3. Intraoperative monitoring during surgery for hypoglossal schwannoma.

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    Ishikawa, Mami; Kusaka, Gen; Takashima, Kouichi; Kamochi, Haruna; Shinoda, Soji

    2010-08-01

    A 54-year-old man presented with an intracranial schwannoma of the hypoglossal nerve between the medulla and the left hypoglossal canal. The condylar fossa approach was used with intra-operative electromyography (EMG) monitoring of the lower cranial nerves. The tumor was then removed carefully without decreasing the tongue EMG responses. EMG monitoring enabled us to remove the tumor while maintaining the function of the hypoglossal nerve. Tongue EMG was easily recorded by stimulating the hypoglossal nerve fibers, which was useful in identifying the hypoglossal nerve and evaluating its function. This suggests that tongue EMG is a useful monitoring tool to enhance neurological outcome following removal of tumors in this region.

  4. Hypoglossal Schowannoma: A Case Report and Review of Literature

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    Masoud Naghibzadeh

    2011-01-01

    Schwannoma of the hypoglossal nerve usually develops in the intracranial and extracranial portion or both in the intracranial and extracranial components forming a dumbbell shape tumor .The peripheral hypoglossal schwannomas are extremely rare.

  5. Bilateral hypoglossal schwannoma: a radiologic diagnosis.

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    Bektaş, Devrim; Caylan, Refik

    2004-01-01

    A 53-year-old woman presented with a complaint of a sore throat. Examination showed a left-sided atrophy of the tongue. Upon protrusion, the tongue deviated to the left, suggestive of a unilateral hypoglossal nerve palsy. Computed tomography revealed enlarged hypoglossal canals. Magnetic resonance imaging (MRI) demonstrated bilateral hypoglossal canal masses, with enhancement following gadolinium administration. Magnetic resonance angiography and MRI with fat suppression revealed nonvascular masses in both hypoglossal canals. Radiological diagnosis of bilateral hypoglossal nerve schwannoma was made and the patient was scheduled for MRI monitoring with six-month intervals. The size of the masses and the clinical manifestations remained unchanged during a two-year follow-up period.

  6. 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.

  7. 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.

  8. Parapharyngeal space schwannoma of hypoglossal nerve

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    Surya Kanta Pradhan

    2015-01-01

    Full Text Available Parapharyngeal schwannomas are rare benign neoplasms located in a difficult anatomical region. Most of them are asymptomatic and some presents late. Neurological deficit is a late finding, and it occurs only when the lesion is very large and compresses contiguous structures. Computed tomography (CT guided fine needle aspiration cytology along with preoperative CT and magnetic resonance imaging can detect and diagnose it correctly and helps in proper planning and management. Total surgical excision is the treatment of choice. The approach is different as per the site, but trans-cervical approach is preferred. Recurrence is rare after complete excision. We are presenting a very rare parapharyngeal schwannoma arising from the hypoglossal nerve that was excised by trans-cervical approach without any complications and less morbidity as compared to other described approaches.

  9. [Schwannoma of the hypoglossal nerve presenting as a syndrome of Collet-Sicard].

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    Garcia-Escrivà, A; Pampliega Pérez, A; Martín-Estefania, C; Botella, C

    2005-01-01

    Collet-Sicard is a rare syndrome that consists of the palsy of all the lower four cranial nerves. We describe this entity in relation with a schwannoma of the hypoglossal nerve. A 45 year-old-patient was admitted to the hospital referring hoarseness and difficulty in swallowing for two weeks. On neurological examination, the patient exhibited palsy of the ninth, tenth, eleventh and twelfth nerves. This is a syndrome of Collet-Sicard. The cranial MRI revealed a small intracranial and extracranial tumor adjacent to the hypoglossal foramen. The tumor involved the jugular foramen and was moderately enhanced with gadolinium The patient underwent surgical removal. The pathologic examination of the surgical specimen confirmed the diagnosis of a schwannoma of the hypoglossal nerve. We have carried out a research of the Collet-Sicard syndrome and of its aetiology. Although schwannoma the hypoglossal nerve is a rare disorder we consider that this entity should be included in the differential diagnosis of the Collet-Sicard syndrome.

  10. Hemiatrophy of the tongue due to hypoglossal schwannoma shown by MRI.

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    Okura, A; Shigemori, M; Abe, T; Yamashita, M; Kojima, K; Noguchi, S

    1994-04-01

    Schwannomas account for 8.5% of all intracranial tumours; more than 90% arise from the 8th cranial nerve. Only 42 cases of schwannoma of the hypoglossal nerve have been reported. A 59 year-old woman developed right hemiatrophy of the tongue, clearly demonstrated on MRI, as was a small hypoglossal schwannoma. High signal was seen in the atrophic side of the tongue on both T1- and T2-weighted images, as described in the literature.

  11. Diagnosis and Management of Extracranial Head and Neck Schwannomas: A Review of 27 Cases

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    Ryuji Yasumatsu

    2013-01-01

    Full Text Available Objectives. Clinical records of 27 patients with extracranial head and neck schwannoma were retrospectively reviewed. Methods. Ultrasonography (US was performed in all cases. Seven patients underwent CT. Twenty-five patients underwent MRI. Fine needle aspiration cytology (FNAC was performed for 12 of the 27 patients. Clinical history, surgical data, and postoperative morbidity were analyzed. Results. The images of US showed a well-defined, hypoechoic, primarily homogeneous solid mass. At CT, only one of 7 cases (14% was able to suggest the diagnosis of schwannoma. At MRI, twenty of 25 cases (80% suggested the diagnosis of schwannoma. Only three of 12 cases (25% displayed a specific diagnosis of schwannoma rendered on FNAC. The distribution of 27 nerves of origin was 10 (37% vagus nerves, 6 (22% sympathetic trunks, 5 (19% cervical plexuses, 3 (11% brachial plexuses, 2 (7% hypoglossal nerves, and 1 (4% accessory nerve. Complete tumor resection was performed in 11 patients, and intracapsular enucleation of the tumor was performed in 16 patients. The rate of nerve palsy was 100 (11/11 and 31% (5/16. Conclusions. MRI is sensitive and specific in the diagnosis of schwannoma. Intracapsular enucleation was an effective and feasible method for preserving the neurological functions.

  12. Spontaneous regression of a cystic hypoglossal schwannoma causing unilateral tongue atrophy.

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    Durnford, Andrew J; Harrisson, Stuart E; Ditchfield, Adam; Shenouda, Emad

    2014-01-01

    A 60-year-old lady presented with intermittent headaches. Examination revealed striking marked unilateral tongue atrophy. Magnetic resonance imaging (MRI) revealed a cystic lesion in the hypoglossal canal and a provisional diagnosis of cystic hypoglossal schwannoma made. Annual surveillance scans showed stable appearances but surprisingly at 3 years they showed a significant reduction in the size of the lesion. Most patients with hypoglossal schwannomas present with ipsilateral hypoglossal nerve palsy; careful cranial nerve examination is vital in diagnosing such rare lesions. Little is known of their natural history, with most lesions undergoing surgery. This case highlights spontaneous regression following non-operative management.

  13. Hypoglossal Schowannoma: A Case Report and Review of Literature

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    Masoud Naghibzadeh

    2011-01-01

    Full Text Available Introduction: Schawannomas (neuromas, neurilemmomas are benign tumors originating from showann cells or nerve fiber sheet cells. They are solitary, encapsulated tumors usually attached to, or surrounded by a nerve. Case Report: We present a case of left hypoglossal nerve schwannoma in a 19 year old man who was admitted with progressive left tongue atrophy. Conclusion: Schwannoma of the hypoglossal nerve usually develops in the intracranial and extracranial portion or both in the intracranial and extracranial components forming a dumbbell shape tumor .The peripheral hypoglossal schwannomas are extremely rare.

  14. Schwannoma of the descending loop of the hypoglossal nerve: Case report.

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    Illuminati, Giulio; Pizzardi, Giulia; Pasqua, Rocco; Palumbo, Piergaspare; Vietri, Francesco

    2017-01-01

    Schwannomas of the descending loop of the hypoglossal nerve are very rare. They are slow-growing tumors that may masquerade a carotid body tumor. A 60-year-old female was referred for a latero-cervical mass appearing as a chemodectoma at CT-scan. At operation, a 2cm mass arising from the descending loop of the hypoglossal nerve was resected en bloc with the loop itself and a functional lymphadenectomy was associated. Post-operative course was uneventful and the patient is free from disease recurrence at one year follow-up. En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, beside requiring reintervention, it may harbor a malignant evolution towards sarcoma. Schwannomas of the descending lop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Intradural microsurgery and extradural gamma knife surgery for hypoglossal schwannoma: case report and review of the literature.

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    Tucker, A; Miyake, H; Tsuji, M; Ukita, T; Nishihara, K; Ohmura, T

    2007-12-01

    There have been only 26 cases of hypoglossal schwannomas reported to originate intradurally and extend extradurally into the hypoglossal canal. This 31-year-old mother of two children presented with a 5-day history of progressive headache, nausea, vomiting and vertigo. Her neurological exam was significant for nystagmus and left tongue deviation with marked atrophy. An initial head CT revealed extensive left hypoglossal canal erosion with 4th ventricle compression. T1-weighted MR images with contrast revealed a 4x3 cm left cerebellopontine angle non-homogeneously enhancing mass with an intracranial cystic component and prominent extension into the eroded hypoglossal canal. A left lateral suboccipital craniotomy was performed for subtotal microsurgical resection of the intradural posterior fossa mass. A schwannoma was diagnosed after resection and gamma knife surgery (GKS) was performed three months later for the extradural residual tumor without further deficits. This is a rare report of a hypoglossal schwannoma in a young patient who was treated with a multimodality approach in order to minimize risks. A review of the literature and discussion of the respective benefits of microsurgery versus GKS and long-term follow-up issues are presented.

  16. Hypofractionated stereotactic radiotherapy for dumbbell-shaped hypoglossal schwannomas: Two cases of long-term follow-up and a review of the literature

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    Li, Yong; Lou, Jinrong; Qiu, Shujun; Guo, Yutian; Pan, Mianshun

    2016-01-01

    Cases of hypoglossal schwannoma are extremely rare. Historically, microsurgical resection has been the standard treatment, but it may not always be feasible; thus, it is crucial to investigate alternative treatments. We herein present the cases of two patients, both of whom presented with tongue deviation and hemiatrophy, accompanied by headaches. Magnetic resonance imaging revealed a dumbbell-shaped tumor originating from the hypoglossal nerve that was adjacent to the cranial base in each patient. Hypofractionated stereotactic radiotherapy was used to treat the tumors, with a total dose of 30 Gy in 3-Gy fractions delivered to the planning target volume. Several months later, the tumors had significantly decreased in size and the symptoms of the two patients had gradually improved. PMID:27446582

  17. [Lingual schwannoma].

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    Ulkü, Cağatay Han; Demir, Hilal; Yeşildemir, Huri Sultan; Esen, Hasan

    2014-01-01

    Schwannomas are benign, slow growing, solitary and encapsulated neuroectodermal tumors arising from Schwann cells of the nerve sheath. Twenty-five percent of all extracranial schwannomas are seen in the head and neck region. Intra-oral schwannomas are rare and commonly seen at the tongue base. In this article, a 20-year-old female case with lingual schwannoma as a rare clinical condition and characteristics of the disease were summarized in the lights of the literature.

  18. Tongue schwannoma: clinicopathological findings.

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    Catalfamo, Luciano; Lombardo, Giuseppe; Nava, Carla; Familiari, Elena; Petrocelli, Marzia; Iudicello, Valeria; Ieni, Antonio; Barresi, Valeria; De Ponte, Francesco Saverio

    2011-05-01

    Schwannomas are peripheral nerve sheath tumors. Approximately 25% of extracranial schwannomas are located in the head and neck district, but only 1% shows an intraoral origin. We report a case of a 28-year-old patient with a tongue schwannoma. Morphologic analysis and immunohistochemical findings strongly support the diagnosis. Surgical treatment is discussed.

  19. Imaging the hypoglossal nerve

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    Alves, Pedro [Department of Radiology, Centro Hospitalar de Lisboa Central-Hospital de Sao Jose, Rua Jose Antonio Serrano, 1150-199 Lisboa Codex (Portugal)], E-mail: tojais.pedro@gmail.com

    2010-05-15

    The hypoglossal nerve is a pure motor nerve. It provides motor control to the intrinsic and extrinsic tongue muscles thus being essential for normal tongue movement and coordination. In order to design a useful imaging approach and a working differential diagnosis in cases of hypoglossal nerve damage one has to have a good knowledge of the normal anatomy of the nerve trunk and its main branches. A successful imaging evaluation to hypoglossal diseases always requires high resolution studies due to the small size of the structures being studied. MRI is the preferred modality to directly visualize the nerve, while CT is superior in displaying the bony anatomy of the neurovascular foramina of the skull base. Also, while CT is only able to detect nerve pathology by indirect signs, such as bony expansion of the hypoglossal canal, MRI is able to visualize directly the causative pathological process as in the case of small tumors, or infectious/inflammatory processes affecting the nerve. The easiest way to approach the study of the hypoglossal nerve is to divide it in its main segments: intra-axial, cisternal, skull base and extracranial segment, tailoring the imaging technique to each anatomical area while bearing in mind the main disease entities affecting each segment.

  20. [Peripheral nerve injuries complicating extracranial vascular surgery (author's transl)].

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    Grobe, T; Raithel, D

    1978-10-01

    Peripheral nerve injuries may complicate extracranial vascular surgery. Pareses of the recurrent and hypoglossal nerves are clinically important. The nervus laryngeus superior, the ramus marginalis mandibulae of the facial nerve and the brachial plexus may be involved. Horner's syndrom indicating damage of sympathetic fibers may also appear. Lesions of the glossopharyngeal, vagus and phrenic nerves are rather seldom.

  1. [A rare case of schwannoma of the tongue].

    Science.gov (United States)

    Grabowski, Leszek

    2008-01-01

    Author described a rare case of lingual Schwannoma in 20 years old female. After complete surgical excision she has not shown recurrence during 2 years of follow-up. Schwannomas are peripheral nerve tumors of nerve sheath origin. Extracranial schwannoma in the head and neck region comprise 25-45% of all shwannomas, but only 1% are located intraoral and usually present as slow growing mass of long duration, producing few symptoms. The treatment is surgical excision.

  2. [Four cases of extracranial trigeminal benign neurogenic tumors].

    Science.gov (United States)

    Mada, Yusuke; Ueki, Yuji; Konno, Akiyoshi

    2014-11-01

    Extracranial trigeminal schwannomas are rare tumors accounting for about 10% of all trigeminal schwannomas. We report herein on four cases of extracranial trigeminal benign neurogenic tumors. The patients were aged between 39 and 75 years; they consisted of one male and three females. The origins of the schwannomas consisted of the maxillary nerve in two cases and the mandibular nerve in two cases. All cases were surgically treated using a transmaxillary approach in three cases, and a combination of the transcervical-parotid approach with a midline mandibulotomy in one case. In two cases, the schwannomas located in the pterygopalatine fossa were removed using a transmaxillary approach with the endoscope and the surgical microscope. Two patients underwent selective intravascular embolization of the feeding artery to reduce intraoperative bleeding, and they were less invasively treated via the transmaxillary approach.

  3. Intracochlear schwannoma

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    Manoj Manikoth Puthiyaparambil

    2016-01-01

    Full Text Available Intracochlear schwannoma is rarely diagnosed. We report the case of a 27-year-old woman with intracochlear schwannoma who presented with 7 years history of hearing impairment. Audiological tests and imaging studies revealed a possibility of intracochlear schwannoma. Excision of the tumor was done by transcochlear approach. The histologic diagnosis was schwannoma. Her postoperative course was uneventful. We present this rare case and discuss the presentation, diagnosis, and management options in such cases.

  4. Surgical approaches for tongue base schwannoma.

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    Ying, Binbin; Zhu, Songsong; Qiao, Yang; Ye, Weimin; Maimaiti, Abdikerimjian; Hu, Jingzhou; Zhang, Yong

    2013-01-01

    Schwannomas (neurilemmomas) are benign nerve sheath tumor originating from Schwann cells. They are well circumscribed and rarely infiltrate and metastasize. Schwannomas of the head and neck commonly occur in the tongue followed by the palate, floor of mouth, buccal mucosa, and mandible. Tongue base schwannomas could extend to the pharyngeal cavity or the floor of the mouse, and it is difficult to differentiate between tumors of the lingual, hypoglossal, and glossopharyngeal nerves.Surgical treatment of tongue base schwannomas is difficult because of limited operative exposure. Although mandibulotomy with lip splitting could obtain good exposure, surgeons might strike a balance between exposure obtaining and morbidity following because there are intricate neurovascular anatomical relationships in this region, and mandibulotomy with lip splitting would cause significant morbidity. Surgical approach options are important for tongue base schwannoma removal. From March 2008 to March 2010, 8 patients were clinically and pathologically diagnosed with tongue base schwannomas in our department, and all underwent surgical treatment. In our experience, transoral approach was used for tongue base schwannomas extending to the floor of the mouse and suprahyroid pharyngotomy approach for those extending to the pharyngeal cavity. Follow-up was made until now. One patient who experienced transoral excision still experienced numbness in the region of the lateral tongue tip, and the other 7 patients had no postoperative long-term complications.

  5. Lingual schwannoma.

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    Enoz, Murat; Suoglu, Yusufhan; Ilhan, Ridvan

    2006-01-01

    Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach.

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

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    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.

  7. Intraosseous Schwannoma

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    Bhavna Nayal

    2015-06-01

    Full Text Available Intraosseous schwannomas are rare and benign neoplasms originating from the nerve sheath cells. We present two such cases, one located in the ninth thoracic vertebrae and the other involving the sacrum. Clinicoradiological diagnosis in both the cases was a primary bone tumour. Histopathological examination revealed characteristic morphology of schwannoma which was confirmed by immunohistochemistry. These two cases highlight the importance of clinical, radiological and histopathological correlation in the diagnosis of these uncommon bone tumors. [J Interdiscipl Histopathol 2015; 3(2.000: 74-77

  8. Plexiform (multinodular) schwannoma of soft palate. Report of a case.

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    Kapetanakis, Stylianos; Vasileiadis, Ioannis; Petousis, Aristotelis; Fiska, Aliki; Stavrianaki, Anna

    2012-01-01

    Plexiform schwannoma is a rare benign neoplasm of the neural sheath characterized by a multinodular plexiform growth pattern. Only 5% of schwannomas have a plexiform or multinodular growth pattern. Schwannoma apparently derives from the Schwann cells. Extracranially, 25% of all schwannomas are located in the head and neck region, but only 1% show an intraoral origin. The intraoral lesions show a predilection for the tongue, followed by the palate, buccal mucosa, lip and gingival. Microscopic examination is necessary to confirm the diagnosis. Characteristic histological signs are the palisading of the spindle-shaped Schwann cells around the central acellular area, so called Verocay bodies. We report a case of a 21-year-old woman with a smooth mass of the soft palate that was gradually increasing. Surgical excision of the mass was done and the histopathology and immunohistochemistry study of the excised lesion revealed a multinodular plexiform schwannoma of the soft palate. The patient is under regular clinical control, with no signs of recurrence after 17 months. Plexiform schwannomas of the soft palate are mentioned very rarely in the English literature. This rare benign tumor is worthy of recognition because it can be misdiagnosed as plexiform neurofibroma.

  9. Schwannoma of tongue.

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    Moreno-García, Carlos; Pons-García, María Asunción; González-García, Raúl; Monje-Gil, Florencio

    2014-06-01

    The schwannomas are nervous tissue tumors. We report a case of schwannoma of oral tongue. Because schwannomas are quite rare in the oral cavity, they are often not immediately included in the differential diagnosis of oropharyngeal masses, causing delay in identification and treatment. The definitive diagnosis requires histopathologic examination.

  10. Osteoplastic maxillotomy approach for infraorbital nerve schwannoma, a case report.

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    Karkas, Alexandre A; Schmerber, Sébastien A; Bettega, Georges V; Reyt, Emile P; Righini, Christian A

    2008-03-01

    Extracranial schwannomas can readily occur in the head and neck region and rarely involve the trigeminal nerve. As a rule, their treatment is surgical and dictated by the location of the tumor and nerve of origin. We describe a case of a 14-year-old boy with a mass invading right nasal fossa, maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. The diagnosis of a nerve sheath tumor was evoked after angiography showed no vascular blush. The tumor was removed through a Weber-Fergusson incision with subciliary extension followed by maxillozygomatic osteotomy. This approach showed the tumor to be coming from the infraorbital nerve and allowed complete tumor exposure and removal. Pathology confirmed the diagnosis of a schwannoma. We describe the osteoplastic maxillotomy approach which we felt most appropriate for removal of the infraorbital schwannoma and discuss other possible surgical options for this type of tumor. (c) 2007 Wiley Periodicals, Inc. Head Neck 2008.

  11. [Neuroanatomy of the optic, trigeminal, facial, glossopharyngeal, vagus, accessory and hypoglossal nerves (author's transl)].

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    Lang, J

    1981-01-01

    1. The intracranial and intraorbital course of the optic nerve is described concisely, the intracanicular one in full details. Apart from the wide and small sections of the optic canal, its axis opposite to the cranial planes, the coating of the canal and the adjacency to the paranasal sinuses and arteries are exactly described. 2. At the trigeminal nerve the trigeminal ganglion, its roots and also the mandibular nerve have great importance in the practical medicine considering thermo-coagulation or surgery of the trigeminal nerve. This segments and also the adjacency of the fifth nerve to the internal carotid artery and subarachinoid brain vessels are exactly, the nuclei areas and central tracts are briefly explained. 3. The nuclei of the facial nerve the intracerebral and intracisternal course and its development, the facial canal and its narrow passes are described. Also the position of the internal acoustic pore in the skull, the dimensions of the internal acoustic meatus and the relations between nerves and vessels are explained. In addition to the geniculate ganglion and the chorda tympani the communications of the facial nerve inside the temporal bone, the tympanic intumescentia (ganglion) and the nervus intermedius, also the petrosal nerves are included in the description. The sheaths of the segments of the seventh cranial nerve and also the fasciculation are exactly, the somatotopic organization is briefly described. 4. The extracranial course of the glossopharyngeal nerve is briefly, its intracranial sections are included exactly in the investigation. 5. The nuclei of the vagus nerve and the intra- und extracranial course are described. 6. The accessory nerve, its nucleus and the intra- and extracranial course are concisely explained. 7. The hypoglossal nerve, its nucleus, the emergence of the fibres and also the relations of nerves and vessels in the posterior cranial fossa are described. The hypoglossal canal and also the extracranial course are

  12. Dilde Schwannoma

    OpenAIRE

    2001-01-01

    Schwannoma, sinir kılıflarının Schwan hücrelerinden kaynaklanan, nöroektodermden ori jin alan, sert, düzgün sınırlı, kapsüllü, yavaş büyüyen ve genellikle sarımtırak renkte iyi huylu bir tümördür. Etiyolojisi bilinmemektedir. En sık baş ve boyun bölgesinde görülür. İntrakranial olguların büyük bir bölümü 8. kran ial sinirden kaynaklanmaktadır. Oral kavitede ve özellikle dilde oldukça nadir görülür. Tedavisi kitlenin cerrahi olarak çıkarılmasıdır. İngilizce literatürde dilde yerleşimli sadece ...

  13. [Submucosal lingual schwannoma].

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    Ulusoy, Bülent; Bozdemir, Kazım; Ersoy Çallıoğlu, Elif; Kutluhan, Ahmet; Korkmaz, Mehmet Hakan

    2015-01-01

    Schwannoma or neurilemmoma is a slow growing, solitary, and encapsulated benign tumor originating from Schwann cells of the peripheral nerves. Lingual schwannomas are rare. A 46-year-old male patient admitted with a complaint of swelling on the right half of the tongue for one year. An approximately 1x1 cm submucosal mass was detected on the right side of the tongue. The submucosal mass was totally excised under local anesthesia. Pathological examination was consistent with schwannoma. Lingual schwannomas should be considered in the differential diagnosis of tongue masses.

  14. Intraosseous schwannoma in schwannomatosis

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. 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.

  16. Solitary eyelid schwannoma

    Directory of Open Access Journals (Sweden)

    Renu M Magdum

    2014-01-01

    Full Text Available Schwannomas are rare benign tumors arising from Schwann cells of peripheral nerves that form the neural sheath. While there have been reports of such tumors in the orbit, solitary schwannomas arising from the eyelids are very rare. There are reports of schwannomas being erroneously diagnosed as chalazion, inclusion cysts or even eyelid malignancy. We are reporting a case of a 20-year-old female who presented with a painless, non-tender, slow-growing mass in the upper eyelid of the right eye. The external appearance of the mass was suggestive of an implantation cyst of the eyelid and it could be completely excised as it had a well-defined capsule. Histopathological examination showed characteristic hypercellular and hypocellular areas with fusiform nuclei that tended to form palisades. The purpose of reporting this case of schwannoma in a young female is to recommend the inclusion of this entity as a differential diagnosis of well-defined lid tumors.

  17. SCHWANNOMA TONGUE - CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sanjay

    2013-11-01

    Full Text Available A schwannoma (also known as an "neurilemmomma (1, is a benign nerve sheath tumor composed of Schwann cells , which normally produce the insulating myelin sheath covering peripheral nerves .

  18. LINGUAL SCHWANNOMA: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    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.

  19. Management of Large Tongue Schwannoma – A Short Report

    Directory of Open Access Journals (Sweden)

    Jayanta Medhi

    2016-03-01

    Full Text Available Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site for schwannomas, tongue being the most common location. Here we are presenting a case of a young adult who presented with a huge swelling in the tongue which was removed by mandibulotomy approach and pre-operative tracheostomy. A 22-year-old male patient presented to the outpatient department with a history of swelling in the tongue for the last 4 years with progressive difficulty in swallowing food and change of voice over the last few months. Upon examination a large swelling was observed on the posterior part of the tongue compromising the oropharyngeal inlet. The approximate size of the swelling was 5cmx4cm. After proper clinical evaluation the patient was advised to obtain a magnetic resonance imaging (MRI study of the oral cavity, which showed it to be a nerve sheath tumor (Schwannoma originating from the hypoglossal nerve branch. The patient was admitted for surgery. As difficult intubation was anticipated, pre-operative tracheostomy was performed. The tongue mass was approached by right paramedian mandibulotomy using a transcervical lip split incision. Post operative histopathological examination of the removed specimen showed hypercellular ‘Antony A’ area with plump spindle cells and hypocellular ‘Antony B’ area in a Hematoxylin & eosin stain (200x. This confirmed the diagnosis for a schwannoma. As each and every case is unique in its presentation, so is the management. The idea of presenting the above case is to emphasise the role of selection for the proper approach and foresee the preventable complications while working around the airway.

  20. Schwannoma of the vagus nerve masquerading as a carotid body tumor.

    Science.gov (United States)

    Schupp, Daniela J; Mukherjee, Dipankar; Sharma, Gopesh K

    2009-01-01

    A 45-year-old male presented with increasing hoarseness and swelling of his right neck over 5 months. He was noted to have right vocal cord paralysis and hemiatrophy of his tongue. He was found to have a schwannoma of the vagus nerve with compression of the right hypoglossal nerve. One month after his surgery, the patient's tongue mobility was improving, he was not aspirating, his voice was better and his right vocal cord remained abducted. A discussion of this case is followed by a review of the literature surrounding this rare disease and this unique presentation.

  1. SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE: CASE REPORT.

    LENUS (Irish Health Repository)

    2012-02-01

    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.

  2. SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE: CASE REPORT.

    LENUS (Irish Health Repository)

    Raza, Kazim

    2011-01-25

    SOLITARY PARAGANGLIOMA OF THE HYPOGLOSSAL NERVE:: Case Report BACKGROUND AND IMPORTANCE:: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumour are discussed with literature review. CLINICAL PRESENTATION:: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left sided tongue wasting. On examination there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2cm x 2cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral sub occipital craniotomy was carried out in the sitting position. The hypoglossal nerve appeared to be enlarged and the jugular foramen was normal. Complete surgical debulking of the tumour was not attempted due to its vascular nature. The nerve was decompressed and neuropathology confirmed a low grade paraganglioma arising from the hypoglossal nerve. The patient is scheduled to receive stereotactic radiation for further management. CONCLUSION:: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focussed on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted in the MRI scan, a pre-operative angiogram should be performed with a view for embolisation.We decompressed the hypoglossal canal and achieved a good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumours and regular follow up with MRI scans.

  3. [Hypoglossal nerve neuropraxia after shoulder hemiarthroplasty].

    Science.gov (United States)

    Pariente, L; Camarena, P; Koo, M; Sabaté, A; Armengol, J

    2014-05-01

    We report a case of hypoglossal nerve damage after shoulder hemiarthroplasty with the patient in "beach chair" position, performed with general anesthesia with orotracheal intubation, and without complications. An ultrasound-guided interscalene block was previously performed in an alert patient. After the intervention, the patient showed clinical symptomatology compatible with paralysis of the right hypoglossal nerve that completely disappeared after 4 weeks. Mechanisms such as hyperextension of the neck during intubation, endotracheal tube cuff pressure, excessive hyperextension, or head lateralization during surgery have been described as causes of this neurological damage. We discuss the causes, the associated factors and suggest preventive measures. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  4. Plexiform schwannoma of the clitoris.

    Science.gov (United States)

    Chuang, Wen-Yu; Yeh, Chi-Ju; Jung, Shih-Ming; Hsueh, Swei

    2007-07-01

    Only three cases of clitoral schwannoma have been reported in the English language literature, with none of them being a plexiform schwannoma. Here we report the first plexiform schwannoma of the clitoris. A 41-year-old woman without neurofibromatosis presented with a 2 x 2 cm, slowly growing, painless tumor of the clitoris. Simple excision of the tumor was performed, and pathological examination revealed a plexiform schwannoma. No evidence of recurrence was noted after 2 years of follow-up. Despite its rarity, a schwannoma should be included in the differential diagnosis of a clitoral enlargement or mass. Our case, despite its unique plexiform growth pattern, has clinical features similar to those of other reported cases of clitoral schwannoma.

  5. Solitary paraganglioma of the hypoglossal nerve: case report.

    LENUS (Irish Health Repository)

    Raza, Kazim

    2011-04-01

    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 × 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  6. Solitary paraganglioma of the hypoglossal nerve: case report.

    LENUS (Irish Health Repository)

    Raza, Kazim

    2012-02-01

    BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 x 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient\\'s symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

  7. Schwannoma of the nasal septum

    Directory of Open Access Journals (Sweden)

    Abdullah Karatas

    2016-11-01

    Full Text Available Schwannomas are benign and slow growing tumors originating from the Schwann cells of peripheral nerve sheath. Schwannomas of sinonasal origin are rare (4% however septal schwannomas are much more rarer. We presented a 31 year old female patient. At physical examination a pale gray, smooth polypoid lesion obstructing the right nasal cavity was detected. Midfacial degloving and endoscopic approach were combined for surgical treatment. The tumor was originating from posteromedial area of the septal nasal cartilage, close to the bony cartilaginous junction. Postoperative histological examination of the specimen showed a benign tumoral growth consisting of spindle shaped cells and immunohistochemical staining of the tumor proved septal schwannoma.

  8. 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....

  9. 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....

  10. 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...... targets the angiogenic process by investigation of tumor expression of MMP-2, MMP-9, and tissue inhibitors of metalloproteinase (TIMP)-1. A possible correlation with gender, patient age, symptom duration, tumor size, and the absolute and relative growth rate is explored....

  11. [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.

  12. 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.

  13. Intraosseous schwannoma of the humerus

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  14. Parietal intraparenchymal Schwannoma: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hwan; Chung, Tae Woong; Yoon, Woong; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National University Hospital, Kwangju (Korea, Republic of)

    2008-10-15

    We report a case of an intraparenchymal schwannoma of the left parietal lobe. A 51-year-old woman was admitted to our hospital with complaints of intermittent headaches. Computed tomography and magnetic resonance images revealed a 1.3 cm sized intra-axial homogeneous enhancing mass in the left parietal lobe. The lesion was pathologically confirmed to be a schwannoma.

  15. 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.

  16. Anatomical and Clinical Aspects of the Hypoglossal Nerve: Literature Review

    OpenAIRE

    Rivera Cardona, Guillermo; Pontificia Universidad Javeriana

    2014-01-01

    Hypoglossal nerve or twelfth cranial nerve supplies the tongue´s muscles, it has its real origin general somatic efferent in the hypoglossal motor nucleus; it is localized in the brain stem and its apparent origin in preolivary sulcus. It passes through anterior condyle foramen, after passes through neck and tongue. Along the hypoglossal nerve pathway by trigonum caroticum, trigonum submandibulare and trigonum submentale, it receives branches of the cervical plexus for the infra-hyoid muscles...

  17. Intraosseous schwannoma of the ilium.

    Science.gov (United States)

    Kato, Hiroki; Kanematsu, Masayuki; Ohno, Takatoshi; Oshima, Koji; Nagano, Akihito; Hatano, Yuichiro; Nishibori, Hironori

    2015-01-01

    We presented a 27-year-old male diagnosed with intraosseous schwannoma of the ilium. Computed tomographic images revealed a well-demarcated, lobulated, expansile, osteolytic lesion in the right supraacetabular region of the ilium. In addition, an intratumoral punctate calcification and a sclerotic rim were observed. T2-weighted magnetic resonance (MR) images demonstrated a heterogeneously hyperintense lesion with a hypointense rim. Major parts of the lesion, excluding some central areas, were enhanced on gadolinium-enhanced MR images. Pathological examination revealed an intraosseous schwannoma. Our findings indicate that intraosseous schwannoma should be considered when images demonstrate a well-demarcated, lobulated, expansile, osteolytic lesion with a sclerotic rim.

  18. 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.

  19. Schwannoma of the palatine tonsil.

    Science.gov (United States)

    Anil, H T; Gowda, B V Chandre; Lakshmi, S; Niveditha, S R

    2005-07-01

    Schwannoma is a solitary, benign tumour arising from the neural sheath Schwann cells of the peripheral, cranial or autonomic nerves. In the head and neck region, it occurs most commonly in association with the acoustic nerve within the skull and is rarely found in oral structures. When it is found in oral structures, the tongue is reported to be the favoured site. Schwannoma of the tonsil is extremely rare, with only two cases reported in the literature. We report what is, to our knowledge, the third case of schwannoma of the tonsil, diagnosed by histopathology.

  20. Intraosseous schwannoma of the metacarpal

    Energy Technology Data Exchange (ETDEWEB)

    Vora, R.A.; Athanasian, E.A. [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Mintz, D.N. [Hospital for Special Surgery, New York, NY (United States)

    2000-04-01

    Intraosseous schwannoma (neurilemmoma) is an extremely rare, benign neoplasm, constituting less than 0.2% of primary bone tumors. It infrequently involves the bones of the hand. We present a case of intraosseous neurilemmoma of the metacarpal. (orig.)

  1. Multiple isolated cutaneous plexiform schwannomas

    Directory of Open Access Journals (Sweden)

    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.

  2. Schwannoma of the hard palate.

    Science.gov (United States)

    Isildak, Huseyin; Yilmaz, Mehmet; Ibrahimov, Metin; Aslan, Mehmet; Karaman, Emin; Enver, Ozgun

    2010-01-01

    About half of all neurogenic tumors are seen in the head and neck region. The types of neurogenic tumors must be distinguished. Schwannomas originate from Schwann cells of the neural sheath and are solitary, well-encapsulated, slow-growing adjacent to the parental nerve but extrinsic to the nerve fascicles.Approximately 25% to 45% of all schwannomas are seen in the head and neck region and are found rarely in the oral cavity. Most of the intraoral schwannomas are located in the tongue. Other less common locations are the buccal mucosa, palate, base of the mouth, gingiva, and lips.In this study, we report a rare case of schwannoma of the hard palate, which was excised intraorally.

  3. 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.)

  4. Schwannoma of the hard palate

    OpenAIRE

    2009-01-01

    Schwannomas are benign encapsulated perineural tumors. The head and neck region is the most common site. Intraoral origin is seen in only 1% of cases, tongue being the most common site; its location in the palate is rare. We report a case of hard-palate schwannoma with bony erosion which was immunohistochemically confirmed. The tumor was excised completely intraorally. After two months of follow-up, the defect was found to be completely covered with palatal mucosa.

  5. Schwannoma of the sigmoid colon

    OpenAIRE

    Çakır, Tuğrul; Aslaner, Arif; Yaz, Müjgan; Gündüz, Umut Rıza

    2015-01-01

    Colonic schwannomas are very rare gastrointestinal tumours originating from Schwann cells, which form the neural sheath. Primary schwannomas of the lower gastrointestinal tract are very rare and usually benign in nature. However, if they are not surgically removed, malign degeneration can occur. We report a case of a 79-year-old woman who presented to our clinic with rectal bleeding and constipation. She underwent a lower gastrointestinal tract endoscopy. A mass subtotally obstructing the lum...

  6. Correlation between intra- and extracranial background EEG

    DEFF Research Database (Denmark)

    Duun-Henriksen, Jonas; Kjær, Troels Wesenberg; Madsen, Rasmus Elsborg

    2012-01-01

    Scalp EEG is the most widely used modality to record the electrical signals of the brain. It is well known that the volume conduction of these brain waves through the brain, cerebrospinal fluid, skull and scalp reduces the spatial resolution and the signal amplitude. So far the volume conduction...... has primarily been investigated by realistic head models or interictal spike analysis. We have set up a novel and more realistic experiment that made it possible to compare the information in the intra- and extracranial EEG. We found that intracranial EEG channels contained correlated patterns when...... placed less than 30 mm apart, that intra- and extracranial channels were partly correlated when placed less than 40 mm apart, and that extracranial channels probably were correlated over larger distances. The underlying cortical area that influences the extracranial EEG is found to be up to 45 cm2...

  7. [Anterior skull-base schwannoma].

    Science.gov (United States)

    Esquivel-Miranda, Miguel; De la O Ríos, Elier; Vargas-Valenciano, Emmanuelle; Moreno-Medina, Eva

    2017-06-24

    Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Foramen magnum, occipital condyles and hypoglossal canals morphometry: anatomical study with clinical implications.

    Science.gov (United States)

    Lyrtzis, Ch; Piagkou, M; Gkioka, A; Anastasopoulos, N; Apostolidis, S; Natsis, K

    2017-01-01

    Current study examines morphometric alterations of the foramen magnum (FM), occipital condyles (OCs) and hypoglossal canals (HCs) and highlights all the morphometric parameters of the FM area that present side asymmetry, gender dimorphism and are affected by the ageing. One hundred and forty-one (73 male and 68 female) Greek adult dry skulls were examined. Short and long OCs were detected in 27.7% and 26.2%. A combination of short OCs and long HCs was presented in 27.5%. A complete septum was found in 23.6% of the HCs and osseous spurs in 12.9%. Side asymmetry was detected regarding the HCs length (p = 0.046), the maximum extracranial (p = 0.001) and minimum intracranial (p = 0.001) diameters. Mean FM anteroposterior and transverse diameters, FM perimeter and FM surface area were significantly larger in male than in female skulls (p = 0.001 for each parameter). Similarly, the OCs length (right, p = 0.004 and left, p = 0.024) and width (right, p = 0.008 and left, p = 0.006) the left distance HC-OC posterior border (p = 0.048), the anterior (p = 0.011) and posterior (p = 0.001) intercondylar distances and the HCs right length (p = 0.046) were significantly greater in males. A significant decrease was observed with ageing in FM anteroposterior diameter (p = 0.038), FM surface area (p = 0.05), anterior intercondylar distance (p = 0.014) and HC-OC posterior border (p = 0.013). The study confirmed that only specific HC dimensions showed side asymmetry (HCs maximum extracranial and minimum intracranial diameters and HCs length), gender dimorphism (HCs right length and left distance HC-OC posterior border) and age influence (HC-OC posterior border and HC left extracranial minimum diameter) among young, adults and elderly individuals. FM and OCs dimensions presented gender dimorphism and the age influenced only FM anteroposterior diameter and surface area and the anterior intercondylar distance. The safe zone of OCs drilling in Greeks, calculated by the distance HC

  9. A Huge Ancient Schwannoma of the Epiglottis.

    Science.gov (United States)

    Lee, Dong Hoon; Kim, Jo Heon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

    2016-03-01

    Ancient schwannoma of the epiglottis is extremely rare. The authors report the first case of a patient with a huge ancient schwannoma of the epiglottis. Clinicians should consider the possibility that ancient schwannoma may originate in the epiglottis mimicking the other more frequently observed lesions.

  10. Endoscope-assisted retrosigmoid intradural suprameatal approach for surgical treatment of trigeminal schwannomas.

    Science.gov (United States)

    Samii, Madjid; Alimohamadi, Maysam; Gerganov, Venelin

    2014-12-01

    Trigeminal schwannomas are the most common intracranial nonvestibular schwannomas, and the dumbbell-shaped subtype is the most challenging. To evaluate the efficiency and safety of the endoscope-assisted retrosigmoid intradural suprameatal approach (EA-RISA) for dumbbell trigeminal schwannomas and to compare EA-RISA with classic RISA. A retrospective study of all patients with trigeminal schwannomas was performed with a focus on dumbbell tumors. Tumors were classified according to a modified Samii classification. Extent of tumor removal, outcome, and morbidity rates in the 2 subgroups were compared. Twenty patients were enrolled: 8 had dumbbell-shaped tumors (type C1), 8 had middle fossa tumors (A1-3), 3 had extracranial extension (D2), and 1 had posterior fossa tumor. Gross total resection was achieved in 15 and near-total resection in 5 patients. In 4 patients with dumbbell tumors, the classic RISA (Samii approach) was used; EA-RISA was used in the other 4 patients. The extent of petrous apex drilling was determined individually on the basis of the anatomic variability of suprameatal tubercle and degree of tumor-induced petrous apex erosion; in 2 patients, only minimal drilling was needed. The endoscope was applied after microsurgical tumor removal and in 3 of 4 patients revealed a significant unrecognized tumor remnant in the anterolateral and superolateral aspects of the Meckel cave. Thus, the EA-RISA technique allowed gross total resection of the tumor. The EA-RISA enlarges the exposure obtained with the classic RISA. Its judicious use can help achieve safe and radical removal of dumbbell-shaped trigeminal schwannomas (C1 type).

  11. Giant Plexiform Schwannoma of the Tongue

    Directory of Open Access Journals (Sweden)

    Lluís Nisa

    2011-01-01

    Full Text Available We present the case of a 38-year-old woman that presented with a very slowly enlarging mass of the tongue. MRI revealed a large mass originating in the tongue base and extending to the supraglottic space. Biopsy of this tumor confirmed the diagnosis of schwannoma. An endaural approach allowed complete resection of the tumor. Definitive histopathological examination showed a plexiform schwannoma. Schwannoma or neurilemoma represents a benign tumor potentially affecting any nerve. The head and neck region is a relatively common location for schwannomas, but tongue schwannomas are considered to be rare and pose the problem of both clinical and histological differential diagnosis of tongue masses.

  12. Giant plexiform schwannoma of the tongue.

    Science.gov (United States)

    Nisa, Lluís; von Büren, Toni; Tiab, Amine; Giger, Roland

    2011-01-01

    We present the case of a 38-year-old woman that presented with a very slowly enlarging mass of the tongue. MRI revealed a large mass originating in the tongue base and extending to the supraglottic space. Biopsy of this tumor confirmed the diagnosis of schwannoma. An endaural approach allowed complete resection of the tumor. Definitive histopathological examination showed a plexiform schwannoma. Schwannoma or neurilemoma represents a benign tumor potentially affecting any nerve. The head and neck region is a relatively common location for schwannomas, but tongue schwannomas are considered to be rare and pose the problem of both clinical and histological differential diagnosis of tongue masses.

  13. Schwannoma in the Upper Limbs

    Directory of Open Access Journals (Sweden)

    Chris Yuk Kwan Tang

    2013-01-01

    Full Text Available Schwannomas are the commonest tumours of peripheral nerves. Despite the classical description that schwannomas are well encapsulated and can be completely enucleated during excision, a portion of them have fascicular involvement and could not be completely shelled out. A retrospective review for 8 patients was carried out over 10 years. 75% of schwannoma occurred over the distal region of upper limb (at elbow or distal to it. It occurs more in the mixed nerve instead of pure sensory or motor nerve. 50% of patients had mixed nerve involvement. Fascicular involvement was very common in schwannoma (75% of patients. Removal of the tumour with fascicles can cause functional deficit. At present, there is no method (including preoperative MRI which can predict the occurrence of fascicular involvement; the authors therefore proposed a new system to stratify patients who may benefit from interfascicular nerve grafts. In this group of patients, the authors strongly recommend that the possibility and option of nerve graft should be discussed with patients prior to schwannoma excision, so that nerve grafting could be directly proceeded with patient consent in case there is fascicular involvement of tumour found intraoperatively.

  14. Intrathoracic Schwannoma Presented with Hemothorax

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    Alkin Yazicioglu

    2016-05-01

    Full Text Available Intrathoracic schwannomas are typically benign and asymptomatic tumors that originate from the Schwann cells of a neural sheath. Hemorrhage from intrathoracic schwannomas is an uncommon finding. We present the case of a 17 year-old girl who had dyspnea and numbness of the right arm. Chest x%u2013ray showed a right-sided massive pleural effusion and exploratory puncture showed hemothorax. After tube thoracostomy and drainage of the bloody effusion, a mass was observed in the right upper hemithorax. Chest tomography revealed a 76x104 mm mass arising from the fourth intercostal nerve. The tumor was successfully resected and, on histopathologic examination it was reported as a schwannoma. After resection, the patient has remained problem-free for fourteen months.

  15. Intercostal schwannoma simulating pulmonary Neoplasia

    OpenAIRE

    1998-01-01

    RESUMO – 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 la...

  16. Retroperitoneal Schwannoma: A Rare Case

    Directory of Open Access Journals (Sweden)

    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.

  17. Radiosurgery for vestibular schwannomas

    Directory of Open Access Journals (Sweden)

    Sumit Sinha

    2014-01-01

    Full Text Available Vestibular schwannomas (VS are benign tumours arising from the 8 th cranial nerve. There are various treatment options for these tumours, which depend upon the tumour size and patient age. However, the surgical treatment has been the conventional method of management of these tumours, since they are frequently detected when quite large in size, especially in our country. Gamma knife radiosurgery (GKRS is frequently reserved for young patients with small and medium-sized VS (<3 cm and few symptoms. The tumour control dose is the most important consideration in GKRS, with higher doses having a risk for cranial nerve palsies, whereas lower doses leading to non-treatment of the tumour. The accepted tumour control dose ranges from 12 to 16 Gy among the various series with the tumour control rates of from 87% to 98% considered generally acceptable. The preservation of hearing is an issue worthwhile to be taken into account in GKRS and various series reporting this to range from 40% to 80%. The comparison between microsurgery and GKRS is still debatable because of different indications for both forms of therapies. Microsurgery is chosen for large tumours and GKRS for relatively smaller tumours.

  18. [A Case of Foramen Magnum Meningioma Manifesting as Hypoglossal Nerve Palsy].

    Science.gov (United States)

    Inaka, Yasufumi; Otani, Naoki; Nishida, Sho; Ueno, Hideaki; Tomiyama, Arata; Tomura, Satoshi; Toyooka, Terushige; Wada, Kojiro; Mori, Kentaro

    2017-04-01

    We report a case of foramen magnum meningioma manifesting as hypoglossal nerve palsy. A 72-year-old woman presented with progressive hypoglossal nerve palsy and lingual atrophy on the left side. Gadolinium-enhanced T1-weighted magnetic resonance imaging revealed a heterogeneously enhanced mass lesion with dural tail sign partially extending into the hypoglossal canal. The transcondylar approach was performed to expose the hypoglossal canal and resect the tumor completely. Histological examination revealed a transitional meningioma. The postoperative course was uneventful. Hypoglossal nerve palsy improved gradually after the operation.

  19. MR findings in intralabyrinthine schwannomas

    Energy Technology Data Exchange (ETDEWEB)

    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)

  20. Atypical Manifestation of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

  2. Management of Extracranial Carotid Artery Aneurysm

    NARCIS (Netherlands)

    Welleweerd, J. C.; den Ruijter, H. M.; Nelissen, B. G. L.; Bots, M. L.; Kappelle, L. J.; Rinkel, G. J. E.; Moll, F. L.; de Borst, G. J.

    2015-01-01

    Introduction: Aneurysms of the extracranial carotid artery (ECAA) are rare. Several treatments have been developed over the last 20 years, yet the preferred method to treat ECAA remains unknown. This paper is a review of all available literature on the risk of complications and long-term outcome aft

  3. AN INTERESTING CASE OF ANCIENT SCHWANNOMA

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    Binu

    2015-01-01

    Full Text Available INTRODUCTION : Schwannoma is a common benign tumour of nerve sheath. Degenerating type of schwannoma is called ancient schwannoma. Ancient schwannomas of scalp are rare and are often misdiagnosed as sebaceous cyst or dermoid cyst. CASE REPORT : We present a thirty two year old male presented with scalp swel ling of eight years duration. X - ray showed no intracranial extension. He underwent excision of the tumour and histopathology was reported as ancient schwannoma. DISCUSSION : Histopathologically , ancient schwannomas charecterised by cellular Antoni type A ar eas and less cellular Antoni type - B areas. 9 th , 7 th , 11 th , 5 th and 4 th cranial nerves are often affected and may be associated with multiple neuro fibramatosis (Von - Recklinghausen’s disease. Impact : Case is presented for its rarity and possible pre - operative misdiagnosis

  4. Schwannoma of the tongue in a child.

    Science.gov (United States)

    Lukšić, Ivica; Müller, Danko; Virag, Mišo; Manojlović, Spomenka; Ostović, Karmen Trutin

    2011-09-01

    A schwannoma or neurilemmoma is a benign, slow growing, usually solitary and encapsulated tumour originating from Schwann cells of the nerve sheath. Approximately 25-40% of all schwannomas are seen in the soft tissues of the head and neck, often originate from the acoustic nerve. Intraoral schwannomas are rare and account for 1% of schwannomas of the head and neck region. We report the case of a 10-year-old boy diagnosed with a schwannoma of the tongue. The purpose of this report is to emphasize the possibility of diagnosing schwannoma among all other lingual lesions in children. The disease itself was diagnosed histologically after complete surgical excision. Five years after surgical treatment, the patient is without signs of recurrence. This paper highlights the importance of a multidisciplinary approach in the diagnosis and surgical treatment of this very rare entity.

  5. Gastric schwannoma coexists with peptic ulcer perforation

    Directory of Open Access Journals (Sweden)

    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.

  6. Schwannomas of the head and neck

    Directory of Open Access Journals (Sweden)

    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. Facial nerve schwannoma in revision stapedotomy surgery.

    Science.gov (United States)

    Schmerber, Sébastien; Lavieille, Jean-Pierre

    2004-05-01

    We describe a male patient who presented a progressive conductive unilateral hearing loss 20 years after otosclerosis surgery. Computed tomography (CT) scan and magnetic resonance imaging (MRI) findings suggested a facial schwannoma in its tympanic segment. At the time of revision surgery, a facial schwannoma was found to originate at the tympanic segment, pushing the prosthesis out of the oval window fenestration. The Teflon-piston was repositioned with difficulties in the central platinotomy, and the facial schwannoma was left intact.

  8. Primary Psammomatous Melanotic Schwannoma of the Spine.

    Science.gov (United States)

    Bakan, Selim; Kayadibi, Yasemin; Ersen, Ezel; Vatankulu, Betul; Ustundag, Nil; Hasıloglu, Zehra Isık

    2015-06-01

    Schwannoma is an easily identifiable and frequently diagnosed lesion of the spinal column. However, if the schwannoma contains a melanin component, the diagnosis is challenging. Our purpose in this case report is to discuss the imaging and histopathologic findings of a rarely seen psammomatous type of melanotic schwannoma diagnosed in a 31-year-old woman. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Giant Plexiform Schwannoma of the Tongue

    OpenAIRE

    2011-01-01

    We present the case of a 38-year-old woman that presented with a very slowly enlarging mass of the tongue. MRI revealed a large mass originating in the tongue base and extending to the supraglottic space. Biopsy of this tumor confirmed the diagnosis of schwannoma. An endaural approach allowed complete resection of the tumor. Definitive histopathological examination showed a plexiform schwannoma. Schwannoma or neurilemoma represents a benign tumor potentially affecting any nerve. The head and ...

  10. 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......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 treatment strategy based on the natural history of tumor growth and hearing also is discussed....

  11. Congenital plexiform schwannoma of the clitoris.

    Science.gov (United States)

    Yegane, Rooh A; Alaee, Mohammadreza S; Khanicheh, Elham

    2008-04-01

    Schwannomas are slow-growing nerve sheet neoplasms which are rarely found in the female genital system. In this article, we present a patient with Antony A congenital plexiform schwannoma of the clitoris. A 6-year-old girl was brought to our hospital with the history of a firm non-cystic clitoral mass from birth, which had been growing more rapidly during the previous year. The patient was scheduled for surgery. Histological studies revealed plexiform schwannoma of the clitoris post-operatively. Therefore, schwannoma should be considered in the differential diagnosis of clitoral masses.

  12. Palatal schwannoma in an elderly woman.

    Science.gov (United States)

    Shetty, Shishir Ram; Mishra, Chandni; Shetty, Pushparaj; Kaur, Arshdeep; Babu, Subhas

    2012-06-01

    Schwannoma also known as neurilemmoma is a benign tumour derived from schwann cells and is relatively rare in occurrence. Only 1% of the schwannomas in the head and neck region occur at intra-oral sites. Schwannomas usually occur during the third or fourth decades of life and the tongue is the most common intra-oral site. A case of intra-oral schwannoma in a 70-year-old female in the region of hard palate is described which is extremely rare.

  13. Multimodality Management of Trigeminal Schwannomas.

    Science.gov (United States)

    Niranjan, Ajay; Barnett, Samuel; Anand, Vijay; Agazzi, Siviero

    2016-08-01

    Patients presenting with trigeminal schwannomas require multimodality management by a skull base surgical team that can offer expertise in both transcranial and transnasal approaches as well as radiosurgical and microsurgical strategies. Improvement in neurologic symptoms, preservation of cranial nerve function, and control of mass effect are the primary goals of management for trigeminal schwannomas. Complete surgical resection is the treatment of choice but may not be possible in all cases. Radiosurgery is an option as primary management for small- to moderate-sized tumors and can be used for postoperative residuals or recurrences. Planned surgical resection followed by SRS for residual tumor is an effective option for larger trigeminal schwannomas. The endoscopic resection is an excellent approach for patients with an extradural tumor or tumors isolated to the Meckel cave. A detailed analysis of a tumor and its surroundings based on high-quality imaging can help better estimate the expected outcome from each treatment. An expert skull base team should be able to provide precise counseling for each patient's situation for selecting the best option.

  14. Gastric schwannoma: a case report

    Directory of Open Access Journals (Sweden)

    Hayfa Romdhane

    2016-11-01

    Full Text Available Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis via endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.

  15. Lingual schwannoma in pediatric patients.

    Science.gov (United States)

    Manna, Francesco; Barbi, Egidio; Murru, Flora; Bussani, Rossana

    2012-09-01

    We present the case of a 15-year-old boy who presented to our emergency department because of a soft lesion growing on the back of his tongue. On examination, a vegetant mass on the posteromidline lingual part of the body of the tongue was noticed: it was not painful, even if the boy reported discomfort because of its size; there was no bleeding or signs of infection. The magnetic resonance imaging showed the lesion as trilobated and capsulated, but was not diriment to define a diagnosis; excisional biopsy was performed under general anesthesia, and the mass was identified as a schwannoma. Schwannoma, or neurilemmoma, is a benign tumor originating from Schwann cells of the nerve sheath surrounding peripheral nerves. It is slow-growing, usually solitary, and encapsulated. Intraoral schwannomas are rare and account for 1% of lesions of the head and neck region. There is no sex predilection. The symptoms depend on size and location of the tumor. Recurrence is rare after complete surgical resection. The present study aimed to retrospectively describe our experience with a case of neurilemmoma of the tongue presenting in childhood, the diagnostic methods used, the surgical decision, and the treatment outcome and to analyze the data and review the literature available on this type of tumor. The etiology, clinical presentation, differential diagnosis, and management are discussed.

  16. Schwannoma of the adrenal gland

    Directory of Open Access Journals (Sweden)

    Anunayi Jeshtadi

    2014-07-01

    Full Text Available Visceral schwannomas are extremely rare and are usually discov-ered incidentally on USG/CT-Scan. Primary schwannomas of the adrenal gland are extremely uncommon. It has been theorized that they originate from Schwann cells that insulate the nerve fi-bers innervating the adrenal medulla. Histopathological examina-tion coupled with immunohistochemistry provides the definitive diagnosis. A 55 year old normotensive female presented with pain in the right loin since 5 months. Her renal parameters were normal. Contrast enhanced computed tomography of abdomen showed a well delineated 6.5 x 5cms mass at upper pole of her right kidney. 24-hour urinary metanephrine was slightly elevated (3.07mg/24hrs. A decline in Serum cortisol levels was observed following a dexamethasone suppression test (18.89nmol/l. Histopathological examination revealed a spindle cell tumor. Immunohistochemistry showed strong and diffuse positive staining for S-100 with negative expression for CD-117, desmin, CD-34, HMB-45, synaptophysin, chromogranin, cytokeratin, and SMA. Ki-67 index was 2%.A diagnosis of cellular schwannoma of adrenal gland was confirmed.

  17. Schwannoma intercostal simulando neoplasia pulmonar

    Directory of Open Access Journals (Sweden)

    Henn L.A.

    1998-01-01

    Full Text Available 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 laboratoriais e de imagem (radiografia e tomografia computadorizada de tórax do caso em estudo, assim como os exames anatomopatológico e imuno-histoquímico do espécime cirúrgico. RESULTADOS: O paciente foi submetido à toracotomia direita diagnóstica com ressecção da tumoração. O exame anatomopatológico convencional mostrou células tumorais de aspecto fusiforme, dispostas em paliçada, formando os corpos de Verocay, compatível com schwannoma intercostal. A imuno-histoquímica foi positiva para proteína S-100, vimentina e enolase, e negativa para neurofilamentos. CONCLUSÃO: O diagnóstico definitivo de schwannoma só é possível por meio da análise histopatológica e imuno-histoquímica da lesão. Seu aspecto celular, associado à atividade mitótica e a áreas de pleomorfismo, pode levar ao diagnóstico incorreto de malignidade. A imuno-histoquímica, por meio da proteína S-100, é útil na caracterização da benignidade da lesão, já que não é detectada nas lesões malignas. Os schwannomas de parede torácica podem simular neoplasias pulmonares na radiografia e tomografia computadorizada de tórax.

  18. Effects of the pyrethroid insecticide, deltamethrin, on respiratory modulated hypoglossal motoneurons in a brain stem slice from newborn mice

    DEFF Research Database (Denmark)

    Rekling, J C; Theophilidis, G

    1995-01-01

    We have studied the action of deltamethrin on respiratory modulated hypoglossal motoneurons in a brain stem slice from newborn mice. Deltamethrin depolarized the hypoglossal motoneurons, increased the background synaptic noise and reduced the frequency and amplitude of current elicited action...

  19. Intracochlear Schwannoma: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    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.

  20. Intracochlear schwannoma: diagnosis and management.

    Science.gov (United States)

    Bittencourt, Aline Gomes; Alves, Ricardo Dourado; Ikari, Liliane Satomi; Burke, Patrick Rademaker; Gebrim, Eloisa Maria Santiago; Bento, Ricardo Ferreira

    2014-07-01

    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.

  1. Pineal germinoma with extracranial metastases: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Rang; Lee, Seung Ro; Park, Dong Woo; Hahm, Chang Kok; Park, Moon Hyang; Ko, Yong [College of Medicine, Hanyang Univ., Seoul (Korea, Republic of)

    2004-08-01

    Pineal germinoma is the commonest pineal region tumor of childhood and adolescence. Metastatic germinoma most commonly occurs via the cerebrospinal fluid (CSF), and it is usually limited to the cerebrospinal axis. ExtacraniaI hematogenous metastasis is known to be very rare. We report here on a case of pineal germinoma with gradual extracranial metastases that occurred both through the CSF pathway and by hematogenous spread. The patient had multifocal CSF seeding after his surgery for pineal germinoma, and the left iliac metastasis and lung metastasis then occurred.

  2. 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.

  3. Tratamento cirúrgico do schwannoma traqueal

    Directory of Open Access Journals (Sweden)

    Orlando Jorge Martins Torres

    Full Text Available Schwannoma is a rare benign tumor of the proximal tracheobronchial tree. The aim of the present study is to report a case of tracheal schwannoma causing airway obstruction. A 16-year-old woman complained of cough, wheezing and dyspneia. Bronchoscopy and computerized tomography showed a polypoide intratracheal mass obstructing approximately 80% of the lumen. The treatment consisted of tracheal resection and primary anastomosis. Histological analysis revealed a tracheal schwannoma. The postoperative course was uneventful and the patient remains well twelve months after surgery.

  4. Schwannoma of the tongue: one case report.

    Science.gov (United States)

    Mevio, E; Gorini, E; Lenzi, A; Migliorini, L

    2002-01-01

    The schwannomas are nervous tissue tumours that arise from Schwann cells; they are uncommon in peripheral nerves and rare in the tongue. After, a review of the literature, we present a case of schwannoma which arose in the ventral part of the body of the tongue. The tumour presented as a slowly growing mass producing few symptoms. The diagnosis of schwannoma is usually made post-operatively by histological identification although modern imaging techniques can provide useful indications. The treatment is exclusively surgical and usually enucleation of the mass is uncomplicated. There are no reports of malignant transformation.

  5. Persistent primitive hypoglossal artery associated with Chiari II malformation: Diagnosis and clinical implications

    Directory of Open Access Journals (Sweden)

    Gupta Mudit

    2010-01-01

    Full Text Available We present a case of persistent primitive hypoglossal artery (PPHA associated with Chiari II malformation and discuss the clinical implications. There has been one reported case of PPHA associated with Chiari 1 malformation, but none in association with Chiari II. Our patient also had a widened hypoglossal canal, with cerebrospinal fluid (CSF sac herniation through it.

  6. Extracranial arterial aneurysms: a cause of crescendo transient ischaemic attacks.

    Science.gov (United States)

    Paterson, H M; Holdsworth, R J

    2000-12-01

    Crescendo transient ischaemic attacks (TIAs) should be regarded as a medical emergency. Patients require hospitalisation with urgent assessment and symptom control with anticoagulant therapy. We report on three patients, all of whom had atherosclerotic aneurysmal disease of the extracranial arterial circulation who presented with crescendo TIAs. The possibility of extracranial aneurysmal disease should always be considered and excluded.

  7. Severe progressive sensorineural hearing loss improved after removal of large jugular foramen schwannoma.

    Science.gov (United States)

    Oishi, Naoki; Kohno, Naoyuki; Shiokawa, Yoshiaki

    2011-06-01

    We report a very rare case of hearing improvement after removal of the intracranial part of a jugular foramen schwannoma (JFS) presenting with chronic and severe progressive sensorineural hearing loss (SNHL). The patient presented with progressive hearing impairment in his right ear, lasting 2 years. The patient's pure tone audiogram revealed severe SNHL. His speech discrimination score (SDS) was 0%. Auditory-evoked brain responses (ABRs) comprised only I waves following 30-100dB stimulation, although distortion-product otoacoustic emissions (DPOAEs) had good responses. These test results indicated that his hearing impairment was retrocochlear SNHL. Magnetic resonance imaging revealed within the right jugular foramen a large intracranial-extracranial tumor that compressed the brainstem. The intracranial part of the tumor was resected through retrosigmoidal craniotomy, and the tumor was pathologically diagnosed as a schwannoma. Several months after the operation, the patient's auditory thresholds improved to a level consistent with mild SNHL, ABR V waves emerged following 60-90dB stimulation, and SDS improved significantly to 95%. This case demonstrates that hearing improvement can be achieved after surgery for JFS presenting with severe and chronic progressive SNHL, and that good DPOAE responses and the presence of ABR I waves may be predictors of postoperative hearing recovery in JFS.

  8. 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.

  9. Tentorium schwannoma mimicking meningioma: an unusual location.

    Science.gov (United States)

    Calişaneller, Tarkan; Ozen, Ozlem; Altinörs, Nur; Caner, Hakan

    2008-07-01

    A 60-year-old female was admitted to our clinic complaining of a long-lasting headache. Cranial magnetic resonance imagining examination of the patient revealed a 22x24 mm extra-axial, well-demarcated, mass lesion based on the left tentorium. The patient underwent a craniotomy and the tumor was totally excised with the adjacent tentorium. The histopathological examination of the tumor complied with the diagnosis of schwannoma. The rest of the clinical course was uneventful and the patient was released from the hospital without any neurological deficit. Intracranial schwannomas can rarely originate from atypical dural locations and radiological techniques are not always helpful in distinguishing tentorial schwannoma from tentorial meningioma. We presented a patient with a tentorium schwannoma mimicking meningioma and discussed the current literature.

  10. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    Science.gov (United States)

    ... the inner ear. The tumor comes from an overproduction of Schwann cells—the cells that normally wrap ... begin to develop new therapies to control the overproduction of Schwann cells in individuals with vestibular schwannoma. ...

  11. 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

  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. Case report 872. "Ancient" schwannoma (degenerated neurilemoma).

    Science.gov (United States)

    Schultz, E; Sapan, M R; McHeffey-Atkinson, B; Naidich, J B; Arlen, M

    1994-10-01

    A case of an ancient schwannoma was presented. The rare occurrence of this tumor has resulted in only a few reported cases with descriptions of its features on imaging. Our patient's tumor, like one previously reported case, demonstrated calcification on the plain film - a finding not associated with other histologic types of schwannomas. Angiography revealed the tumor to be hypervascular. Evaluation by MRI demonstrated a lobulated, encapsulated soft tissue mass containing several cystic areas that corresponded histologically to areas of necrosis. Hypertrophied blood vessels were seen in the periphery of the tumoral mass. Too few ancient schwannomas have been reported to conclude whether or not radiographic evidence of soft tissue calcification is characteristic of this histologically distinctive subtype of schwannoma. However, since calcification is seen histologically as part of the degenerating process, its presence on plain films could be a feature of this tumor. Furthermore, the presence of cystic areas on MRI is not surprising given the pathological changes that occur in this tumor. We suggest that a diagnosis of ancient schwannoma be considered when a patient presents with a hypervascular soft tissue mass containing amorphous calcification on plain films and cystic areas on MRI. Despite the nonspecificity of these imaging findings, this point is relevant because each of these features suggests the presence of a malignant mass. Awareness of the possibility of a benign ancient schwannoma could obviate unnecessary radical surgery.

  14. Intraosseous Schwannoma of the Petrous Apex.

    Science.gov (United States)

    Tamura, Ryota; Takahashi, Satoshi; Kohno, Maya; Kameyama, Kaori; Fujiwara, Hirokazu; Yoshida, Kazunari

    2015-07-01

    Background and Importance Intraosseous schwannoma is a relatively rare clinical entity that typically arises in vertebral and mandibular bone. Intraosseous schwannoma located entirely within the petrous bone is exceedingly rare, and only two cases have been reported to date. Clinical Presentation A 47-year-old Asian man was referred to our hospital with a chief complaint of double vision. Neurologic examination revealed left abducens nerve palsy. Radiologic imaging showed a 35-mm osteolytic expansive lesion located in the left petrous apex. We made a preoperative diagnosis of chondrosarcoma and performed surgical resection. Surgery was performed via a left subtemporal epidural approach with anterior petrosectomy. The histopathologic diagnosis of the tumor was schwannoma. Schwannoma arising from cranial nerves was excluded from intraoperative findings in conjunction with the results for cranial nerves, and intraosseous schwannoma was diagnosed. Postoperative course was uneventful, and abducens nerve palsy resolved immediately after surgery. Conclusion The differential diagnosis of intraosseous schwannoma should be considered for an osteolytic mass lesion within the petrous apex. Subcapsular tumor removal was considered ideal in terms of preservation of the cranial nerves and vessels around the tumor.

  15. 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.

  16. 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.

  17. Chemogenetic stimulation of the hypoglossal neurons improves upper airway patency

    Science.gov (United States)

    Fleury Curado, Thomaz; Fishbein, Kenneth; Pho, Huy; Brennick, Michael; Dergacheva, Olga; Sennes, Luiz U.; Pham, Luu V.; Ladenheim, Ellen E.; Spencer, Richard; Mendelowitz, David; Schwartz, Alan R.; Polotsky, Vsevolod Y.

    2017-01-01

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep. OSA leads to high cardiovascular morbidity and mortality. The pathogenesis of OSA has been linked to a defect in neuromuscular control of the pharynx. There is no effective pharmacotherapy for OSA. The objective of this study was to determine whether upper airway patency can be improved using chemogenetic approach by deploying designer receptors exclusively activated by designer drug (DREADD) in the hypoglossal motorneurons. DREADD (rAAV5-hSyn-hM3(Gq)-mCherry) and control virus (rAAV5-hSyn-EGFP) were stereotactically administered to the hypoglossal nucleus of C57BL/6J mice. In 6–8 weeks genioglossus EMG and dynamic MRI of the upper airway were performed before and after administration of the DREADD ligand clozapine-N-oxide (CNO) or vehicle (saline). In DREADD-treated mice, CNO activated the genioglossus muscle and markedly dilated the pharynx, whereas saline had no effect. Control virus treated mice showed no effect of CNO. Our results suggest that chemogenetic approach can be considered as a treatment option for OSA and other motorneuron disorders. PMID:28281681

  18. Pancreatic schwannoma: Report of a case and review of literature.

    Science.gov (United States)

    Kinhal, Vidyadhar A; Ravishankar, T H S; Melapure, Ashok I; Jayaprakasha, G; Range Gowda, B C; Manjunath

    2010-07-01

    Connective tissue tumors of pancreas are uncommon, among them pancreatic schwannoma is very rare tumor, very few cases were reported in literature. Aggressive resections like whipple's procedure, or distal pancreatectomy are not necessary for pancreatic schwannoma as it rarely goes to malignant change and simple enuclation is sufficient.In our patient pancreatic schwannoma is associated with simple cyst in liver and absence of one kidney. Here, we are presenting a case of pancreatic schwannoma treated by simple enucleation.

  19. TDP-43 in the hypoglossal nucleus identifies amyotrophic lateral sclerosis in behavioral variant frontotemporal dementia.

    Science.gov (United States)

    Halliday, Glenda M; Kiernan, Matthew C; Kril, Jillian J; Mito, Remika; Masuda-Suzukake, Masami; Hasegawa, Masato; McCann, Heather; Bartley, Lauren; Dobson-Stone, Carol; Kwok, John B J; Hornberger, Michael; Hodges, John R; Tan, Rachel H

    2016-07-15

    The hypoglossal nucleus was recently identified as a key brain region in which the presence of TDP-43 pathology could accurately discriminate TDP-43 proteinopathy cases with clinical amyotrophic lateral sclerosis (ALS). The objective of the present study was to assess the hypoglossal nucleus in behavioral variant frontotemporal dementia (bvFTD), and determine whether TDP-43 in this region is associated with clinical ALS. Twenty-nine cases with neuropathological FTLD-TDP and clinical bvFTD that had not been previously assessed for hypoglossal TDP-43 pathology were included in this study. Of these 29 cases, 41% (n=12) had a dual diagnosis of bvFTD-ALS at presentation, all 100% (n=12) of which demonstrated hypoglossal TDP-43 pathology. Of the 59% (n=17) cohort that presented with pure bvFTD, 35% (n=6) were identified with hypoglossal TDP-43 pathology. Review of the case files of all pure bvFTD cases revealed evidence of possible or probable ALS in 5 of the 6 hypoglossal-positive cases (83%) towards the end of disease, and this was absent from all cases without such pathology. In conclusion, the present study validates grading the presence of TDP-43 in the hypoglossal nucleus for the pathological identification of bvFTD cases with clinical ALS, and extends this to include the identification of cases with possible ALS at end-stage.

  20. Fast-Growing Vestibular Schwannoma

    Science.gov (United States)

    Falcioni, Maurizio; Taibah, Abdelkader; De Donato, Giuseppe; Piccirillo, Enrico; Russo, Alessandra; Sanna, Mario

    2000-01-01

    A case of a Jehovah's witness affected by an intracanalicular vestibular schwannoma with an extremely fast growth rate is presented. Nine months after presentation, the tumor reached 23 mm in the cerebellopontine angle. A partial removal through a retrosigmoid approach was planned. Because of the presence of a dominant high jugular bulb masquering the internal auditory canal, the intracanalicular portion of the tumor was left in place. The residual tumor grew 12 mm in 2 months. Even after a gross total removal through a middle cranial fossa approach, the tumor recurred, reaching the size of 30 mm in 17 months. A modified transcochlear approach was then performed, and the patient was free of disease at the last radiologic follow-up, 8 months after the surgery. We illustrate our strategy in treating this aggressive benign lesion with unusual behavior. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10 PMID:17171109

  1. A CASE OF GASTRIC SCHWANNOMA

    Directory of Open Access Journals (Sweden)

    Ch. Deepak

    2013-03-01

    Full Text Available ABSTRACT: A 65 years old lady from Nagamapal, Imphal, India pre sented with pain in upper abdomen off and on for about 1 year duration and hi story of upper gastrointestinal bleeding and melena occasionally for which blood transfusion was required. Routine haematological investigations were normal, liver function test and kidney function test were within normal limits. EGD shows fundal polypoid growth of about 5cm diameter with areas of ulceration at places. Biopsy o f EGD specimen shows inflammatory cells with marked fibroblastic proliferation and no eviden ce of malignancy. CT of whole abdomen shows features suggestive of large gastric polyp in f undus of stomach. Laparotomy was done and surgical resection of the polypoid mass from fun dus of stomach was performed. HPE revealed schwannoma with degenerative changes.

  2. 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.

  3. SCHWANNOMA PRESENTING AS PAPILLOMA – A DIAGNOSTIC DILEMMA

    Directory of Open Access Journals (Sweden)

    Sourabh Mandwariya

    2013-07-01

    Full Text Available Schwannomas are slow growing benign nerve sheath tumors. They are notcommonly seen in the oral cavity and the tongue is the most common site of schwannomas found there. Here, we report a case of a tongue swelling presenting asa Papilloma clinically, which was histopathologically diagnosed as Schwannoma(Neurilemmoma and discuss its clinical presentation, histological features andmanagement.

  4. Wasted tongue in neuromyelitis optica spectrum disorders due to hypoglossal nerve involvement.

    Science.gov (United States)

    Viswanathan, Shanthi

    2015-04-01

    We report two cases of neuromyelitis optica spectrum disorder with hypoglossal nerve involvement resulting in a wasted tongue associated with other brainstem symptoms of hypogeusia, hypersalivation, hiccough, increased sweating, hyperemesis and myelitis (in the second patient). This occurred due to involvement of the hypoglossal, tractus solitarius and dorsal vagal nuclei. Though the myelitis and other brainstem signs recovered the hypoglossal nerve involvement resulting in a unilateral wasted tongue did not. It is important to consider neuromyelitis optica and its spectrum disorders in the differential diagnosis of a wasted tongue though its occurrence is rare.

  5. Schwannoma de colon: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Marlen Vega-Vega

    2003-06-01

    Full Text Available Los schwannomas del tracto gastrointestinal son muy raros, los más comúnmente encontrados son los de estómago. Se presenta un caso de un schwannoma de colon, el cual es aún menos común. Los schwannomas se han asociado con neurofibromatosis. La incidencia es igual en ambos sexos y el rango de edad es amplio, desde los 18 hasta los 87 años. Los síntomas más hallados son el sangrado, el dolor abdominal y la obstrucción intestinal. El método diagnóstico más certero es la tomografía axial computarizada. El tratamiento es quirúrgico y consiste en la resección completa del tumor; la quimioterapia y radioterapia no han mostrado resultados favorables. El pronóstico depende principalmente del tamaño del tumor, edad mayor de siete años, la necrosis del 25% del tumor o más y la presencia de neurofibromatosis.Schwannomas of the gastrointestinal tract are uncommon, gastric schwannomas are the most common. We report a case of a colonic schwannoma, wich are even less frecuent. They occur in association with neurofibromatosis. Schwannomas occur equally in men and women, in a wide age range. Haemorrhage, abdominal pain and bowel obstruction the most common presenting features. Computerized tomography confirms the diagnosis. Primary treatment is the complete surgical excision. Radiation therapy and chemotherapy do any have additional benefit over surgery. Size, age greater than 7 years, more than 25% of tumor necrosis and neurofibromatosis are the most important factors regarding in prognosis.

  6. Olfactory schwannoma: A report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    Zheng Wang

    2014-01-01

    Full Text Available Intracranial schwannoma is a kind of benign intracranial tumors, derived from neuron myelin sheath, growing slowly and curable. Olfactory schwannoma is an exceedingly rare kind of schwannoma, whose origin is still uncovered. Although several theories have been put up for pathogenesis of olfactory schwannoma, till now, none of these hypotheses has been widely accepted and acknowledged officially. Up to date, only 46 cases of olfactory schwannoma were reported across numerous institutes worldwide. Here we gathered two cases from Department of Neurosurgery in Beijing Tiantan Hospital across two years collection.

  7. 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.

  8. Base of tongue schwannoma: a case report.

    Science.gov (United States)

    Ying, Yu-Lan Mary; Zimmer, Lee A; Myers, Eugene N

    2006-07-01

    Both malignant and benign lesions may be found on the base of the tongue, including metastasis from other sites. Various surgical approaches to the base of tongue have been described. Here, we report a case of a 26-year-old woman with a schwannoma in the base of tongue removed through a suprahyoid pharyngotomy approach. The biology and pathology of schwannoma in the oral cavity are discussed. The advantage of the suprahyoid pharyngotomy approach for complete excision of a mass in the base of tongue is demonstrated.

  9. THREE YEARS STUDY OF SCHWANNOMAS OF PERIPHERAL NERVES

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    Subha Dhua

    2017-02-01

    Full Text Available BACKGROUND In this paper authors present three cases of schwannomas including a case of multiple schwannomas without the features of neurofibromatosis (NF. There was no family history of neurofibromatosis. All the patients underwent surgical excision and improved from the symptomatic lesions. Histopathology confirmed these lesions as schwannomas. The authors recommend surgery for symptomatic lesions. Asymptomatic tumours can be monitored. Regular follow up is essential as they may develop fresh lesions at any time. The relevant literature is discussed. • Malignant transformation of the schwannomas is rare and has poor prognosis. It should be considered in the differential diagnosis of schwannomas. • We should distinguish between “ancient schwannoma” and malignant transformation of schwannoma since treatment and prognosis vary. • Imaging is not entirely reliable in differentiating benign from malignant peripheral nerve tumours. MATERIALS AND METHODS All the patients underwent surgical excision and improved from the symptomatic lesions. Histopathology confirmed these lesions as schwannomas. The authors recommend surgery for symptomatic lesions. RESULTS The histopathological studies confirmed the lesion as Flexi Schwannoma and surgery was considered to be the best option. CONCLUSION Schwannomas and meningiomas are usually benign tumours curable by complete removal. They occur either as single sporadic tumors in otherwise healthy individuals in the fourth to sixth decades of life or as multiple tumours at an early age as part of the autosomal dominant genetic disorder neurofibromatosis 2 (NF2. The hallmark feature of NF2 is bilateral vestibular schwannomas. Multiplicity, a lobular growth pattern, and invasiveness are typical features of NF2 schwannomas. The diagnosis of NF2 is difficult in a group of heterogeneous and poorly defined patients who do not have BVSs but present with other features suggestive of NF2, namely (1 multiple

  10. [Malignant schwannoma metastasizing to the heart].

    Science.gov (United States)

    Menezes Júnior, A da S; Greco, O T; Fiorini, M; Pavarino, P; Corbucci, H; Caixeta, A M

    1992-01-01

    We introduce the case of a 34-year-old male with a malignant metastasizing tumor in the heart associated with skin manifestations. The patient was submitted to heart surgery to resect the tumor. The correct diagnosis was done by pathological findings and immunohistochemical methods and showed, malignant schwannoma.

  11. Atypical sinonasal Schwannomas: a difficult diagnostic challenge.

    Science.gov (United States)

    Jacopo, Galli; Micaela, Imperiali; Italo, Cantore; Luigi, Corina; Larocca, Luigi M; Gaetano, Paludetti

    2009-08-01

    Schwannomas are benign tumours arising from Schwann cells of the peripheral nerve sheath. They are relatively frequent in the head and neck region (25-45%) but rarely involve in the sinonasal tract (4%). The authors outline the diagnostic difficulties and the problems in choosing the best surgical approach in two atypical cases of sinonasal Schwannomas. In the first case reported clinical data, sex and age of the patient, nasal endoscopy and angio-MRI led us to suspect an angiofibroma; therefore, we approached the case without a biopsy performing a preoperative selective embolization followed by an endoscopic resection. In the second case, due to initial visual symptoms and to the ethmoid-orbital compartment involvement, we performed a sinonasal endoscopy and collected a biopsy which resulted to be fundamental in the diagnostic assessment. Tumour excision was then obtained throughout an intracranial/endonasal approach. The two presented cases revealed the presence of cystic Schwannomas. In the first case, diagnosis was made only post-operatively after histological examination. Patients underwent complete surgical excision by means of an endoscopic sinonasal approach, in the second case associated to a left frontal craniotomy. The patients showed no signs of recurrence at a 9 months follow-up. Nasal endoscopy was extremely important in making the diagnosis, allowing an accurate assessment of the tumour extension and a biopsy. The diagnosis of sinonasal Schwannomas remains challenging; sometimes, clinical behaviour and modern imaging may be misleading. The diagnostic and therapeutic importance of sinonasal endoscopy is emphasised in the two presented cases.

  12. Giant Trigeminal Schwannoma Presenting with Obstructive Hydrocephalus

    Science.gov (United States)

    Martinez-Gutierrez, Juan Carlos; Elder, Benjamin D; Olivi, Alessandro

    2015-01-01

    Trigeminal schwannomas represent between 0.07% and 0.36% of all intracranial tumors and 0.8% to 8% of intracranial schwannomas. Selection of the appropriate management strategy requires an understanding of the tumor’s natural history and treatment outcomes. This report describes the case of a 36-year-old male who presented with a three-month history of progressive headaches, dizziness, loss of balance, decreased sleep, and cognitive decline. Magnetic resonance imaging revealed a large enhancing lesion centered around the left Meckel’s cave and extending into both the middle and the posterior fossa with obstructive hydrocephalus secondary to compression of the fourth ventricle. Resection of the posterior fossa component of the tumor was performed in order to relieve the mass effect upon the brainstem without attempting a radical removal of the middle fossa component and a potential risk of further cognitive impairment. The pathological exam confirmed the diagnosis of a trigeminal schwannoma. The residual tumor showed progressive spontaneous volumetric shrinkage after a subtotal surgical resection. This case shows the value of a planned conservative surgery in complex schwannomas and highlights the challenges in interpreting the treatment responses in these benign tumors, whether approached surgically or with stereotactic radiation techniques. PMID:26719829

  13. 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.

  14. Spontaneous expulsion of schwannoma of epiglottis

    OpenAIRE

    1997-01-01

    A rare case of spontaneous expulsion of schwannoma of epiglottis is being reported. These are neurogenic tumours arising from the schwan sheath of peripheral, cranial and sympathetic nerves. The great majority of these neurogenic tumours originate from aryepiglottic fold or false vocal cords. However the neurofibroma of the epiglottis are quite uncommon.

  15. Suppression of jaw-opening and trigemino-hypoglossal reflexes during swallowing in the cat.

    Science.gov (United States)

    Ono, T; Ishiwata, Y; Kuroda, T; Nakamura, Y

    1999-11-01

    Jaw-opening and trigemino-hypoglossal reflexes can be evoked by innocuous as well as noxious afferents from intra-oral structures. It has been reported that the amplitude of the jaw-opening reflex evoked by weak electrical stimulation of the upper lip is subject not only to tonic suppression but also to phase-linked modulation during mastication. In this study, we investigated whether the jaw-opening and trigemino-hypoglossal reflexes are modulated during swallowing. Data were obtained from 8 chloralose-anesthetized cats. Reflexes were monitored by electromyographic activities recorded from the anterior digastric, genioglossus, and styloglossus muscles and, after paralysis, by the efferent discharge in the digastric and hypoglossal nerves. Swallowing was elicited either by water dropped on the tongue or by repetitive stimulation of the superior laryngeal nerve. Jaw-opening and trigemino-hypoglossal reflexes were evoked by stimulation of the lingual nerve, and the evoked afferent volley was recorded from the Gasserian ganglion so that the threshold of the lingual nerve could be determined. The following results were obtained: (1) The jaw-opening and trigemino-hypoglossal reflexes evoked by stimulation of the low-threshold, but not high-threshold, lingual afferents were remarkably suppressed during swallowing; and (2) both the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents were suppressed during fictive swallowing after the animals were paralyzed. We conclude that the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents are suppressed during swallowing by a central motor program.

  16. 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).

  17. Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail; Hougaard, Anders

    2013-01-01

    Extracranial arterial dilatation has been hypothesised to be the cause of pain in patients who have migraine without aura. To test that hypothesis, we aimed to measure extracranial and intracranial arteries during attacks of migraine without aura.......Extracranial arterial dilatation has been hypothesised to be the cause of pain in patients who have migraine without aura. To test that hypothesis, we aimed to measure extracranial and intracranial arteries during attacks of migraine without aura....

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  19. Intrinsic excitability differs between murine hypoglossal and spinal motoneurons.

    Science.gov (United States)

    Tadros, M A; Fuglevand, A J; Brichta, A M; Callister, R J

    2016-05-01

    Motoneurons differ in the behaviors they control and their vulnerability to disease and aging. For example, brain stem motoneurons such as hypoglossal motoneurons (HMs) are involved in licking, suckling, swallowing, respiration, and vocalization. In contrast, spinal motoneurons (SMs) innervating the limbs are involved in postural and locomotor tasks requiring higher loads and lower movement velocities. Surprisingly, the properties of these two motoneuron pools have not been directly compared, even though studies on HMs predominate in the literature compared with SMs, especially for adult animals. Here we used whole cell patch-clamp recording to compare the electrophysiological properties of HMs and SMs in age-matched neonatal mice (P7-P10). Passive membrane properties were remarkably similar in HMs and SMs, and afterhyperpolarization properties did not differ markedly between the two populations. HMs had narrower action potentials (APs) and a faster upstroke on their APs compared with SMs. Furthermore, HMs discharged APs at higher frequencies in response to both step and ramp current injection than SMs. Therefore, while HMs and SMs have similar passive properties, they differ in their response to similar levels of depolarizing current. This suggests that each population possesses differing suites of ion channels that allow them to discharge at rates matched to the different mechanical properties of the muscle fibers that drive their distinct motor functions.

  20. Neurotoxicity of propofol on rat hypoglossal motoneurons in vitro.

    Science.gov (United States)

    Monni, Laura; Ghezzi, Filippo; Corsini, Silvia; Nistri, Andrea

    2017-08-10

    Although propofol is a widely used intravenous general anaesthetic, many studies report its toxic potential, particularly on the developing central nervous system. We investigated its action on hypoglossal motoneurons (HMs) that control two critical functions in neonates, namely tongue muscle activity and airway patency. Thus, clinically relevant concentrations of propofol (1 and 5μM) were applied (4h) to neonatal rat brainstem slices to evaluate the expression of apoptosis-inducing factor (AIF) as biomarker of toxicity. This anaesthetic strongly increased AIF in the cytoplasm and the nucleus, without early loss of HMs. Electrophysiological recordings from HMs showed that propofol (5μM) enhanced GABA- and glycine-evoked current amplitude and lengthened GABAergic current decay time. Propofol also depressed NMDA receptor-mediated responses without affecting AMPA receptors. Since GABA and glycine depolarize neonatal HMs, we propose that the damaging action by propofol on these motoneurons might arise from the facilitated action of these transmitters with subsequent cytoplasmic Ca(2+) overload. This phenomenon, in turn, may trigger cell death mechanisms manifested as increased expression of AIF and its translocation into the nucleus. Since propofol is also employed for induction and maintenance of paediatric surgery, caution is needed because its potential neurotoxicity might negatively impact neurodevelopment. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Primary extra-cranial meningioma following total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)

    2009-01-15

    A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

  2. 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.

  3. Solitary Schwannoma in the breast: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yun Jung; Kim, Ji Young; Park, Kyeong Mee; Han, Se Hwan; Kim, Soung Hee; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University, Seoul (Korea, Republic of)

    2006-08-15

    Schwannoma (neurilemoma) is a benign nerve tumor derived from the nerve sheath. The most common locations are the flexor surfaces of the extremities, and the head and the neck. Schwannoma of the breast is unusual. To our knowledge, few studies have reported the radiologic appearance of Schwannoma in the breast and there has been only one report from Korea (1-3). This tumor can be clinically and radiologically considered to be fibroadenoma, which is a common benign tumor of the breast. We describe the mammographic and sonographic findings of a case of Schwannoma in the breast.

  4. 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.

  5. A rare case of persistent hypoglossal artery associated with contralateral proximal subclavian stenosis

    Directory of Open Access Journals (Sweden)

    Romeo Antonio

    2016-01-01

    Full Text Available The persistent hypoglossal artery is rare vascular anomalies. We report the case of a 50-year old man with right hypoglossal artery, ipsilateral hypoplasic internal carotid artery, associated with left proximal subclavian stenosis with subclavian steal syndrome. Power-Doppler-Ultra-Sonography spectral images obtained after the patient exercised the left arm showed mid-systolic deceleration with retrograde late-systolic velocities. A Computed Tomography Angiography demonstrated a proximal stenosis of the left SA, a mild right ICA hypoplasia and an anomalous artery arising from right ICA at C2–C3 level, entering the cranium via the hypoglossal canal and joining the basilar artery. Usually the presence of PHA may be completely asymptomatic, and detected as an incidental finding by CTA or MRA, but in our case its diagnosis is extremely important because it is often the only vessel supplying blood to the basilar trunk and posterior circulation.

  6. Microsurgical management of non-neurofibromatosis spinal schwannoma.

    Science.gov (United States)

    Altaş, Murat; Cerçi, Ajlan; Silav, Gokalp; Sari, Ramazan; Coşkun, Kenan; Balak, Naci; Işik, Nejat; Elmaci, Ilhan

    2013-01-01

    The aim of this study is to assess the clinical properties and surgical results of patients diagnosed with spinal schwannomas without neurofibromatosis (NF) properties. The data obtained from 35 patients who underwent resection of spinal schwannomas were analyzed. All cases with neurofibromas and those with a known diagnosis of NF Type 1 or 2 were excluded. 35 patients underwent surgery for spinal schwannoma at our institution between January 1997 and 2010. The data were gathered retrospectively from medical records and included clinical presentation, tumor location and post-operative complications. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists with histopathological sections in paraffin stained with hematoxylin-eosin. We treated 35 (20 males and 15 females) patients with spinal schwannomas. The mean age of the patients was 47.2 (between 13 and 76) years. Of the cases, six schwannomas were located in the cervical spine, four in the thoracic spine, two in cervico-thoracic area, 10 in the thoraco-lumbar area and 13 in the lumbar spine. Two patients had malignant schwannomas that were recurrent. Of the 35 cases, the schwannomas were intradural-extramedullary in 30 cases (86%), intradural-intramedullar in 2 cases (6%), and extradural in 3 cases (9%). Spinal schwannomas may occur at any level of the spinal axis and are most frequently intradural-extramedullary. The most common clinical presentation is pain. Most of the spinal schwannomas in non-NF patients can be resected completely without or with minor post-operative deficits. This knowledge may help us to create a strategy for total resection of a spinal schwannomas. Copyright © 2011 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  7. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery

    NARCIS (Netherlands)

    Vos, P.C.; Riordan, A.J.; Smit, E.J.; Jong, H.W. de; Zwan, A. van der; Velthuis, B.K.; Viergever, M.A.; Dankbaar, J.W.

    2015-01-01

    OBJECTIVE: Perfusion imaging is increasingly used for postoperative evaluation of extracranial to intracranial (EC-IC) bypass surgery. Altered hemodynamics and delayed arrival of the contrast agent in the area fed by the bypass can influence perfusion measurement. We compared perfusion asymmetry obt

  8. [Neonatal subgaleal haemorrhage; a potential life-threatening extracranial haemorrhage

    NARCIS (Netherlands)

    Fuijkschot, J.; Antonius, T.A.J.; Meijers, P.W.; Vrancken, S.L.A.G.

    2008-01-01

    A female neonate delivered at term developed hypovolemic shock due to a subgaleal haemorrhage, i.e. extracranial bleeding between the galea aponeurotica and the cranial periosteum. The subgaleal haemorrhage was most likely the result of a traumatic vacuum extraction. The patient was treated with lar

  9. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery

    NARCIS (Netherlands)

    Vos, Pieter C.; Riordan, Alan J.; Smit, Ewoud J.; de Jong, Hugo W. A. M.; van der Zwan, Albert; Velthuis, BK; Viergever, Max A.; Dankbaar, Jan Willem

    2015-01-01

    Objective: Perfusion imaging is increasingly used for postoperative evaluation of extracranial to intracranial (EC-IC) bypass surgery. Altered hemodynamics and delayed arrival of the contrast agent in the area fed by the bypass can influence perfusion measurement. We compared perfusion asymmetry obt

  10. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji [University of Tokushima, Department of Neurosurgery, Tokushima (Japan)

    2008-08-15

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a 'magic wand' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  11. [A case of tongue base schwannoma].

    Science.gov (United States)

    Xie, Huishan; Yang, Feng; Zhuo, Mingying

    2013-09-01

    Published reports of benign nerve sheath tumors of the oropharynx especially at tongue base are extremely rare. They may slowly growing but represent a potential threat to the airway, prompt diagnosis and treatment are vital. To our knowledge, this case presents the rare clinical condition and the first giant one. Due to the rarity, awareness of the possibility of a schwannoma in various otolaryngological conditions is an important step in making a correct clinical diagnosis. Here we represent a rare case of a giant schwannoma that arose from valleculae projecting to supraglottis to cause swallowing difficult but no breathing problem. The mass was completely removed, and no recurrence during next 2 years follow-up.

  12. Hypoglossal neuropathology and respiratory activity in Pompe mice

    Directory of Open Access Journals (Sweden)

    Kun-Ze eLee

    2011-06-01

    Full Text Available Pompe disease is a lysosomal storage disorder associated with systemic deficiency of acid α-glucosidase (GAA. Respiratory-related problems in Pompe disease include hypoventilation and upper airway dysfunction. Although these problems have generally been attributed to muscular pathology, recent work has highlighted the potential role of central nervous system (CNS neuropathology in Pompe motor deficiencies. We used a murine model of Pompe disease to test the hypothesis that systemic GAA deficiency is associated with hypoglossal (XII motoneuron pathology and altered XII motor output during breathing. Brainstem tissue was harvested from adult Gaa-/- mice and the periodic acid Schiff (PAS method was used to examine neuronal glycogen accumulation. Semi-thin (2 µm plastic sections showed widespread medullary neuropathology with extensive cytoplasmic glycogen accumulation in XII motoneuron soma. We next recorded efferent XII bursting in anesthetized and ventilated Gaa-/- and B6/129 mice both before and after bilateral vagotomy. The coefficient of variation of respiratory cycle duration was greater in Gaa-/- compared to B6/129 mice (P < 0.01. Vagotomy caused a robust increase in XII inspiratory burst amplitude in B6/129 mice (239 ± 44 %baseline; P < 0.01 but had little impact on burst amplitude in Gaa-/- mice (130 ± 23 %baseline; P > 0.05. We conclude that CNS GAA deficiency results in substantial glycogen accumulation in XII motoneuron cell bodies and altered XII motor output. Therapeutic strategies targeting the CNS may be required to fully correct respiratory-related deficits in Pompe disease.

  13. Hypoglossal motoneurons in newborn mice receive respiratory drive from both sides of the medulla

    DEFF Research Database (Denmark)

    Tarras-Wahlberg, S; Rekling, J C

    2009-01-01

    Respiratory motor output in bilateral cranial nerves is synchronized, but the underlying synchronizing mechanisms are not clear. We used an in vitro slice preparation from newborn mice to investigate the effect of systematic transsections on respiratory activity in bilateral XII nerves. Complete...... correlations, where large-amplitude XII-bursts on one side was synchronized with small-amplitude XII-burst on the contralateral side. These characteristic amplitude correlations suggest that hypoglossal motoneurons receive respiratory drive from bilateral sources. Retrograde labeling confirmed that commissural...... in bilateral XII nerves. Hypoglossal motoneurons receive respiratory drive from both sides of the medulla, possibly mediated by contralaterally projecting dendrites....

  14. Pelvic schwannoma in the right parametrium

    Directory of Open Access Journals (Sweden)

    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

  15. Schwannoma da goteira olfatória: relato de caso Olfactory groove schwannoma: case report

    OpenAIRE

    Heider Lopes de Souza; Ana Maria de Oliveira Ramos; Carlos Cesar Formiga Ramos; Syomara Pereira da Costa Melo; Hougelle Simplício Gomes Pereira; João Flávio Gurjão Madureira; Janaína Martins de Lana

    2003-01-01

    Schwannomas intracranianos não associados a nervos cranianos são incomuns e raramente encontrados na região subfrontal. Apresentamos raro caso de schwannoma da goteira olfatória, acometendo paciente de 27 anos, masculino, com quadro iniciado há 1 ano com perda da olfação e cefaléia. Ao exame de admissão, apresentava papiledema bilateral e anosmia. Tomografia computadorizada de Cranio (TC) revelou processo expansivo bifrontal hipodenso ao parênquima, com aspecto multicístico, sem captação do c...

  16. 舌下神经管及其毗邻结构的观测和临床意义%Survey of hypoglossal canal and its adjacent structures and their clinical significances

    Institute of Scientific and Technical Information of China (English)

    李桂成; 江林; 龙启柳

    2012-01-01

    目的:研究舌下神经管及其毗邻结构的位置关系,为临床手术提供解剖学依据.方法:取成人头颅干骨标本60例(120侧),观察和测量舌下神经管及其毗邻结构的距离,并对双侧距离差别作统计学分析.结果:舌下神经管长度左(11.22±1.67)mn,右(11.28±1.79)mm;其长轴与矢状面的夹角左45.19°±1.51°、右45.30°±1.33°;其长轴与枕髁长轴的夹角左62.44°±3.62°、右62.32°±3.64°;枕髁后缘到达舌下神经管内口、外口的距离左(9.38±1.67)mm、(16.18±1.97)mm,右(9.35±1.70)mm、(16.13±1.94)mm.颈静脉结节上表面到达舌下神经管内口的距离左(6.17±1.34)mm、右(6.22±1.36)mm;髁管的出现率为65%,2侧均含有双髁管1.67%.舌下神经管内口有骨性突起分隔者8.33%,内口分为双管者18.33%、三管者6.67%、二分管1.67%.以上结果左、右侧差异没有统计学意义.结论:熟悉舌下神经管及其毗邻结构的解剖知识,有助于临床相关疾病的诊断和手术治疗方案的制定.%Objective: To provide anatomic basis for clinical surgery by studying the position relationship of the hypoglossal canal and its adjacent structures. Methods: The distance between the hypoglossal canal and its adjacent structures of 60 adult dry skullbase bones was observed and measured, and the data between bilateral sides were statistically analyzed. Results: The length of the hypoglossal canal on the left and right sides was (11. 22±1. 67)mm and (11. 28+1. 79)mm respectively; the angle formed by the long axis of the hypoglossal canal and the sagittal plane on the left and right sides were (45. 19 + 1. 51) and (45. 30 + 1. 33) degree respectively; and the angle formed by the hypoglossal canal and the occipital con-dyle on the left and right sides were (62. 44 + 3. 62) and (62. 32 + 3. 64) degree respectively. The distance from the posterior edge of the occipital condyle to the intracranial orifice or the extracranial orifice of the

  17. Ancient Schwannoma of the Thumb Pulp

    Directory of Open Access Journals (Sweden)

    Hajime Matsumine, MD, PhD

    2015-01-01

    Full Text Available Summary: A 21-year-old woman had become aware of a mass on the palmar aspect of the distal phalanx of her left thumb 11 years earlier. Her medical history was unremarkable, with no traumatic injury of the left thumb. Initial examination revealed a hard but elastic, immovable tumor of 30 × 25 mm on the palmar aspect of the distal phalanx of the left thumb, with an ulcer formed at the center. No pain, sensory disturbance, or motor dysfunction was noted. The patient underwent punch biopsy at the outpatient clinic, and the tumor was histopathologically diagnosed as benign schwannoma. Total excision of the tumor was performed with digital nerve block under surgical microscope. Histopathological findings revealed a fibrous capsule covering the tumor, directional growth of tightly organized spindle-shaped cells, and mixed Antoni A and B patterns. The tumor also contained many various sized cysts and showed histological degenerative changes not observed in ordinary schwannoma, such as hemorrhage and prominent blood vessels with hyalinized walls. The S-100 stain was positive. Based on these findings, the patient was diagnosed as having ancient schwannoma. There was no evidence of infection, pain, complications such as ulcer formation, or recurrent tumor at 6 months postoperative.

  18. Non surgical treatment of vestibular schwannoma.

    Science.gov (United States)

    Arribas, Leoncio; Chust, María L; Menéndez, Antonio; Arana, Estanislao; Vendrell, Juan B; Crispín, Vicente; Pesudo, Carmen; Mengual, José L; Mut, Alejandro; Arribas, Mar; Guinot, José L

    2015-01-01

    To evaluate the results of local control and complications in the treatment of vestibular schwannoma treated with radiation. A retrospective study of 194 patients diagnosed with vestibular schwannoma, treated consecutively with radiation (either stereotactic radiosurgery or fractionated radiotherapy) from 1997 to 2012. We analyze the local control of tumors, as well as secondary complications to treatment with radiation. A total of 132 (68%) tumors 68% are grade I-II tumors of the Koos classification, 40 (19%) are grade III, and 22 (13%) are grade IV. The tumors associated with neurofibromatosis (NF2), are 3.6% (6 tumors in 4 patients). The tumor control for the overall serie is 97% at 5 years, with a median follow-up of 80.4 months. For large tumors the local control is 91% at 5 years. Free survival of chronic complications is 89% at 5 years. Additionally, 50 tumors were subjected to regular follow-up with MRI without treatment, and 28 (58%) did not experienced tumor growth. Radiation and follow up with MRI, are an alternative to surgery in the treatment of vestibular schwannoma, with a low level of complications inside of multidisciplinary approach. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  19. 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.

  20. A Case Report of Schwannoma Presenting as Sciatica

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    A Afshar Fard

    2012-08-01

    The patient underwent operation and sciatic nerve explored via posterior tight and unique neural branch of mass dissociated of sciatic and mass resected. Pathology report confirmed Schwannoma in the patient. Conclusion: In patients with sciatic pain, schwannoma nerve is one of the differential diagnosis and it needs to be considered in assessing of patients.

  1. Pancreatic schwannoma: Report of a case and review of literature

    OpenAIRE

    Vidyadhar A Kinhal; Ravishankar, T. H. S.; Melapure, Ashok I.; Jayaprakasha, G.; Range Gowda, B. C.; Manjunath

    2010-01-01

    Connective tissue tumors of pancreas are uncommon, among them pancreatic schwannoma is very rare tumor, very few cases were reported in literature. Aggressive resections like whipple’s procedure, or distal pancreatectomy are not necessary for pancreatic schwannoma as it rarely goes to malignant change and simple enuclation is sufficient.

  2. [Case report and review of the literature: a perineal schwannoma].

    Science.gov (United States)

    Ravier, E; Lopez, J-G; Augros, M; Romy, P; Pugeat, G

    2011-05-01

    Schwannoma is a rare and benign peripheral nerve sheath tumor arising from Schwann cells. Perineal localisation is exceptional. It is most frequently isolated but can be associated with neurofibromatosis 2 or schwannomatosis. This article describes a case of perineal schwannoma, its management and update diagnosis modality and treatment of this tumor. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  3. Schwannoma of the tongue: An unusual presentation in a child

    Directory of Open Access Journals (Sweden)

    Naidu Giridhar

    2010-01-01

    Full Text Available Schwannomas are benign tumors of nerve sheath and quite uncommon in the oral cavity. In contrast to the earlier reports in the literature, a confounding case of a lingual schwannoma presenting as a symptomatic and exophytic growth on the ventral surface of the tongue in a 12-year-old boy is discussed here.

  4. Schwannoma of the tongue: an unusual presentation in a child.

    Science.gov (United States)

    Naidu, Giridhar S; Sinha, Samindra Mohan

    2010-01-01

    Schwannomas are benign tumors of nerve sheath and quite uncommon in the oral cavity. In contrast to the earlier reports in the literature, a confounding case of a lingual schwannoma presenting as a symptomatic and exophytic growth on the ventral surface of the tongue in a 12-year-old boy is discussed here.

  5. SCHWANNOMA IN A YOUNG MALE BREAST: A DIFFICULT DIFFERENTIAL DIAGNOSIS

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    Minakshi

    2014-12-01

    Full Text Available A benign tumour of Schwann cells of the peripheral nerve sheath is called Schwannoma, also called as neurilemoma or neurinoma. Most breast cancers and other breast tumors have an epithelial cell origin, with stromal and myoepithelial cell tumors being less common. A nerve sheath tumor arising from neural crest-derived Schwann cells within the breast is rarer still. For unknown reasons, these cells can sometimes grow in a neoplastic fashion which results in a benign tumor termed as schwannoma. Neurilemoma, neurinoma, peripheral nerve sheath tumor and schwannoma are considered to be synonymous though the term schwannoma appears to be more precise than the others as this tumour is believed to arise from schwan cells. Schwannoma are commonly slow growing solitary lesions which rarely show malignant transformation. The clinical significance of this benign tumor is that it may clinically and radiographically simulate malignant neoplasm.

  6. Tongue base schwannoma: report, review, and unique surgical approach.

    Science.gov (United States)

    Sawhney, Raja; Carron, Michael A; Mathog, Robert H

    2008-01-01

    Base of tongue schwannomas are exceedingly rare and therefore often are not immediately included in the differential diagnosis and treatment of oropharyngeal tumors. After a thorough review of the English literature, we found only 6 previously reported cases of tongue base schwannomas. We are contributing a report of a 37-year-old woman with progressive dysphagia, dysarthria, and large tongue base schwannoma. Diagnosis was confirmed by imaging studies and biopsy followed by surgical excision designed to preserve nerve function. A number of surgical approaches have been described for tongue base schwannomas. Each has its own degree of postoperative morbidity. The use of a unilateral transcervical incision with blunt dissection was simple and quickly accomplished with protection of nearby nerves. Histologic identification of Antoni A and B areas along with strong and diffuse staining with S-100 stain pathologically completed the diagnosis of schwannoma.

  7. Concurrent spinal nerve root schwannoma and meningioma mimicking single-component schwannoma.

    Science.gov (United States)

    Nakamizo, Akira; Suzuki, Satoshi O; Shimogawa, Takafumi; Amano, Toshiyuki; Mizoguchi, Masahiro; Yoshimoto, Koji; Sasaki, Tomio

    2012-04-01

    We present a first case of concurrent tumors consisting of schwannoma and meningioma arising at the same spinal level in a patient without neurofibromatosis. A 49-year-old man without clinical evidence of neurofibromatosis presented with a 5-month history of right neck pain. MRI demonstrated an extradural tumor involving the right-sided C2 nerve root with a small intradural component. T1- and T2-weighted and contrast-enhanced MRI could not differentiate the intradural tumor as different from the extradural tumor. Total removal of the tumors was performed. No contiguity of the extradural tumor with the intradural tumor was seen. The intradural tumor attached strongly to the dura mater around the C2 nerve root exits. Intraoperative pathological diagnosis confirmed the extradural tumor as schwannoma and the intradural tumor as meningioma. We therefore thoroughly coagulated the dura mater adjacent to the intradural tumor and resected the dura mater around the nerve root exits together with the tumor. Pathological examination revealed that the resection edge of the extradural component consisted of a spinal nerve with thickened epineurium and was free of neoplastic cells. No schwannoma component was evident in the intradural tumor. No obvious transition thus existed between the extra- and intradural tumors. Distinguishing these tumors prior to surgery is critical for determining an optimal surgical plan, as schwannoma and meningioma require different surgical procedures. We therefore recommend a careful review of preoperative imaging with the possibility of concurrent tumors in mind. © 2011 Japanese Society of Neuropathology.

  8. In vivo intraoperative hypoglossal nerve stimulation for quantitative tongue motion analysis

    NARCIS (Netherlands)

    Alphen, van M.J.A.; Eskes, M.; Smeele, L.E.; Balm, A.J.M.; Heijden, van der F.

    2015-01-01

    This is the first study quantitatively measuring tongue motion in 3D after in vivo intraoperative neurostimulation of the hypoglossal nerve and its branches during a neck dissection procedure. Firstly, this study is performed to show whether this set-up is suitable for innervating different muscles

  9. Hypoglossal-facial nerve anastomosis in the rabbits using laser welding.

    Science.gov (United States)

    Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

    2008-10-01

    The aim of this study is to compare laser nerve welding of hypoglossal-facial nerve to microsurgical suturing and a result of immediate and delayed repair, and to evaluate the effectiveness of laser nerve welding in reanimation of facial paralysis of the rabbit models. The first group of 5 rabbits underwent immediate hypoglossal-facial anastomosis (HFA) by microsurgical suturing and the second group of 5 rabbits by CO2 laser welding. The third group of 5 rabbits underwent delayed HFA by microsurgical suturing and the fourth group of 5 rabbits by laser nerve welding. The fifth group of 5 rabbits sustained intact hypoglossal and facial nerve as control. In all rabbits of the 4 different groups, cholera toxin subunit B (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative sixth week and in normal hypoglossal nerve in the 5 rabbits of control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically and the numbers were counted. In the immediate HFA groups, CTb positive neurons were 1416 +/- 118 in the laser welding group (n = 5) and 1429 +/- 90 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.75). In the delayed HFA groups, CTb positive neurons were 1503 +/- 66 in the laser welding group (n = 5) and 1207 +/- 68 in the microsurgical suturing group (n = 5). Difference was significant (P = 0.009). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.208), but some significant difference was observed between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.016). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1970 +/- 165. No dehiscence was seen on the laser welding site of nerve anastomosis in all the rabbits as re-exploration was done for injection of CTb. This study shows that regeneration of the anastomosed hypoglossal-facial nerve was affected similarly by either

  10. Features of Extracranial Hemodynamics in Children with Bronchial Asthma

    Directory of Open Access Journals (Sweden)

    S.M. Nedelska

    2014-11-01

    Full Text Available The paper analyzes the performance of extracranial hemodynamics — volumetric and linear blood flow velocity, the state of peripheral vascular resistance and vascular reactivity at ultrasound Doppler examination of the internal carotid and vertebral arteries of 66 children with bronchial asthma and and 22 healthy children. Development of regional hypoperfusion in vertebrobasilar zone, disorders of the carotid system are proven, but these changes have not led to a decrease in the volumetric blood flow velocity in both internal carotid arteries and the total volume of cerebral blood flow, indicating the compensation of hemodynamic disturbances due to the influence of constant rates in volumetric blood flow in the carotid system. Changes in parameters of extracranial hemodynamics in children with bronchial asthma should be considered as predictor of cerebrovascular complications in this group of patients.

  11. 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...

  12. 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

  13. Cervical sympathetic chain schwannoma: A case report

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    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.

  14. SCHWANNOMA OF THE TONGUE - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Satyananda Rao

    2013-11-01

    Full Text Available ABSTRACT: A case report of an 18 - year - old young girl presented with a slow - growing, painless swelling on the right side of the tongue since 4 years. This was associated with disturbances in mastication. Examination revealed a 3 cm x 4 cm, globular smooth, mobile mass on right side of the tongue. There was no neurological deficit and no neck nodes palpable. She underwent excision of the mass under general anaesthesia. Complete enucleation with primary closure was carried out. The patient had an uneventful postoperative recovery and histo patho logical evaluation was consistent with schwannoma. The patient is recurrence free till date

  15. 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.

  16. Retroperitoneal ancient schwannoma: Review of clinico-radiological features

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L.; Lo, K.K.L.; Lo, J.; Chan, J.C.S. [United Christian Hospital, Kwun Tong, (Hong Kong). Department of Diagnostics Radiology; Yuen, N.W.F. [United Christian Hospital, Kwun Tong, (Hong Kong). Department of Histopathology

    1998-05-01

    A case is reported here of an ancient schwannoma in the retroperitoneum. The findings of abdominal ultrasound and CT in a patient with a retroperitoneal ancient schwannoma are presented, and the clinical and radiological features of this unusual tumour are reviewed. The presence of a large, well-delineated complex cystic mass in the deep soft tissues should raise the possibility of an ancient schwannoma. It is important to recognize these tumours as benign with excellent prognosis so as to avoid unnecessary radical surgery. Copyright (1998) Blackwell Science Pty Ltd 12 refs., 2 figs.

  17. Extracranial internal carotid artery aneurysm treated by combined endovascular - microsurgical techniques

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2015-09-01

    Full Text Available Extracranial internal carotid artery aneurysms are rare lesions that still represent a challenge from diagnosis and treatment point of view. Giant complex aneurysms of extracranial internal carotid artery are usually completely excluded by surgical approaches. We present a case of a patient with an extracranial internal carotid artery aneurysm treated by a combined treatment, along with a short review of this pathology.

  18. Malignant renal schwannoma in a cat

    Directory of Open Access Journals (Sweden)

    Monier Sharif

    2017-07-01

    Full Text Available A nine-year-old male European shorthair cat with rapidly enlarging mass at the left kidney doubted to be malignant was presented. The purpose of this study is to present the clinical, radiological and pathological findings of a primary renal tumor in the cat. Grossly, the mass mostly encapsulated the kidney. Histologically, excisional biopsy showed worrying histological features. A sarcoma-like tumor composed mainly of neoplastic spindle-shaped cells. Neoplastic nodules of aggregations of fusiform cells arranged in multidirectional bundles. Immunohistochemically, several immunohistochemical satins (melan-A, S-100, vimentin, actin, desmin, cytokeratin, neurofilament, melan-A, NSE, synaptophysin, chromogranin, Glial Fibrillary Acidic Protein GFAP, Collagen IV and CD99 were used to differentially diagnose the mass. The stained neoplastic sections positively tested to S-100, but negative to the other aforementioned immunohistochemical stains. Immunohistochemistry with S-100 antibody staining showed an unusually strong positive reaction throughout the tumor cells. Based on our comparative diagnosis relative to other tumors, in addition to the progressive clinical signs, histopathological and immunohistochemical results, this case was presumptively diagnosis as a malignant schwannoma. According to our investigation of the relevant literature, this study of malignant renal Schwannoma (malignant peripheral nerve sheath tumor is a highly rare case not previously characterized in a cat.

  19. 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.

  20. An enigmatic clinical entity: A new case of olfactory schwannoma.

    Science.gov (United States)

    Manto, Andrea; Manzo, Gaetana; De Gennaro, Angela; Martino, Vincenzo; Buono, Vincenzo; Serino, Antonietta

    2016-06-01

    Olfactory schwannomas, also described as subfrontal or olfactory groove schwannomas, are very rare tumors, whose pathogenesis is still largely debated. We report a case of olfactory schwannoma in a 39-year-old woman who presented with anosmia and headache. The clinical examination did not show lesions in the nose-frontal region and there was no history of neurofibromatosis. Head MRI and CT scan revealed a lobulated extra-axial mass localized in the right anterior cranial fossa that elevated the ipsilateral frontal pole. Bilateral frontal craniotomy demonstrated a tumor strictly attached to the right portion of the cribriform plate that surrounded the right olfactory tract, not clearly identifiable. The immunohistochemical analysis suggested the diagnosis of typical schwannoma. The patient was discharged without any neurological deficit and a four-month postoperative MRI scan of the brain showed no residual or recurrent tumor. © The Author(s) 2016.

  1. A rare Cervical Nerve Root, C2-C3 Schwannoma

    Directory of Open Access Journals (Sweden)

    Nilesh Chordia

    2014-04-01

    Full Text Available Schwannomas, neurilemmomas or neurinomas are benign nerve sheath tumors deriving from Schwann cells that occur in the head and neck region in 25-45% of cases 1 .About 10% of schwannoma that occur in the head and neck region generally originate from the vagus or sympathetic nervous system, those arising from C2 nerve root are extremely rare. 2 Preoperative imaging studies such as magnetic resonance imaging (MRI and computed tomography (CT are used to distinguish its location and origin. The treatment of schwannoma is surgical resection, with several surgical modalities have been introduced to preserve the neurological function. We present a rare case of Cervical nerve (C2-C3 root schwannoma of 70 years old male who presented with lateral neck swelling with no neurological deficit ,swelling which also had intervertebral part was removed successfully through neck incision with no post-operative neurological symptoms

  2. 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.

  3. Schwannoma of the base of tongue – A rare presentation

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    M. Panduranga Kamath

    2014-03-01

    Conclusion: Schwannomas arising in the base of tongue are rare and are not often included in the differential diagnosis. They are usually benign and have excellent prognosis as compared to the usual malignant lesions which occur in the tongue base.

  4. Isolated tongue tremor after gamma knife radiosurgery for acoustic schwannoma.

    Science.gov (United States)

    Chung, Sun J; Im, Joo-Hyuk; Lee, Jae-Hong; Cho, A-Hyun; Kwon, Miseon; Lee, Myoung C

    2005-01-01

    We describe a patient who had an isolated tongue tremor with an audible click after gamma knife radiosurgery for acoustic schwannoma. The nature of the tongue tremor was clearly demonstrated by videofluoroscopy. The possible pathogenic mechanisms are discussed.

  5. 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.

  6. SCHWANNOMA OF TONGUE, A RARE INTRAORAL NEOPLASM: CASE REPORT

    OpenAIRE

    2015-01-01

    Schwannomas are truly encapsulated neoplasms of the human body and are always solitary. Only 1-2% occur intraorally with tongue being the most common site. A 20yr old male presented with a painless, slow growing swelling on the left side of the tongue for the past 1 year. Fine needle aspiration cytology was done and a benign mesenchymal lesion, possibility of Schwannoma was given. Biopsy of the tumour was performed and sent for histopathological examination which confirmed the diagnosis of Sc...

  7. Ancient schwannoma of the tongue: a case report.

    Science.gov (United States)

    Bilici, Suat; Akpınar, Meltem; Yiğit, Ozgür; Günver, Feray

    2011-01-01

    A 45-year-old male patient had left sided submucosal swelling extending backwards from the tip of the tongue disturbing articulation and swallowing. Submucosally located lesion was 3 x 2 x 1.5 cm in size and totally excised under local anesthesia. In this article, we present a case of ancient schwannoma of tongue. Although a very rare entity, ancient schwannoma should be considered in differential diagnosis of tongue lesions.

  8. A columellar deformity caused by a congenital schwannoma

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    Mohamed El Bouihi

    2013-04-01

    Full Text Available Schwannoma is a benign neoplasm arising from Schwann cells of the peripheral nerve. It very rarely located in the nasal tip. We report two cases of congenital schwannoma of the nasal columella and discuss the surgical approach of such tumor.Case report: Case 1: An 18 year-old female was referred to us for a very slow growing tumor of the columella. The deformity had been present since the birth. The patient underwent an excision of its tumor using an open rhinoplasty approach. The histological examination revealed a schwannoma. No recurrence was found within 2 years of follow up.Case 2: A 4 month male baby presenting a congenital tumor of his columella. He underwent an excision using open rhinoplasty approach. The histological examination showed a plexiform schwannoma.Discussion: Schwannoma of the nasal tip is a benign tumor that gradually causes aesthetic and functional disorders. Congenital schwannoma of columella is an extremely rare clinical situation. Its diagnosis and treatment can pose certain challenges. The treatment is surgical excision and histological analysis of the specimen. Open rhinoplasty approach provided a good surgical exploration and a good cosmetic result on this nasal tip tumor.

  9. Trigemino-hypoglossal somatic reflex in the pharmacological studies of nociception in orofacial area.

    Science.gov (United States)

    Zubrzycki, Marek; Janecka, Anna; Zubrzycka, Maria

    2015-01-01

    Disorders involving the orofacial area represent a major medical and social problem. They are a consequence of central nociceptive processes associated with stimulation of the trigeminal nerve nucleus. A rat model of trigeminal pain, utilizing tongue jerks evoked by electrical tooth pulp stimulation during perfusion of the cerebral ventricles with various neuropeptide solutions, can be used in the pharmacological studies of nociception in orofacial area. The investigated neuropeptides diffuse through the cerebroventricular lining producing an analgesic effect either directly, through the trigemino-hypoglossal reflex arc neurons or indirectly through the periaqueductal central gray, raphe nuclei or locus coeruleus neurons. The aim of this review is to present the effect of pharmacological activity of various neuropeptides affecting the transmission of the sensory information from the orofacial area on the example of trigemino-hypoglossal reflex in rats.

  10. Lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy.

    Science.gov (United States)

    Li, Xiaodi; Wang, Yuzhou

    2014-04-01

    Here, we present a rare case of a lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy. In this case, we proved Opalski's hypothesis by diffusion tensor tractography that ipsilateral hemiparesis in a medullary infarction is due to the involvement of the decussated corticospinal tract. We found that the clinical triad of ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy, which had been regarded as a variant of medial medullary syndrome, turned out to be caused by lateral lower medullary infarction. Therefore, this clinical triad does not imply the involvement of the anteromedial part of medulla oblongata, when it is hard to distinguish a massive lateral medullary infarction from a hemimedullary infarction merely from MR images. At last, we suggest that hyperreflexia and Babinski's sign may not be indispensable to the diagnosis of Opalski's syndrome and we propose that "hemimedullary infarction with ipsilateral hemiparesis" is intrinsically a variant of lateral medullary infarction.

  11. Unilateral compression neuropathy of the hypoglossal nerve due to head suspension orthosis in mitochondriopathy.

    Science.gov (United States)

    Finsterer, Josef; Hess, Barbara

    2004-12-01

    An 85-year-old woman with multisystem mitochondriopathy experienced tension headache, cervical pain, torque head-posture, and vertigo since 1980 for which she was continuously wearing a head-suspension-orthosis- since 1990. Since 1996 she developed severe left-sided weakness and wasting of the tongue. Needle-EMG of the left genioglossus muscle revealed abnormal spontaneous activity and reduced interference-pattern. No morphological alterations in the anatomical course of the hypoglossal nerve were found. Severe, unilateral weakness and wasting of the tongue was interpreted due to chronic compression of the hypoglossal nerve by long-standing use of a head-suspension-orthosis for cervical pain from cervical muscle weakness and resulting spinal degeneration.

  12. Excitatory effects of thyrotropin-releasing hormone (TRH) in hypoglossal motoneurons

    DEFF Research Database (Denmark)

    Rekling, J C

    1990-01-01

    The effect of thyrotropin-releasing hormone (TRH) was studied in 30 hypoglossal motoneurons from brainstem slices of guinea pigs. Bath application of TRH resulted in an increase of the spontaneous excitatory synaptic activity, depolarization of the neurons, increase of the input resistance...... and change of the duration of the falling phase of excitatory postsynaptic potentials. The depolarizing response and membrane conductance change was the result of a direct postsynaptic action of TRH, possibly mediated by a reduction of a potassium conductance....

  13. Anaesthetic management of a child with massive extracranial arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2012-01-01

    Full Text Available Vascular tumors affect the head and neck commonly but arteriovenous malformations are rare. Vascular malformations are often present at birth and grow with the patient, usually only becoming significant later in childhood. Embolization has been the mainstay of treatment in massive and complex arteriovenous malformations. We present a case of massive extracranial arteriovenous malformation in a 7-year-old boy causing significant workload on right heart and respiratory distress. The management of angioembolization under general anaesthesia and anaesthetic concerns are presented.

  14. Skull-base Ewing sarcoma with multifocal extracranial metastases

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    Sumit Thakar

    2012-01-01

    Full Text Available Intracranial occurrence of Ewing sarcoma (ES is unusual, with a skull-base location being anecdotal. We report a 29-year-old man who presented with rapidly progressive ophthalmoplegia, and was found to be harboring an infiltrative lesion involving the sphenoid sinus, sella, and clivus. He underwent trans-sphenoidal decompression of the lesion which was histologically suggestive of ES. He developed paraparesis 2 weeks after commencing adjuvant therapy. Imaging revealed two thoracic extradural lesions and florid vertebral and pulmonary metastases. This is the first report in indexed literature of a primary intracranial ES on the skull-base with disseminated extracranial disease.

  15. Effect of cerebral ventricles perfusion with naloxone on trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Janecka, A

    2001-02-02

    The goal of this study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) -- a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three series of experiments were performed. In the first two groups perfusions of lateral ventricles-cerebellomedullary cistern with McIlwain-Rodnight's solution and naloxone were carried out. In group 3 naloxone was infused through a catheter through the jugular vein. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with naloxone (100 nmol/ml) increased the trigemino-hypoglossal reflex up to 143%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant -- 93% -- inhibition of ETJ (7% of the control), naloxone (100 nmol/ml) was added to the perfusion fluid. This led to a significant increase of the reflex up to 68%. Infusion of naloxone through the jugular vein did not affect the reflex. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

  16. Ganglioneuromas involving the hypoglossal nerve and the vagus nerve in a child: Surgical difficulties.

    Science.gov (United States)

    Bakshi, Jaimanti; Mohammed, Abdul Wadood; Lele, Saudamini; Nada, Ritambra

    2016-02-01

    Ganglioneuromas are benign tumors that arise from the Schwann cells of the autonomic nervous system. They are usually seen in the posterior mediastinum and the paraspinal retroperitoneum in relation to the sympathetic chain. In the head and neck, they are usually related to the cervical sympathetic ganglia or to the ganglion nodosum of the vagus nerve or the hypoglossal nerve. We describe what we believe is the first reported case of multiple ganglioneuromas of the parapharyngeal space in which two separate cranial nerves were involved. The patient was a 10-year-old girl who presented with a 2-year history of a painless and slowly progressive swelling on the left side of her neck and a 1-year history hoarseness. She had no history of relevant trauma or surgery. Intraoperatively, we found two tumors in the left parapharyngeal space-one that had arisen from the hypoglossal nerve and the other from the vagus nerve. Both ganglioneuromas were surgically removed, but the affected nerves had to be sacrificed. Postoperatively, the patient exhibited hypoglossal nerve and vocal fold palsy, but she was asymptomatic. In addition to the case description, we discuss the difficulties we faced during surgical excision.

  17. A quantitative study of subsurface cisterns and their relationships in normal and axotomized hypoglossal neurones.

    Science.gov (United States)

    Sumner, B E

    1975-01-01

    A quantitative ultrastructural survey was made of subsurface cisterns and their association with overlying structures in the left hypoglossal nucleus of normal rats, and rats which had received left hypoglossal axotomies 7-84 days previously. Subsurface cisterns in normal rats occurred in some hypoglossal neurones, and, sporadically, in proximal dendrites. They were mostly subsynaptic, and often associated with Nissl substance; From 7-14 days postoperatively, when many somatic boutons temporarily lost contact with the perikaryal surface, and were replaced by a microglial sheath, the percentage of perikaryon with underlying cistern was significantly reduced. The Nissl substance was also dispersed at this stage, and not restored until 28 days postoperatively. At 21 days normal percentages of subsurface cistern were restored, but the cisterns were now mostly subastrocytic, an astrocytic sheath having replaced the microglial sheath. From 63 days onwards the cisterns were mostly subsynaptic again as boutons returned to the regenerating perikarya and the temporary astrocytic sheath disappeared. It is suggested that subsurface cisterns might alter the overlying perikaryal surface in some way during neuronal regeneration, causing certain boutons to adhere there.

  18. Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

    Directory of Open Access Journals (Sweden)

    Kenichi Takahoko

    2014-01-01

    Full Text Available Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%, and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

  19. Unilateral Recurrent Laryngeal and Hypoglossal Nerve Paralysis Following Rhinoplasty: A Case Report and review of Articles

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2014-01-01

    Full Text Available Introduction: Injury to cranial nerves IX, X, and XII is a known complication of laryngoscopy and intubation. Here we present a patient with concurrent hypoglossal and recurrent laryngeal nerve paralysis after rhinoplasty. Case Report: The patient was a 27-year-old woman who was candidate for rhinoplastic surgery. The next morning after the operation, the patient complained of dysphonia and a sore throat .7 days after the operation she was still complaining of dysphonia. She underwent a direct laryngoscopy, and right TVC paralysis was observed. Right hypoglossal nerve paralysis was also detected during physical cranial nerve function tests. Hypoglossal and recurrent laryngeal nerve function was completely recovered after 5 and 7 months, respectively, and no complication was remained. Conclusion: Accurate and atraumatic intubation and extubation, true positioning of the head and neck, delicate and gentle packing of the oropharynx, and maintenance of mean blood pressure at a safe level are appropriate methods to prevent this complication during anesthesia and surgical procedures.

  20. Extracranial soft-tissue swelling: a normal postmortem radiographic finding or a sign of trauma?

    Energy Technology Data Exchange (ETDEWEB)

    Strouse, P.J. [Section of Pediatric Radiology, University of Michigan Medical Center, Ann Arbor (United States); Caplan, M. [Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan (United States); Owings, C.L. [Department of Pediatrics and Communicable Diseases, C. S. Mott Children`s Hospital, Ann Arbor, Michigan (United States)

    1998-08-01

    Objective. To determine if extracranial soft-tissue swelling is an expected postmortem finding or a sign of trauma. Materials and methods. Extracranial soft-tissue thickness was measured at 5 standardized locations on postmortem skull films obtained of 18 infants with no evidence of trauma on autopsy. The same measurements were performed on the skull films of 100 living children, all less than 3 years old and without clinical history of trauma. Results. Extracranial soft tissues measured only slightly greater in the postmortem group than on films of living children; however, the difference did achieve statistical significance. Conclusion. Minimal extracranial soft-tissue swelling is a normal finding on a postmortem skeletal survey. The presence of substantial or asymmetric extracranial soft-tissue swelling should be viewed with suspicion for trauma. (orig.) With 2 tabs., 5 refs.

  1. 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.

  2. Spontaneous acute hemorrhage of intraspinal canal cellular schwannoma with paraplegia: A case report.

    Science.gov (United States)

    Zhang, Heng-Zhu; Li, Yuping; Han, Yang; Wang, Xiaodong; She, Lei; Yan, Zhengcun; Dong, Lun

    2015-06-01

    Cellular schwannoma, an unusual histological subtype of schwannoma, is a benign hypercellular variant of a peripheral nerve sheath tumor. We report a 48-year-old woman with sudden onset of paraplegia. The complete surgical resection was achieved. This is the first report about intraspinal canal cellular schwannoma following spontaneous acute hemorrhage and paraplegia.

  3. Repeat Gamma Knife surgery for vestibular schwannomas

    Science.gov (United States)

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

    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 median margin dose used for the first, second, and third GK treatments was 12 Gy, 12 Gy, and 14 Gy, respectively. Six patients (4 patients for the second irradiation and 2 patients for the third irradiation) with partial tumor regrowth were treated only on the growing part of the tumor using a median margin dose of 13 Gy. The median tumor volume was 0.9, 2.3, and 0.7 cc for the first, second, and third treatments, respectively. Stereotactic positron emission tomography (PET) guidance was used for dose planning in 6 cases. Results: Mean follow-up duration was 46 months (range 24–110). At the last follow-up, 85% of schwannomas were controlled. The tumor volume decreased, remained unchanged, or increased after retreatment in 15, 8, and 4 cases, respectively. Four patients had PET during follow-up, and all showed a significant metabolic decrease of the tumor. Hearing was not preserved after retreatment in any patients. New facial or trigeminal palsy did not occur after retreatment. Conclusions: Our results support the long-term efficacy and low morbidity of repeat GK treatment for selected patients with tumor growth after initial treatment. PMID:26500799

  4. Extracranial stereotactic radiotherapy: evaluation of PTV coverage and dose conformity.

    Science.gov (United States)

    Hädinger, Ulrich; Thiele, Wibke; Wulf, Jörn

    2002-01-01

    During the past few years the concept of cranial stereotactic radiotherapy has been successfully extended to extracranial tumoral targets. In our department, hypofractionated treatment of tumours in lung, liver, abdomen, and pelvis is performed in the Stereotactic Body Frame (ELEKTA Instrument AB) since 1997. We present the evaluation of 63 consecutively treated targets (22 lung, 21 liver, 20 abdomen/pelvis) in 58 patients with respect to dose coverage of the planning target volume (PTV) as well as conformity of the dose distribution. The mean PTV coverage was found to be 96.3% +/- 2.3% (lung), 95.0% +/- 4.5% (liver), and 92.1% +/- 5.2% (abdomen/pelvis). For the so-called conformation number we obtained values of 0.73 +/- 0.09 (lung), 0.77 +/- 0.10 (liver), and 0.70 +/- 0.08 (abdomen/pelvis). The results show that highly conformal treatment techniques can be applied also in extracranial stereotactic radiotherapy. This is primarily due to the relatively simple geometrical shape of most of the targets. Especially lung and liver targets turned out to be approximately spherically/cylindrically shaped, so that the dose distribution can be easily tailored by rotational fields.

  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. PMID:27695572

  6. Three cases of retroperitoneal schwannoma diagnosed by EUS-FNA

    Institute of Scientific and Technical Information of China (English)

    Taiki Kudo; Hiroshi Kawakami; Masaki Kuwatani; Nobuyuki Ehira; Hiroaki Yamato; Kazunori Eto; Kanako Kubota; Masahiro Asaka

    2011-01-01

    Schwannomas are peripheral nerve tumors that are typically solitary and benign. Their diagnosis is largely based on surgically resected specimens. Recently, a number of case reports have indicated that retroperitoneal schwannomas could be diagnosed with endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)We report the diagnosis of three cases of schwannoma using EUS-FNA. Subjects weree two males and one fe-twomale,ages 22, 40, and 46 years, respectively, all of whom were symptom-free. Imaging findings showed well-circumscribed round tumors.However, as the tumors could not be diagnosed using these findings alone, EUS-FNA was performed. Hematoxylin-eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading. There was no disparity in nuclear sizes.Immunostaining revealed S-100 protein positivity and all cases were diagnosed as schwannomas. Ki-67 indexes were 3%-15%,2%-3%,and 3%, respectively. No case showed any signs of malignancy.As most schwannomas are benign tumors and seldom become malignant, we observed these patients without therapy. All tumors demonstrated no enlargement and no change in characteristics.Schwannomasa are almost always benign and can be observed following diagnosis by EUS-FNA.

  7. 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.

  8. 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.

  9. 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.

  10. Doppler sonography of extracranial and intracranial vessels in patients with thrombotic stroke

    Directory of Open Access Journals (Sweden)

    Farhad Iranmanesh

    2006-12-01

    Full Text Available INTRODUCTION: The results of intracranial and extracranial vessel color Doppler sonography, which is now an inseparable part of patient evaluation, vary in different studies. The objective of this study was to evaluate the pattern of vascular involvement in thrombotic stroke and its relationship with risk factors of stroke. METHODS: One-hundred patients (45 males and 55 females with thrombotic stroke underwent transcranial sonography and color Doppler sonography of extracranial vessels. The pattern of vascular involvement was analyzed. The risk factors of stroke were also evaluated. RESULTS: Forty-seven percent of the studied individuals had some variations in their color Doppler sonography of extracranial vessels, 27% had changes in the intracranial vessels and 26% showed changes in both. The most frequently involved vessels among the intracranial and extracranial vessels were the middle cerebral artery and the internal carotid artery, respectively. The pattern of vascular involvement was unrelated to hypertension, cigarette smoking, diabetes mellitus, dyslipidemia or history of ischemic heart disease. Extracranial involvement in patients with positive history of MI was more prevalent than in those without such history. CONCLUSIONS: Extracranial vessel involvement in thrombotic stroke was found to be more prevalent than intracranial vessel involvement in the city of Rafsanjan; however, intracranial vessel involvement was more prevalent than in western countries. KEY WORDS: Thrombotic stroke, color Doppler sonography, intracranial vessels, extracranial, cerebrovascular risk factors

  11. Isolated trochlear nerve schwannoma presenting with diplopia: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohammad Samadian

    2015-06-01

    Conclusion: Trochlear nerve schwannoma is a rare type of schwannoma and in almost all of the cases is diagnosed intraoperatively. There are three types of trochlear nerve schwannoma according to the classification proposed for trigeminal schwannoma: cisternal type—confined to the precavernous segment of the trochlear nerve; cistocavernous type—invading the cavernous sinus and the retroclival and retropetrosal cistern; cavernous type—located in the middle cranial fossa on the cavernous or paracavernous segment of the fourth cranial nerves, with or without cavernous sinus invasion. The cisternal type was the most common type encountered in previous studies. The clinical signs and symptoms of trochlear nerve schwannoma are similar to the trigeminal schwannoma and should be considered in the differential diagnosis of trigeminal schwannoma.

  12. Gamma Knife surgery for patients with jugular foramen schwannomas: a multiinstitutional retrospective study in Japan.

    Science.gov (United States)

    Hasegawa, Toshinori; Kato, Takenori; Kida, Yoshihisa; Sasaki, Ayaka; Iwai, Yoshiyasu; Kondoh, Takeshi; Tsugawa, Takahiko; Sato, Manabu; Sato, Mitsuya; Nagano, Osamu; Nakaya, Kotaro; Nakazaki, Kiyoshi; Kano, Tadashige; Hasui, Koichi; Nagatomo, Yasushi; Yasuda, Soichiro; Moriki, Akihito; Serizawa, Toru; Osano, Seiki; Inoue, Akira

    2016-10-01

    OBJECTIVE This study aimed to explore the efficacy and safety of stereotactic radiosurgery in patients with jugular foramen schwannomas (JFSs). METHODS This study was a multiinstitutional retrospective analysis of 117 patients with JFSs who were treated with Gamma Knife surgery (GKS) at 18 medical centers of the Japan Leksell Gamma Knife Society. The median age of the patients was 53 years. Fifty-six patients underwent GKS as their initial treatment, while 61 patients had previously undergone resection. At the time of GKS, 46 patients (39%) had hoarseness, 45 (38%) had hearing disturbances, and 43 (36%) had swallowing disturbances. Eighty-five tumors (73%) were solid, and 32 (27%) had cystic components. The median tumor volume was 4.9 cm(3), and the median prescription dose administered to the tumor margin was 12 Gy. Five patients were treated with fractionated GKS and maximum and marginal doses of 42 and 21 Gy, respectively, using a 3-fraction schedule. RESULTS The median follow-up period was 52 months. The last follow-up images showed partial remission in 62 patients (53%), stable tumors in 42 patients (36%), and tumor progression in 13 patients (11%). The actuarial 3- and 5-year progression-free survival (PFS) rates were 91% and 89%, respectively. The multivariate analysis showed that pre-GKS brainstem edema and dumbbell-shaped tumors significantly affected PFS. During the follow-up period, 20 patients (17%) developed some degree of symptomatic deterioration. This condition was transient in 12 (10%) of these patients and persistent in 8 patients (7%). The cause of the persistent deterioration was tumor progression in 4 patients (3%) and adverse radiation effects in 4 patients (3%), including 2 patients with hearing deterioration, 1 patient with swallowing disturbance, and 1 patient with hearing deterioration and hypoglossal nerve palsy. However, the preexisting hoarseness and swallowing disturbances improved in 66% and 63% of the patients, respectively

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

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    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.

  14. Giant cystic sacral schwannoma mimicking tarlov cyst: a case report.

    Science.gov (United States)

    Attiah, Mark A; Syre, Peter P; Pierce, John; Belyaeva, Elizaveta; Welch, William C

    2016-05-01

    To present a rare case of a giant schwannoma of the sacrum mimicking a Tarlov cyst. A 58-year-old woman had a 1-year history of low back pain. MRI revealed a large cystic mass in the sacral canal with bony erosion. Radiological diagnosis of Tarlov cyst was made. The patient underwent surgical treatment for the lesion, which revealed a solid mass. Histopathological examination of the tumor confirmed the diagnosis of schwannoma. The postoperative course was uneventful and the patient has had significant improvement in her pain 1 month postoperatively. Giant cystic schwannoma of the sacrum is a very rare diagnosis overlooked by practitioners for more common cystic etiologies, but its treatment is significantly different. Care should be taken to include this diagnosis in a differential for a cystic sacral mass.

  15. Schwannoma of tongue base treated with transoral carbon dioxide laser.

    Science.gov (United States)

    Mehrzad, H; Persaud, R; Papadimitriou, N; Kaniyur, S; Mochloulis, G

    2006-12-01

    Schwannomas are benign slow growing solitary tumours of nerve sheath origin and can arise from any myelinated nerve. They have been reported to occur in most parts of the body with the highest incidence (25%) in the head and neck region, although tongue base lesions are rare. The tumour is resistant to radiotherapy, and therefore, the treatment of choice is surgery. We present a case of a tongue base schwannoma which was completely extirpated with a carbon dioxide laser via the transoral approach. The patient experienced virtually no morbidity from the use of the laser. Whilst tongue base schwannoma has been documented, we could not find an earlier report in the English literature describing our method of treatment. We conclude that transoral carbon dioxide laser can be added to the surgical armamentarium for the management of other similar cases in the future.

  16. Intraoral schwannoma--a report of two cases.

    Science.gov (United States)

    Kurup, Seema; Thankappan, Krishnakumar; Krishnan, Nitin; Nair, Preeti P

    2012-07-09

    Schwannomas, also known as neurilemmomas, are uncommon neoplasms, derived from schwann cells. These neoplasms, although rare, should be considered in the differential diagnosis of slow growing tumour masses of the oral cavity. The growth of these tumours sometimes causes displacement and compression of the nerve of origin, giving rise to clinical signs and symptoms. It can develop at any age and there is no sex predilection. Intraorally, the tongue is the most common site followed by the palate, floor of the mouth, buccal mucosa, lips and jaws. Surgical excision is the treatment of choice for schwannomas, with few reports of recurrence or malignant transformation. In this paper, the authors report two cases of patients with intraoral schwannoma, where the preoperative clinical diagnosis was inconclusive and final diagnosis was established based on radiographic and histopathological examination.

  17. Intra-oral schwannoma: case report and literature review.

    Science.gov (United States)

    Martins, Manoela Domingues; Anunciato de Jesus, Luciane; Fernandes, Kristianne Porta Santos; Bussadori, Sandra Kalil; Taghloubi, Saad Ahmad; Martins, Marco Antonio Trevizani

    2009-01-01

    Schwannoma is a relatively uncommon, slow-growing benign tumor that is derived apparently from the Schwann cells. The tongue is the most common site, followed by the palate, floor of mouth, buccal mucosa, lips, and jaws. It can present itself at any age. Usually, this lesion is not taken into account during clinical practice and the differential diagnosis includes numerous benign neoformations based on epithelial and connective tissues. Immunohistochemical features can be useful in determining the neural differentiation. Anti-S100 protein is probably the most used antibody to identify this lesion. The schwannoma is usually a solitary lesion, and can be multiple when associated with neurofibromatosis. In the current study, authors report a case of an intraoral schwannoma situated at the vestibule with 20 years of evolution treated by complete surgical excision. The diagnosis was established based on clinical, histopathological, and immunohistochemical aspects. The patient is under clinical control, with no signs of recurrence even after four years.

  18. Signaling mechanism underlying the histamine-modulated action of hypoglossal motoneurons.

    Science.gov (United States)

    Liu, Zi-Long; Wu, Xu; Luo, Yan-Jia; Wang, Lu; Qu, Wei-Min; Li, Shan-Qun; Huang, Zhi-Li

    2016-04-01

    Histamine, an important modulator of the arousal states of the central nervous system, has been reported to contribute an excitatory drive at the hypoglossal motor nucleus to the genioglossus (GG) muscle, which is involved in the pathogenesis of obstructive sleep apnea. However, the effect of histamine on hypoglossal motoneurons (HMNs) and the underlying signaling mechanisms have remained elusive. Here, whole-cell patch-clamp recordings were conducted using neonatal rat brain sections, which showed that histamine excited HMNs with an inward current under voltage-clamp and a depolarization membrane potential under current-clamp via histamine H1 receptors (H1Rs). The phospholipase C inhibitor U-73122 blocked H1Rs-mediated excitatory effects, but protein kinase A inhibitor and protein kinase C inhibitor did not, indicating that the signal transduction cascades underlying the excitatory action of histamine on HMNs were H1R/Gq/11 /phospholipase C/inositol-1,4,5-trisphosphate (IP3). The effects of histamine were also dependent on extracellular Na(+) and intracellular Ca(2+), which took place via activation of Na(+)-Ca(2+) exchangers. These results identify the signaling molecules associated with the regulatory effect of histamine on HMNs. The findings of this study may provide new insights into therapeutic approaches in obstructive sleep apnea. We proposed the post-synaptic mechanisms underlying the modulation effect of histamine on hypoglossal motoneuron. Histamine activates the H1Rs via PLC and IP3, increases Ca(2+) releases from intracellular stores, promotes Na(+) influx and Ca(2+) efflux via the NCXs, and then produces an inward current and depolarizes the neurons. Histamine modulates the excitability of HMNs with other neuromodulators, such as noradrenaline, serotonin and orexin. We think that these findings should provide an important new direction for drug development for the treatment of obstructive sleep apnea.

  19. Minimally Invasive Approach to the Lingual and Hypoglossal Nerves in the Adult Rat.

    Science.gov (United States)

    Doyle, Edward John; Phillips, Grady W; Gratton, Michael Anne; Long, John P; Varvares, Mark A

    2016-06-01

    Surgical manipulation of the sensory and motor nerves of the rat tongue is often employed in studies evaluating the oral cavity functions of mastication and deglutition. A noninvasive, atraumatic approach that will then facilitate sufficient manipulation of these structures is required. In this study, we detail an approach that consistently allows identification of the hypoglossal (motor) and lingual (sensory) nerves of the rat. Six Wistar rats (250-500 g) were anesthetized and dissected either as fresh tissue (N = 3) or following transcardial perfusion with 4% paraformaldehyde (N = 3). Both fixed and non-fixed specimens of the rat head and neck were incised in the right submandibular region. The first animal in each group was used to gain a basic understanding of the regional muscular anatomy with reference to the hypoglossal and lingual nerves. Subsequent animals were used for the development of an efficient and minimally invasive approach to these nerves. The resultant approach begins as an incision through skin and platysma, followed by medial reflection of the digastric muscle. This allows visualization of the hypoglossal nerve in the region of the bifurcation of the common trunk into medial and lateral subdivisions. Next, the lingual nerve dissection is approached by reflection rostrally of the transversus mandibularis muscle and a caudal reflection of the mylohyoid muscle. This dissection reveals the geniohyoid muscle which when separated bluntly using forceps, exposes the lingual nerve. The anatomical approach described and illustrated herein will aid investigators in consistent identification of these two nerves as fundamental methods of their projects.

  20. End-to-side intrapetrous hypoglossal-facialanastomosis for reanimation of the face. Technical note.

    Science.gov (United States)

    Ferraresi, Stefano; Garozzo, Debora; Migliorini, Vittorino; Buffatti, Paolo

    2006-03-01

    The aim of this paper was to report on further experience with a new technique for reanimation of the facial nerve. This procedure allows a straight end-to-side hypoglossal-facial anastomosis without interruption of the 12th cranial nerve or the need for graft interposition. It is technically demanding and time consuming but offers an effective, reliable, and extraordinarily quick means of reinnervating the facial muscles, including the orbicularis oculi muscle, thus avoiding the need for a gold weight in the eyelid or a fascial sling.

  1. A Usual Schwannoma at an Unusual Site-The Mesorectum

    Directory of Open Access Journals (Sweden)

    Jaya Manchanda

    2016-07-01

    Full Text Available The aim of the article is to present a rare case of mesorectal schwannoma diagnosed by fine needle aspiration cytology in a 36 year old man. Schwannomas are benign encapsulated tumors arising from Schwann cells of motor and peripheral nerves. They commonly present on the head, neck and trunk and on rare occasion arise in the retroperitoneum and in the lumbosacral region. It is however quite uncommon for a schwanomma to originate in the mesorectum. In evaluating such cases, FNAC provides a safe and effective method to resolve the great diagnostic dilemma.

  2. 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.

  3. Schwannoma da goteira olfatória: relato de caso

    OpenAIRE

    Souza Heider Lopes de; Ramos Ana Maria de Oliveira; Ramos Carlos Cesar Formiga; Melo Syomara Pereira da Costa; Pereira Hougelle Simplício Gomes; Madureira João Flávio Gurjão; Lana Janaína Martins de

    2003-01-01

    Schwannomas intracranianos não associados a nervos cranianos são incomuns e raramente encontrados na região subfrontal. Apresentamos raro caso de schwannoma da goteira olfatória, acometendo paciente de 27 anos, masculino, com quadro iniciado há 1 ano com perda da olfação e cefaléia. Ao exame de admissão, apresentava papiledema bilateral e anosmia. Tomografia computadorizada de Cranio (TC) revelou processo expansivo bifrontal hipodenso ao parênquima, com aspecto multicístico, sem captação do c...

  4. Extracranially located PICA aneurysm presenting with supratentorial IVH: A rare event with diagnostic pitfalls

    Directory of Open Access Journals (Sweden)

    Amey Savardekar

    2013-01-01

    Full Text Available Extracranially located posterior inferior cerebellar artery (PICA aneurysms are rare with only 21 cases reported till date. They may arise either from the proximal segment of an extracranially originating PICA or from the tip of its caudal loop when it dips below the foramen magnum. A 16-year-old female presenting with sudden onset severe headache and intraventricular hemorrhage (IVH in the occipital horns of the lateral ventricle and the fourth ventricles, was diagnosed to have an extracranial proximal segment PICA aneurysm on a four vessel digital subtraction angiography (DSA, after initially missing it on the brain magnetic resonance imaging (MRI with angiogram (MRA because of its extracranial location. During surgery, the aneurysm was clipped following a far lateral suboccipital craniectomy with C1-C2 hemilaminectomy. The patient showed good recovery. Thus, we emphasize the need for a dedicated four vessel angiography to diagnose such lesions.

  5. Recanalization of extracranial internal carotid artery occlusion A 12-year retrospective study

    National Research Council Canada - National Science Library

    Liqun Jiao Gang Song Yang Hua Yan Ma Yanfei Chen Yabing Wang Feng Ling

    2013-01-01

    ... internal carotid artery occlusion. The study included 65 patients with extracranial internal ca- rotid artery occlusion who underwent carotid endarterectomy, carotid endarterectomy combined with Fogarty catheter embotectomy, or hybrid...

  6. Extracranial vascular malformation: value of antenatal and postnatal MRI in management

    Energy Technology Data Exchange (ETDEWEB)

    Roche, C.J.; Pilling, D.W. [Dept. of Radiology, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom); Walkinshaw, S.A. [Dept. of Fetal Medicine, Liverpool Women' s Hospital (United Kingdom); May, P.L. [Dept. of Neurosurgery, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom)

    2001-10-01

    We report a case where fetal MRI using a low-field-strength magnet (0.5 T) accurately confirmed a large extracranial vascular malformation, which was suspected on antenatal US. Fetal MRI enabled better counselling of the parents and allowed suitable plans to be made regarding method of delivery and early management of the neonate. To our knowledge this is the first case of an extracranial vascular malformation imaged using fetal MRI. (orig.)

  7. Intraosseous schwannoma originating in inferior alveolar nerve: a case report.

    Science.gov (United States)

    Suga, Kenichiro; Ogane, Satoru; Muramatsu, Kyotaro; Ohata, Hitoshi; Uchiyama, Takeshi; Takano, Nobuo; Shibahara, Takahiko; Eguchi, Jun; Murakami, Satoshi; Matsuzaka, Kenichi

    2013-01-01

    Schwannomas (neurilemmomas) are benign neoplasms derived from Schwann cells of the neurilemma and appear most frequently on the auditory nerve or peripheral nerves of the skin. They arise in the oral and maxillofacial region infrequently, and very rarely in the center of the jaw. We herein present a case of a rare mandibular intraosseous schwannoma derived from the main trunk of the inferior alveolar nerve in a 33-year-old man. Fusiform expansion in the mandibular canal was observed and a mass showing the target sign in the mandibular canal was confirmed on T2-weighted and Gd contrastenhanced T1-weighted MRI. Based on these findings, an inferior alveolar nerve-derived schwannoma or other benign nervous system neoplasm was diagnosed. A buccal side cortical bone flap in the mandibular molar region was removed to expose the mass, which was then peeled away from the nerve fibers and completely removed. Some inferior alveolar nerve fibers that were connected to the mass were removed at the same time, but the remaining nerve fiber bundle was preserved. Histopathology confirmed the diagnosis of a schwannoma with Antoni type A and Antoni type B regions. Although the patient experienced extremely mild paresthesia in the skin over the mental region and mental foramen at immediately after surgery, this had almost entirely disappeared at 7 years and 4 months later, and there has been no tumor recurrence.

  8. 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 hearing preservation was also investigated....

  9. 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...

  10. 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%.

  11. 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...

  12. 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...

  13. Malignant schwannoma of the infratemporal fossa: a case report.

    Science.gov (United States)

    Touati, Mohamed Mliha; Darouassi, Youssef; Chihani, Mehdi; Al Jalil, Abdelfettah; Tourabi, Khalid; Lakouichmi, Mohamed; Essadi, Ismail; Bouaity, Brahim; Ammar, Haddou

    2015-07-04

    Malignant schwannomas or neurofibrosarcomas are rare nerve tumors of unknown etiology. These neoplasms are highly aggressive with a marked propensity for local recurrence and metastatic spread. Their management continues to be a challenge for pathologists and surgeons. Maxillofacial locations are very exceptional. We report the case of a patient with unusual malignant schwannoma of the infratemporal fossa discovered at a late evolving stage. A 56-year-old woman, of Moroccan nationality, presented to our hospital in 2013 with a large right-sided hemifacial swelling that had evolved over the previous 4 months, with a limitation of mouth opening, nasal obstruction and episodes of epistaxis. A CT scan and MRI showed a large and invasive tumor occupying her right infratemporal fossa and maxillary sinus, with sphenoidal, ethmoidonasal, nasopharyngeal and intraorbital extension. A nasal endoscopic biopsy was performed. Immunohistochemical examination concluded a diagnosis of malignant schwannoma, and a palliative radiotherapy was decided; however, our patient died 10 days later. Malignant schwannoma of paranasal sinuses and the anterior skull base is a rare tumor that involves a high rate of local invasion. The prognosis is poorer compared to that occurring in the trunk and extremities.

  14. 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.

  15. Schwannoma located in the palate: clinical case and literature review.

    Science.gov (United States)

    López-Carriches, Carmen; Baca-Pérez-Bryan, Rafael; Montalvo-Montero, Santiago

    2009-09-01

    Schwannoma is a benign tumor that originates from the presence of Schwann cells of the peripheral nerves. They are usually asymptomatic, do not recur, and malignant transformation is rare. The preoperative diagnosis is often difficult, and although computed tomography and magnetic resonance imaging are very helpful, in the majority of cases, the diagnosis can only be made during surgery and by histological study. The immunohistochemistry reveals that the Schwannoma cells test positive for S-100 protein. We describe a clinical case of Schwannoma located in the palate of a 15-year-old patient. It is important to highlight that the Schwannoma is usually found in the head and neck, and rarely in the oral cavity. When it does occur in this area, it is more likely to be found in the tongue. Other locations in the oral cavity include: the floor of the mouth, palate, gingiva, vestibular mucosa, lips and mental nerve area, listed from most common to least common. There has been no sign of recurrence two years after surgery.

  16. 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

  17. The Effect of Tongue Exercise on Serotonergic Input to the Hypoglossal Nucleus in Young and Old Rats

    Science.gov (United States)

    Behan, Mary; Moeser, Adam E.; Thomas, Cathy F.; Russell, John A.; Wang, Hao; Leverson, Glen E.; Connor, Nadine P.

    2012-01-01

    Purpose: Breathing and swallowing problems affect elderly people and may be related to age-associated tongue dysfunction. Hypoglossal motoneurons that innervate the tongue receive a robust, excitatory serotonergic (5HT) input and may be affected by aging. We used a rat model of aging and progressive resistance tongue exercise to determine whether…

  18. Axon reaction in hypoglossal and dorsal motor vagal neurons of adult rat: incorporation of (3H)leucine

    Energy Technology Data Exchange (ETDEWEB)

    Aldskogius, H.; Barron, K.D.; Regal, R.

    1984-07-01

    Pairs of adult rats received (/sup 3/H)leucine 0.25, 1, and 16 h before killing and zero to 164 days after unilateral cervical vagotomy and hypoglossal neurotomy. Grain counts and morphometric measurements were made on axotomized and uninjured neurons in histoautoradiographs of the medullary nuclei. Axotomized hypoglossal neurons, which largely survive the injury, both enlarged and incorporated increased amounts of tritiated leucine at each labeling interval, 3 through 28 days postoperatively. In the vagal dorsal motor nucleus (DMN), axotomized cells, which frequently die after neurotomy, enlarged slightly through 28 days postoperatively, then atrophied; DMN neurons increased amino acid uptake for a shorter period (days 7 through 14) than hypoglossal neurons. Axotomized DMN neurons did not sustain increased protein synthesis as long as their hypoglossal counterparts and seemed to fail to increase synthesis of structural proteins with long half-lives (16-h labeling interval). The frequently necrobiotic response of axotomized DMN neurons may relate to these phenomena. From these and earlier results, the authors conclude that axon reaction appears to differ fundamentally in peripheral and central neurons. This difference may have significance for research on regeneration in the central nervous system.

  19. Breast schwannoma in a patient with diffuse large B-cell lymphoma: a case report

    Directory of Open Access Journals (Sweden)

    Salihoglu Ayse

    2012-12-01

    Full Text Available Abstract Introduction Schwannomas are mostly benign tumors arising from Schwann cells of the nerve sheaths. Breast schwannomas are very rare and account for only 2.6% of cases. As far as we know this is the first reported case of breast schwannoma discovered in a patient with diffuse large B-cell lymphoma. The breast schwannoma was evaluated with positron emission tomography and it exhibited moderate 18F-fluorodeoxyglucose uptake. Case presentation We present the case of a breast schwannoma in a 63-year-old Caucasian woman who was diagnosed with diffuse large B-cell lymphoma. Conclusion Imaging modalities including positron emission tomography-computed tomography failed to distinguish breast schwannoma from diffuse large B-cell lymphoma involvement of the breast.

  20. Blunt Traumatic Extracranial Cerebrovascular Injury and Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Paul M. Foreman

    2017-04-01

    Full Text Available Background: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI. The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. Summary: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma. Patients with TCVI are particularly challenging to manage because they often suffer polytrauma, that is, numerous additional injuries including orthopedic, chest, abdominal, and head injuries. Presently, there is no consensus about optimal management. Key Messages: Most literature about TCVI and stroke has been published in trauma, general surgery, and neurosurgery journals; because of this, and because these patients are managed primarily by trauma surgeons, patients with stroke due to TCVI have been essentially hidden from view of neurologists. This review is intended to bring this clinical entity to the attention of clinicians and investigators with specific expertise in neurology and stroke.

  1. 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.

  2. 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

  3. 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.

  4. Schwannoma (Neurilemmoma) on the Base of the Tongue: A Rare Clinical Case

    OpenAIRE

    2016-01-01

    Patient: Female, 20 Final Diagnosis: Schwannoma of the tongue Symptoms: Dysarthria • dysphagia Medication: — Clinical Procedure: Excision of the mass via trans-oral approach Specialty: Surgery Objective: Rare disease Background: Schwannomas are slow-growing benign tumors. They can arise from any peripheral nerve, including the cranial nerves (except the olfactory and optic nerves), spinal nerves, and autonomic nerves. Schwannomas of the head and neck account for 25–40% of all cases. However, ...

  5. Schwannoma of the tongue: two case reports and review of the literature

    OpenAIRE

    2009-01-01

    The aim of this study was to describe clinicopathologic and radiographic features of two cases of schwannoma involving the oral tongue and to review the literature of this unusual clinical entity. Case reports with review of the pathologic, radiologic and clinical data for two patients with schwannoma of the tongue are reported. Review of the literature of case reports of schwannomas (neurilemmomas) of the tongue from 1955 to 2006 with analysis of the patient’s age, gender, presenting symptom...

  6. Schwannoma of the Tongue in a Paediatric Patient: A Case Report and 20-Year Review

    OpenAIRE

    2014-01-01

    Schwannomas (Neurilemmomas) are benign, encapsulated, slow-growing, and usually solitary tumours originating from Schwann cells of the peripheral nerve sheath with uncertain etiology. Approximately 25–48% of cases are seen in the head and neck region, of which 1% appears in the oral cavity. Lingual schwannoma can affect all age groups with peak incidence between the third and sixth decade. We report a rare case of lingual schwannoma in a 14-year-old girl complaining of asymptomatic swelling o...

  7. Interaction between thyrotropin-releasing hormone (TRH) and NMDA-receptor-mediated responses in hypoglossal motoneurones

    DEFF Research Database (Denmark)

    Rekling, J C

    1992-01-01

    -50 microM TRH markedly potentiated the response to iontophoretically applied NMDA, whereas no potentiation of the response to glutamate, aspartate or quisqualic acid was seen. Voltage clamp experiments showed that TRH did not increase the current flowing through NMDA channels, thus a direct modulatory role......The effect of thyrotropin-releasing hormone (TRH) on the responses to excitatory amino acids was investigated in hypoglossal motoneurones in an in vitro preparation of the brainstem from guinea pigs using current clamp and discontinuous single electrode voltage clamp (dSEVC). Bath application of 20...... of TRH on NMDA channels was not a likely explanation of the potentiation. Voltage clamp studies of the current-voltage relationship showed that the potentiation of the response to NMDA and lack of potentiation of the response to quisqualic acid was a result of an interaction between the actions of TRH...

  8. Persistent hypoglossal artery and its variants diagnosed by CT and MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Kozawa, Eito; Nishi, Naoko; Mizukoshi, Waka; Inoue, Kaiji; Nakajima, Reiko; Takahashi, Masahiro [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2013-01-15

    Persistent hypoglossal artery (PHA) is the second most common anastomosis between the carotid and vertebrobasilar systems and demonstrates some variations. We evaluated the prevalence of PHA on computed tomography (CT) angiography. We also evaluated characteristic features of PHA and its variants on magnetic resonance (MR) angiography. We retrospectively reviewed our database of 2,074 CT angiographic images obtained using either of two 64-slice multidetector CT scanners. We also reviewed our database of 7,646 MR angiographic images obtained using either of two 1.5-T or one 3.0-T imager. We could not determine the exact number of patients whose MR angiography included the hypoglossal canal. Most patients had or were suspected of having cerebrovascular diseases. We found six usual PHAs arising from the cervical internal carotid artery on CT angiography among 2,074 patients. On MR angiography, we also found six additional usual PHAs (total 12, right/left = 6/6, male/female = 3/9), three right PHAs originating from the external carotid artery (ECA), and two posterior inferior cerebellar arteries (PICAs) arising from the ECA without connection to the vertebral artery. The prevalence of usual PHA diagnosed by CT angiography was 0.29 %, slightly higher than that reported for angiography and may be due to selection bias in the examined patients. We propose naming usual PHA ''type 1 PHA''; PHA originating from the ECA, of which we found three, ''type 2 PHA''; and PICA arising from the ECA, of which we found two, ''type 2 PHA variant''. (orig.)

  9. Case of radiation induced aneurysm of extracranial carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takashi; Ikota, Toshio; Yamashita, Kousuke; Kodama, Takao

    1988-08-01

    An unusual case of post-irradiation aneurysm of extracranial internal carotid artery is presented. A 70-year-old man, complaining of left cervical throbbing mass with focal pain, was admitted on February 8, 1985. It was noted, from his past history, that he had had surgery of the removal of cervical lymphnodes and that unknown dosage of irradiation had been added to the cervical region 30 years before. Left carotid angiography (on admission) demonstrated a giant aneurysm in the cervical portion of internal carotid artery. Right carotid angiography with compression of left carotid artery revealed good cross filling through anterior communicating artery. Computed tomography with contrast media showed a ring like enhanced mass, which was thought to suggest that a large part of the aneurysm was filled with intraluminal thrombosis. During 30 days of evaluation, the aneurysm grew larger and his cervical pain became untolerable. Operation, the resection of the aneurysm and the reconstruction (of circulation) with vein graft, was challenged on March 12. It was so difficult with meticulous work that the ligation of left common carotid artery was performed after all. Seven days after the operation, he suffered from the gastrointestinal bleeding, which was enough to lead him to hypovolemic shock. Thereafter, right hemiparesis and aphasia were brought about. Two months later, he died of pneumonia. On histological examination, it was demonstrated that the aneurysm communicated with the necrotic tissue and that the normal structure of the blood vessel was not observed in the aneurysmal wall and consisted of the collagenous fiber and granulated tissue. The aneurysm was interpreted as a false one.

  10. 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.

  11. Malignant epithelioid schwannoma of the oral cavity in a cat.

    Science.gov (United States)

    Boonsriroj, Hassadin; Kimitsuki, Kazunori; Akagi, Tetsuya; Park, Chun-Ho

    2014-06-01

    A malignant epithelioid schwannoma of the oral cavity was diagnosed in an 8-year-old domestic short-hair cat. The mass was located in the gingiva of the upper left premolar to molar region and showed multinodular growth patterns. The mass comprised epithelioid cells arranged in densely packed sheets. Tumor cells had large, round to oval nuclei with prominent nucleoli and an abundant eosinophilic cytoplasm. Immunohistochemically, most of the tumor cells were positive for S-100 protein, glial fibrillary acidic protein and vimentin, but all lacked melanoma-associated antigen and muscle and neuroendocrine markers. Stains for type IV collagen showed linear immunoreactivity around single cells and groups of cells. Ultrastructurally, tumor cells were separated by a well-defined basement membrane, and interdigitating cell processes were observed. To our knowledge, this is the first report of feline malignant epithelioid schwannoma.

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

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    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.

  13. Vascular Pathology in the Extracranial Vertebral Arteries in Patients with Acute Ischemic Stroke

    DEFF Research Database (Denmark)

    Bentsen, L; Nygård, A; Ovesen, C;

    2014-01-01

    INTRODUCTION: Vascular pathology in the extracranial vertebral arteries remains among the possible causes in cryptogenic stroke. However, the diagnosis is challenged by the great variety in the anatomy of the vertebral arteries, clinical symptoms and difficulties in the radiological assessments....... The aim of this study was to assess the prevalence of CT angiography (CTA)-detected pathological findings in the extracranial vertebral arteries in an acute stroke population and secondly to determine the frequency of posterior pathology as probable cause in patients with otherwise cryptogenic stroke...... scans systematically, assessing the four segments of the extracranial vertebral arteries. First, the frequency of pathological findings including stenosis, plaques, dissection, kinked artery and coiling was assessed. Subsequently, we explored the extent of the pathological findings that were the most...

  14. Classical surgical approach and treatment with clips of extracranial internal carotid artery berry aneurysm

    Directory of Open Access Journals (Sweden)

    Haris Vukas

    2016-06-01

    Full Text Available Introduction: We can define extracranial carotid artery aneurysm (ECAA as bulb dilatation greater than 200% of the diameter of the internal carotid artery (ICA or in a case of common carotid artery (CCA greater than 150% of the diameter. Surgical intervention is required for the treatment of this disease.Case report: This study presents an open vascular surgical procedure to resolve ECAA. We report a case of 61 years old woman with an extracranial internal carotid artery berry aneurysm, presented with a headache and dizziness when turning the head aside. Classic open surgery was performed and the lumen of berry aneurysm was separated with three clips from the lumen of ICA.Conclusions: The open surgical approach is the method of choice for the treatment of extracranial internal carotid artery pathological conditions.

  15. Extracranial Vertebral Artery Aneurysm Presenting as a Chronic Cervical Mass Lesion

    Directory of Open Access Journals (Sweden)

    Lampis C. Stavrinou

    2010-01-01

    Full Text Available Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine. Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion. Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.

  16. 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.

  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. 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.

  19. Schwannoma base tongue: Case report and review of literature.

    Science.gov (United States)

    George, N A; Wagh, M; Balagopal, P G; Gupta, S; Sukumaran, R; Sebastian, P

    2014-07-01

    Schwannomas are benign peripheral nerve sheath tumors. These are rare in the oral cavity (1%). The most common site of involvement in oral cavity is the tongue. Posterior third of tongue is not frequently involved. The aim of this paper is to present a case report of base tongue schwannoma and review literature of this rare tumor. Data from literature were analyzed for age, gender, presenting symptom, size at presentation, and surgical approach. We report a case of 26 year-old male who presented with swelling posterior 1/3rd tongue and change in quality of voice. He was evaluated for the same with MR and incision biopsy and was planned for surgery. Surgery was abandoned at a district hospital due to difficulty in intubation. At our center he underwent fibro optic bronchoscopy guided intubation followed by general anesthesia. He underwent excision of mass using left paramedian lip spitting approach with mandibulotomy and mandibular swing. Tumor was excised in toto. His postoperative recovery was uneventful. Literature review between 2001 and 2012 was done. 15 cases of base tongue schwannoma were identified. The most common age group involved was between 30-40 years. There was a slightly higher incidence in females. All patients were symptomatic at presentation. Most common complaints were related to swallowing and throat pain. Most patients underwent transoral excision of the tumor.

  20. Intra-oral schwannoma: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Martins Manoela

    2009-01-01

    Full Text Available Schwannoma is a relatively uncommon, slow-growing benign tumor that is derived apparently from the Schwann cells. The tongue is the most common site, followed by the palate, floor of mouth, buccal mucosa, lips, and jaws. It can present itself at any age. Usually, this lesion is not taken into account during clinical practice and the differential diagnosis includes numerous benign neoformations based on epithelial and connective tissues. Immunohistochemical features can be useful in determining the neural differentiation. Anti-S100 protein is probably the most used antibody to identify this lesion. The schwannoma is usually a solitary lesion, and can be multiple when associated with neurofibromatosis. In the current study, authors report a case of an intraoral schwannoma situated at the vestibule with 20 years of evolution treated by complete surgical excision. The diagnosis was established based on clinical, histopathological, and immunohistochemical aspects. The patient is under clinical control, with no signs of recurrence even after four years.

  1. Schwannoma of the sino-nasal tract: a rare clinico-pathological entity revisited

    Institute of Scientific and Technical Information of China (English)

    Nadia Shirazi; Saurabh Varshney; Meena Harsh; S. S Bisht

    2012-01-01

    Schwannomas are benign neoplasms arising from Schwann cells of the peripheral, cranial and autonomic nerves. We report a case of schwannoma in the sino-nasal tract, a very rare site of tumour origin with unusual pseudoangiomatous histopathological changes, which we came across in a 22 years male with progressive nasal obstruction.

  2. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Pediatric cervical sympathetic chain schwannoma with Horner syndrome: a rare case presentation.

    Science.gov (United States)

    Bhagat, Sanjeev; Varshney, Saurabh; Bist, Sampan S; Gupta, Nitin

    2014-03-01

    Schwannomas are rare, benign, slowly growing neurogenic tumors that originate in peripheral, spinal, or cranial nerves other than the optic and olfactory nerves. In the head and neck, these tumors usually arise from the vagus nerve and the cervical sympathetic chain in the parapharyngeal space. Cervical sympathetic chain schwannomas represent a rare subgroup of schwannomas; fewer than 60 cases have been reported in the literature. These tumors are rarely seen in children and adolescents. Because patients typically present with an asymptomatic neck mass and vague complaints, clinical suspicion is important in making the diagnosis. Neural deficits at presentation are uncommon. The presence of features of Horner syndrome before excision is very rare, having been previously reported in only 10 cases of cervical sympathetic chain schwannoma. We report an extremely rare case of a cervical sympathetic chain schwannoma in a child who presented with Horner syndrome. The lesion was successfully excised.

  5. Ancient schwannoma of thoracic spine in a schizophrenic patient with somatic delusion

    Directory of Open Access Journals (Sweden)

    Ya-Ting Wen

    2016-03-01

    Full Text Available Ancient schwannoma is a rare variant of schwannoma characterized by histopathologic degenerative changes, which are thought to be the result of long-term tumor growth and aging. However, ancient schwannoma in the spinal canal is particularly rare. We report a case of thoracic spine intradural extramedullary ancient schwannoma in a schizophrenic patient, who kept saying that “something in his back was giving him electric shock” for a long time. Unfortunately, this complaint was misinterpreted as somatic delusion symptoms. A spinal cord tumor was taken into consideration only after paraparesis developed. We have highlighted this case to remind every clinician to remain alert about the possibility of organic disease while treating patients with psychotic disorder history. Thorough neurological examination is required to avoid misdiagnosis. Spinal canal schwannoma can be totally removed successfully with good functional outcome and prognosis.

  6. Tandem intercostal thoracic schwannomas resected using a thoracoscopic nerve-sparing technique: case report.

    Science.gov (United States)

    Gantwerker, Brian R; Dickman, Curtis A

    2011-07-01

    To describe a novel nerve-sparing technique for the resection of intercostal nerve schwannomas. This case demonstrates that intercostal neuralgia can be caused by intercostal schwannomas and that it can be relieved by their removal. A young woman with schwannomatosis had progressively worsening intercostal neuralgia caused by compression of the intercostal nerve against the rib by tandem intercostal schwannomas. After the tumors were removed, her symptoms were completely relieved. A thoracoscopic technique was used to define the involved fascicles and to facilitate removal of the tumors while sparing the uninvolved nerve. The patient's radicular pain was relieved completely by the tumor resection. Thoracoscopic surgery offers a safe and minimally invasive technique for removal of intercostal schwannomas and is a valid alternative to open thoracotomy. Removal of thoracic schwannomas can relieve intercostal neuralgia.

  7. The effect of naloxone on trigemino-hypoglossal reflex inhibited by periaqueductal central gray stimulation in rats.

    Science.gov (United States)

    Zubrzycka, M; Janecka, A

    2000-09-01

    The aim of the study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) - a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three subsequent series of perfusions of lateral ventricles - cerebellomedullary cistern with Mc Ilwain-Rodnight's solution, Met-enkaphalin (Enk-Met) and naloxone were carried out. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with Enk-Met (100 nmol/mL) inhibited the trigemino-hypoglossal reflex by 46%, whereas naloxone (100 nmol/mL), added to the solution perfusing the cerebral ventricles system, increased the reflex by 42%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant 93% - inhibition of ETJ, naloxone (100 nmol/mL) was added to the perfusion fluid. This led to a significant increase of the reflex by 68%. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

  8. Effect of cerebral ventricles perfusion with morphiceptin and Met-enkephalin on trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Fichna, J; Janecka, A

    2002-12-01

    Opioids administered by intracerebroventricular injections produce analgesic responses in rats. The present study was undertaken to investigate the effects of a highly selective mu-opioid receptor ligand morphiceptin on trigemino-hypoglossal reflex in rats. The analgesic effect of morphiceptin was compared with another opioid peptide, Met-enkephalin. With the experimental settings used in this study, we have demonstrated that both morphiceptin and Met-enkephalin show significant dose-dependent analgesic effects after i.c.v. administration in rats as assayed by trigemino-hypoglossal reflex test. The antinociceptive response to Met-enkephalin was short lasting and was observed 10 to 15 min after i.c.v. perfusion. Morphiceptin had a relatively longer duration of antinociceptive action, the effect was observed 20-50 min after i.c.v. perfusion. Neither morphiceptin nor Met-enkephalin produced antinociception after peripheral injections. The results of the present study indicate that both tested peptides act at mu-opioid receptors situated in the central nervous system. They also suggest that mu-opioid receptors present in the central nervous system are an important element of the trigemino-hypoglossal reflex arc. For that reason selective mu-opioid receptor ligands, like morphiceptin, inhibit the reflex more significantly.

  9. Application of histamine or serotonin to the hypoglossal nucleus increases genioglossus muscle activity across the wake-sleep cycle.

    Science.gov (United States)

    Neuzeret, Pierre-Charles; Sakai, Kazuya; Gormand, Frédéric; Petitjean, Thierry; Buda, Colette; Sastre, Jean-Pierre; Parrot, Sandrine; Guidon, Gérard; Lin, Jian-Sheng

    2009-03-01

    The decrease in genioglossus (GG) muscle activity during sleep, especially rapid eye movement (REM) or paradoxical sleep, can lead to airway occlusion and obstructive sleep apnoea (OSA). The hypoglossal nucleus innervating the GG muscle is under the control of serotonergic, noradrenergic and histaminergic neurons that cease firing during paradoxical sleep. The objectives of this study were to determine the effect on GG muscle activity during different wake-sleep states of the microdialysis application of serotonin, histamine (HA) or noradrenaline (NE) to the hypoglossal nucleus in freely moving cats. Six adult cats were implanted with electroencephalogram, electro-oculogram and neck electromyogram electrodes to record wake-sleep states and with GG muscle and diaphragm electrodes to record respiratory muscle activity. Microdialysis probes were inserted into the hypoglossal nucleus for monoamine application. Changes in GG muscle activity were assessed by power spectrum analysis. In the baseline conditions, tonic GG muscle activity decreased progressively and significantly from wakefulness to slow-wave sleep and even further during slow-wave sleep with ponto-geniculo-occipital waves and paradoxical sleep. Application of serotonin or HA significantly increased GG muscle activity during the wake-sleep states when compared with controls. By contrast, NE had no excitatory effect. Our results indicate that both serotonin and HA have a potent excitatory action on GG muscle activity, suggesting multiple aminergic control of upper airway muscle activity during the wake-sleep cycle. These data might help in the development of pharmacological approaches for the treatment of OSA.

  10. [Schwannoma located in the tongue. A clinical case report].

    Science.gov (United States)

    Gallesio, C; Berrone, S

    1992-12-01

    Schwannoma or neurilemmoma and neurofibroma are two tumors of the peripheral nerves originating in the nerve sheaths. Schwannoma account for just over 1% of benign tumors reported in the oral cavity. The tongue is unanimously considered the most frequent site at this level; however, the tip is the least affected part of the organ. The case of schwannoma reported here is the third observed with a lingual localization in 18 years by the Division of Maxillo-Facial Surgery of The Odontostomatological Clinic of the University of Turin. The case is of interest due the rarity of this pathology and the presence of non-significant symptoms for a presumed initial diagnosis. CASE REPORT. A 21-year-old woman was referred to our attention following the appearance two years earlier of a slowly growing swelling on the tip of the tongue. The patient complained of the fastidious presence, disturbance to mastication and phonation and occasional paresthesia of the tip of the tongue. The small mass, which was clearly evident on examination, was covered with normal mucosa. On palpation it had a hard-elastic consistency; it was slightly painful, smooth and partial mobile on surrounding levels. The patient underwent the surgical removal of the neoplasia under anesthesia. The mass was well capsulated and a good cleavage plane was easily found. The neoformation was yellowy grey, oval bean-shaped, measuring 1.9 x 1.3 x 1.1 cm. The histological diagnosis, confirmed by immunohistochemical tests, was benign Antoni's, type A schwannoma. The postoperative period was good an there was no recidivation during the course of a one-year follow-up. DISCUSSION AND CONCLUSIONS. Benign schwannoma, which are relatively rare in the oral cavity, represent a pathology which are often not taken into account during clinical practice. Symptoms which take the form of slight hypoesthesia and vague paresthesia may lead to the suspected diagnosis of this type of neoplasia. The final diagnosis is always made after a

  11. Phosphodiesterase 4 D Gene Polymorphism in Relation to Intracranial and Extracranial Atherosclerosis in Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Jayantee Kalita

    2011-01-01

    Full Text Available In ischemic stroke, extracranial MR angiography (ECMRA is more frequently abnormal in Caucasians and intracranial (ICMRA in Asians which may have a genetic basis. We report phosphodiesterase (PDE4D gene polymorphism and its correlation with MRA findings in patients with ischemic stroke.

  12. A rare case of extracranial meningioma in parapharyngeal space presented as a neck mass

    Directory of Open Access Journals (Sweden)

    Nader Albsoul

    2015-01-01

    Conclusion: Extracranial meningiomas are quite rare. The diagnosis of these types of tumors is challenging due to the non specific nature of the symptoms. The anatomic complexity of the region of parapharyngeal space also makes their detection difficult. Imaging modalities can aid in the diagnosis, but pathological examinations are essential in confirming a definite diagnosis.

  13. Thrombolysis in patients with acute ischemic stroke due to arterial extracranial dissection

    NARCIS (Netherlands)

    M.D.I. Vergouwen; P.A.C.A. Beentjes; P.J. Nederkoorn

    2009-01-01

    No data of randomized controlled trials investigating the effect of thrombolysis in patients with ischemic stroke caused by an extracranial dissection are available. Previous case series suggested that thrombolysis in this group of patients is safe and improves outcome, however publication bias may

  14. Predicting the presence of extracranial metastases in patients with brain metastases upon first diagnosis of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rades, D. [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany); Segedin, B. [Institute of Oncology, Department of Radiation Oncology, Ljubljana (Slovenia); Nagy, V. [Oncology Institute Ion Ciricuta, Department of Radiotherapy, Cluj-Napoca (Romania); Schild, S.E. [Mayo Clinic Scottsdale, Department of Radiation Oncology, Arizona (United States); Trang, N.T. [Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Khoa, M.T. [Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Hanoi Medical University, Department of Nuclear Medicine, Hanoi (Viet Nam)

    2014-04-15

    This study aimed to determine factors allowing the prediction of extracranial metastases in patients presenting with brain metastases at the first diagnosis of cancer. Data from 659 patients with brain metastases upon first diagnosis of cancer were retrospectively analyzed. The parameters age, gender, Karnofsky performance score (KPS), primary tumor type and number of brain metastases were compared between 359 patients with extracranial metastases and 300 patients without extracranial metastases. Additional analyses were performed for patients with the most unfavorable and those with the most favorable characteristics. The comparison of patients with versus without extracranial metastases revealed significant differences between the groups in terms of KPS (p < 0.001) and number of brain metastases (p < 0.001). Of the study patients, 113 had both most unfavorable characteristics, i.e. KPS ≤ 50 and ≥ 4 brain metastases. The sensitivity for identifying patients with extracranial metastases was 82 %; specificity was 51 %. A total of 50 patients had KPS ≥ 90 and only one brain metastasis. The sensitivity for identifying patients without extracranial metastases was 86 %; specificity was 58 %. The combination of KPS and the number of brain metastases can help to predict the presence or absence of extracranial metastases. (orig.) [German] Diese Studie soll zur Abschaetzung des Vorliegens extrakranieller Metastasen bei Patienten mit primaer zerebral metastasierter Tumorerkrankung beitragen. Daten von 659 Patienten mit primaer zerebral metastasierter Tumorerkrankung wurden retrospektiv analysiert. Insgesamt 359 Patienten mit extrakraniellen Metastasen wurden mit 300 Patienten ohne extrakranielle Metastasierung hinsichtlich Alter, Geschlecht, Karnofsky-Performance-Score (KPS), Art des Primaertumors und der Anzahl der Hirnmetastasen miteinander verglichen. Weitere Analysen erfolgten bei Patienten mit den unguenstigsten und bei Patienten mit den guenstigsten

  15. Brain metastasis from non-small cell lung cancer (NSCLC). Prognostic importance of the number of involved extracranial organs

    Energy Technology Data Exchange (ETDEWEB)

    Gerdan, L. [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany); University of Luebeck, Section of Nuclear Medicine, Luebeck (Germany); Segedin, B. [Institute of Oncology, Department of Radiation Oncology, Ljubljana (Slovenia); Nagy, V. [Oncology Institute Ion Ciricuta, Department of Radiotherapy, Cluj-Napoca (Romania); Khoa, M.T. [Hanoi Medical University, Department of Nuclear Medicine, Hanoi (Viet Nam); Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Trang, N.T. [Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Schild, S.E. [Mayo Clinic Scottsdale, Department of Radiation Oncology, Scottsdale, AZ (United States); Rades, D. [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany)

    2014-01-15

    This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC). A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 x 4 Gy or 10 x 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung+bone vs. lung+lymph nodes vs. other combinations) extracranial organs. The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥4 extracranial organs were 52, 27, 17, 4, and 14%, respectively (p<0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95% confidence interval 1.19-1.46; p<0.001). Age <65 years (p=0.004), KPS ≥70 (p<0.001), and only 1-3 brain metastases (p=0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement. The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement. (orig.)

  16. Persistência da artéria hipoglossa primitiva Persistent hypoglossal artery: a case report

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    Otto F. Campano Vera

    1969-09-01

    Full Text Available É relatado o terceiro caso registrado na literatura de diagnóstico em vida de persistência da artéria hipoglossa primitiva, sendo o achado casual, feito durante exploração angiográfica em paciente de 42 anos de idade que sofrerá traumatismo crânio-encefálico. É referida a possibilidade de existência de outros vasos anômalos, assim como da concomitância de tais anomalias com malformações vasculares e aneurismas.El autor presenta un caso de persistencia de la arteria hipoglosa primitiva, descubierta por casualidad al afectuar artriografia cerebral en paciente traumatisado. Hace un breve resumen histórico y anatómico de otros vasos anómalos y vierte la opinión y hallazgos de otros autores, sobretodo a la asociación de aneurismas y malformaciones vasculares.The third case registered in medical literature of persistent hypoglossal artery diagnosed intra-vitamis reported. The anomaly was found incidentally in a 42 years old patient submited to an angiographic examination after head trauma. The ocurrence of other persistent anomalous anastomosis and the possibility of its association with vascular malformations is discussed.

  17. Morphometric analysis of hypoglossal canal of the occipital bone in Iranian dry skulls

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    Bayat Parvindokht

    2015-01-01

    Full Text Available Background: The hypoglossal canal (HC is in basal part of cranium that transmits the nerve that supplies the motor innervations to the muscles of tongue. Study on morphometry of (HC and its variations has been a considerable interest field to neurosurgeons and research workers especially because of their racial and regional. Material and Methods: In this retrospective study, 26 adult dry human crania of no sex known were studied for (HC and its variants. Thirty five skulls were observed for any damage of post cranial fossa and those in good condition (26 skullswere selected. Sliding Vernier caliper was used for morphometric analysis. Results: There were significant difference between distances of: a-(HC till anterior tip of condyles (right and left, b-(HC till posterior tip of condyles (right and left, c-(HCtill lower border of occipital condyles (right and left, d-(HC till external border of foramen jugular (right and left, e-(HC till opisthion(right and left, f-(HC till carotid canal (right and left, g-(HC till jugular tubercle (right and left. There wasn′t significant difference in other parameters. Conclusion: Detailed morphometric analysis of (HC will help in planning of surgical intervention of skull base in safer and easier ways.

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

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    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.

  19. Coexistence of meningioma and schwannoma in the same cerebellopontine angle in a patients with NF2.

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    Matyja, Ewa; Kunert, Przemysław; Grajkowska, Wiesława; Marchel, Andrzej

    2012-01-01

    The coexistence of schwannoma and meningioma in the same cerebellopontine angle (CPA) is uncommon. Especially, the presence of a single mixed tumour composed of demarcated or intermingled components of schwannoma and meningioma tissue is extremely rare. Such a phenomenon is mainly reported in a patient with NF2 or with history of previous irradiation. We present two cases of simultaneous occurrence of schwannoma and meningioma in the same cerebellopontine angle in young adult patients with clinical manifestation of NF2. The first patient was a 18-year-old young man who presented with bilateral CPA tumours, spinal mass lesion and multiple, small, schwannoma-like lesions of the cauda equina. Both CPA tumours was initially diagnosed as schwannomas based on preoperative MR imagings, however right CPA tumour appeared to be composed of a well-circumscribed transitional meningioma located inside schwannoma of Antoni A and B type. The second patient, a young 16-year-old boy, presented bilaterall CPA tumours as well as many meningeal tumours supratentorially and infratentorially. Two adjacent tumours in the left CPA proved to be schwannoma and meningioma. In both cases, the different neoplastic components were confirmed by histopathological and immunohistochemical studies. The possible mechanism underlying the occurrence of such coexisting tumors of different histogenesis remains unclear.

  20. Endoscopic ultrasound features of gastric schwannomas with radiological correlation: A case series report

    Institute of Scientific and Technical Information of China (English)

    Dan-Dan Zhong; Cai-Hua Wang; Jing-Hong Xu; Miao-Yan Chen; Jian-Ting Cai

    2012-01-01

    Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extremely limited.In this report,we summarize the features of a series of endoscopic ultrasound (EUS) images of gastric schwannomas in an effort to improve the diagnosis and differential diagnosis rate.We retrospectively reviewed the endosonographic features of four patients with gastric schwannomas and their computed tomography imaging results.Gastric schwannomas had heterogeneous hypoechogenicity or isoechogenicity,and a well-demarcated margin.The tumors originated from the fourth layer.Cystic changes and calcification were uncommon.Marginal hypoechoic haloes were observed in two patients.The results described here were different from those of previous studies.In the EUS evaluation,the internal echogenicity of gastric schwannomas was heterogeneous and low,but slightly higher than that of muscularis propria.These features might help us differentiate gastric schwannomas from other submucosal tumors.Further investigation is needed to differentiate these mesenchymal tumors.

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

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    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.

  2. Ancient Schwannoma of the hard palate. An uncommon case report and review.

    Science.gov (United States)

    Gainza-Cirauqui, Maria L; Eguía-Del Valle, Asier; Martínez-Conde, Rafael; Coca-Meneses, Juan C; Aguirre-Urizar, José M

    2013-02-01

    Schwannoma or neurilemmoma is an infrequent benign tumor in the oral cavity that originates from the Schwann cells on the neural sheath of the peripheral nerves. Schwannomas are frequently located in the soft tissues of head and neck region, but only a 1 to 12% of them are located in the oral cavity. Some histological variants of schwannoma have been described including the cellular, plexiform, epithelioid, ancient, and melanocytic types. The "ancient schwannoma" is an uncommon variant of this tumor that shows specific histological characteristics, and is rare in the oral cavity with less than 15 cases described on the literature. Most of them were located in the tongue or in the floor of the mouth, being the hard palate an extremely rare localization. We present a new clinical case of an ancient schwannoma with a long time of evolution, arising from the nasopalatine nerve, and located in the hard palate of a 35 year old female. We also review the main clinical and histological characteristics of this pathology. Key words:Ancient schwannoma, neurilemmoma, palate, schwannoma.

  3. Anesthetic management of schwannoma of the base of the tongue

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    Upma B Batra

    2011-01-01

    Full Text Available Schwannoma arising from the base of the tongue are very rare and only a few cases have been reported so far. Definitive diagnosis is always made after a histological examination. Apart from an anticipated difficult airway with a risk of airway obstruction upon induction of general anesthesia, anesthetic concerns also include possibility of trauma to the growth and bleeding with attendant risks. We discuss the awake fiberoptic technique used for endotracheal intubation in such a case. This case report highlights the importance of detailed history taking and clinical examination, with emphasis on airway assessment and preoperative planning.

  4. 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.)

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

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    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.

  6. 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.

  7. Intraperitoneal schwannoma. Three cases. Schwanoma intraperitoneal. Tres casos

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    Sanchez Lafuente, J.; Rodriguez Sanpedro, F.; Varela, R.; Lopez Ojeda, J.; Martinez, J. (Hospital regional. Servicio de Radiodignostico. Malaga (Spain))

    1993-01-01

    Schwanomas are nerve sheath tumors which can spread throughout the entire organism, although their intraperitoneal localization is exceptional. Three cases are presented of schwannoma originating in jejunal mesentery, 2 of which were predominantly cystic, with histological features of malignancy, while the third was seen to be solid, non homogenous and histologically benign. The literature is reviewed and the difficulties involved in establishing radiological criteria for benignity or malignity in these tumors are discussed, as is the differential diagnosis with regard to other abdominal cystic or solid masses. (Author) 14 refs.

  8. Anesthetic management of schwannoma of the base of the tongue.

    Science.gov (United States)

    Batra, Upma B; Usha, G; Gogia, Anoop R

    2011-04-01

    Schwannoma arising from the base of the tongue are very rare and only a few cases have been reported so far. Definitive diagnosis is always made after a histological examination. Apart from an anticipated difficult airway with a risk of airway obstruction upon induction of general anesthesia, anesthetic concerns also include possibility of trauma to the growth and bleeding with attendant risks. We discuss the awake fiberoptic technique used for endotracheal intubation in such a case. This case report highlights the importance of detailed history taking and clinical examination, with emphasis on airway assessment and preoperative planning.

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

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    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.

  10. 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.

  11. Rare occurrence of intraosseous schwannoma in a young child, its review and its pathogenesis

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    Ajay Kumar Bansal

    2012-01-01

    Full Text Available Schwannoma is a benign, encapsulated, perineural tumor that arises from the Schwann cells. Approximately 25% of the reported cases originate from the head and neck region. Of these, approximately 1-12% occurs intraorally. The intrabony lesion accounts for less than 1% of the central neoplasms. We report a rare case of intraosseous schwannoma in an 8-year-old male patient characteristically originating from the mental nerve. Radiographic examination followed by histopathological evaluation was further confirmed by immunohistochemical markers, S-100 protein, and GFAP that stained intensely positive for the tumor. Thus, confirming the diagnosis of intraosseous schwannoma.

  12. Schwannoma of the epiglottis: case report focusing on clinico-pathological aspects.

    Science.gov (United States)

    Saita, V; Azzolina, A; Galia, A; Fraggetta, F

    2005-12-01

    Laryngeal schwannomas are uncommon lesions with only few cases reported. Herein we present a further case of a schwannoma of the epiglottis, occurring in a 62-year-old with a clinical history of a cutaneous malignant melanoma and laryngeal glottic keratosis. The schwannoma was incidentally discovered as a small polypoid lesion located on the laryngeal surface of the epiglottis and was removed endoscopically. The procedure was uneventful and the patient is well six months later. Authors focus on the diagnostic and therapeutic options for this unusual lesion and discuss the differential diagnosis of the spindle cell proliferation of the larynx.

  13. Soft Tissue Schwannomas of the Hard Palate and the Mandibular Mentum

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    Cennet Neslihan Eroglu

    2017-01-01

    Full Text Available Schwannomas are benign, slow growing, encapsulated tumours that originate from the Schwann cells. Intraoral schwannomas are rare, and most of these tumours involve the tongue. They are rarely located in the hard palate or in the facial soft tissue. Herein, we present the clinical and histological features as well as the prognoses of two male patients with schwannoma, one of which was localized to the hard palate and the other to the facial soft tissue around the mandibular mentum and caused swelling.

  14. Schwannoma in the midline of hard palate: a case report and review of literature.

    Science.gov (United States)

    Moradzadeh Khiavi, Monir; Taghavi Zenouz, Ali; Mesgarzadeh, Ali Hossein; Sabetmehr, Omid; Mahmoudi, Seyyed Mostafa; Kouhsoltani, Maryam

    2014-01-01

    Schwannoma is a benign encapsulated slow-growing tumor that originates from Schwann cells of the peripheral nerve sheath. It usually occurs in the head and neck; however, it is rare in the oral cavity. The tongue is the most common site of intraoral schwannomas, followed by the floor of the mouth, palate, gingiva, vestibular mucosa, lips and mental nerve area. We report a rare case of schwannoma in the midline of hard palate with ulcerated surface in a 21-year-old male with a two-month history of a painless swelling on his palate. Clinical, radiographic and histopathological features along with differential diagnosis and treatment are also discussed.

  15. Vascular Pathology in the Extracranial Vertebral Arteries in Patients with Acute Ischemic Stroke

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    L. Bentsen

    2014-01-01

    Full Text Available Introduction: Vascular pathology in the extracranial vertebral arteries remains among the possible causes in cryptogenic stroke. However, the diagnosis is challenged by the great variety in the anatomy of the vertebral arteries, clinical symptoms and difficulties in the radiological assessments. The aim of this study was to assess the prevalence of CT angiography (CTA-detected pathological findings in the extracranial vertebral arteries in an acute stroke population and secondly to determine the frequency of posterior pathology as probable cause in patients with otherwise cryptogenic stroke. Method: The analysis was based on 657 consecutive patients with symptoms of acute stroke and a final diagnosis of ischemic stroke or transient ischemic attack. On admission, a noncontrast CT cerebrum and CTA were performed. A senior consultant neuroradiologist, blinded to clinical data, reviewed all CTA scans systematically, assessing the four segments of the extracranial vertebral arteries. First, the frequency of pathological findings including stenosis, plaques, dissection, kinked artery and coiling was assessed. Subsequently, we explored the extent of the pathological findings that were the most plausible causes of stroke, namely either a possible dissection or a kinked artery. Results: Findings in the extracranial vertebral arteries included significant stenosis (0.8%, atherosclerotic plaque types (3.8%, possible dissections (2.6%, kinked arteries (2.6% and coiling (32.0%. Eighteen patients (2.8% with pathological findings had an unknown cause of stroke, likely posterior symptoms and no clinical stroke symptoms from the anterior circuit. Of these, 3 cases were kinked arteries (0.5% and 15 cases (2.3% were possible dissections. Conclusion: We found that in approximately 3% of the study population, the most plausible cause of the cryptogenic strokes was due to a pathological finding in the posterior extracranial vertebral arteries, being either a possible

  16. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

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    Takafumi Nishizaki

    2011-05-01

    Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

  17. Schwannoma of the breast: an unexpected diagnosis by magnetic resonance.

    Science.gov (United States)

    Solano Díaz, P; Hidalgo Martín, M T; Sánchez Cordero, M F; Soto Aguilar, M C

    2017-04-28

    Schwannomas consist of benign tumors that arise from the nerves, however, they are not frequent in the breast. Our search criteria only found 28 cases described in Literature. We show the case about a 63 years old woman who underwent a breast magnetic resonance (MR) because of high risk for breast cancer, in which a lession on her left breast was found. Not only MR features seemed to be benign, but ultrasound and mamography features, too. The diagnosis of schwannoma was confirmed by ultrasound-guided biopsy. Findings in conventional radiology were correlated with those described in the reviewed literature. In our opinion, this case results valuable due to the inicial diagnosis by MR, which is not an imaging proof for bening tumors, innitially. According to the revised bibliography these features are pretty funny, as mamography and ultrasound, with histological findings, are the clues for the usual diagnosis. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Prevalence of hydrocephalus in 157 patients with vestibular schwannoma

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    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.)

  19. Transoral Robotic Surgery in Retrostyloid Parapharyngeal Space Schwannomas

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    Mohssen Ansarin

    2014-01-01

    Full Text Available Parapharyngeal space (PPS tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI. In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new “J”-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space.

  20. Transoral robotic surgery in retrostyloid parapharyngeal space schwannomas.

    Science.gov (United States)

    Ansarin, Mohssen; Tagliabue, Marta; Chu, Francesco; Zorzi, Stefano; Proh, Michele; Preda, Lorenzo

    2014-01-01

    Parapharyngeal space (PPS) tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS) excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI). In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new "J"-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space.

  1. Current injection and receptor-mediated excitation produce similar maximal firing rates in hypoglossal motoneurons.

    Science.gov (United States)

    Wakefield, Hilary E; Fregosi, Ralph F; Fuglevand, Andrew J

    2016-03-01

    The maximum firing rates of motoneurons (MNs), activated in response to synaptic drive, appear to be much lower than that elicited by current injection. It could be that the decrease in input resistance associated with increased synaptic activity (but not current injection) might blunt overall changes in membrane depolarization and thereby limit spike-frequency output. To test this idea, we recorded, in the same cells, maximal firing responses to current injection and to synaptic activation. We prepared 300 μm medullary slices in neonatal rats that contained hypoglossal MNs and used whole-cell patch-clamp electrophysiology to record their maximum firing rates in response to triangular-ramp current injections and to glutamate receptor-mediated excitation. Brief pressure pulses of high-concentration glutamate led to significant depolarization, high firing rates, and temporary cessation of spiking due to spike inactivation. In the same cells, we applied current clamp protocols that approximated the time course of membrane potential change associated with glutamate application and with peak current levels large enough to cause spike inactivation. Means (SD) of maximum firing rates obtained in response to glutamate application were nearly identical to those obtained in response to ramp current injection [glutamate 47.1 ± 12.0 impulses (imp)/s, current injection 47.5 ± 11.2 imp/s], even though input resistance was 40% less during glutamate application compared with current injection. Therefore, these data suggest that the reduction in input resistance associated with receptor-mediated excitation does not, by itself, limit the maximal firing rate responses in MNs.

  2. Opiate-induced suppression of rat hypoglossal motoneuron activity and its reversal by ampakine therapy.

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    Amanda R Lorier

    Full Text Available BACKGROUND: Hypoglossal (XII motoneurons innervate tongue muscles and are vital for maintaining upper-airway patency during inspiration. Depression of XII nerve activity by opioid analgesics is a significant clinical problem, but underlying mechanisms are poorly understood. Currently there are no suitable pharmacological approaches to counter opiate-induced suppression of XII nerve activity while maintaining analgesia. Ampakines accentuate alpha-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA receptor responses. The AMPA family of glutamate receptors mediate excitatory transmission to XII motoneurons. Therefore the objectives were to determine whether the depressant actions of mu-opioid receptor activation on inspiratory activity includes a direct inhibitory action at the inspiratory premotoneuron to XII motoneuron synapse, and to identify underlying mechanism(s. We then examined whether ampakines counteract opioid-induced depression of XII motoneuron activity. METHODOLOGY/PRINCIPAL FINDINGS: A medullary slice preparation from neonatal rat that produces inspiratory-related output in vitro was used. Measurements of inspiratory burst amplitude and frequency were made from XII nerve roots. Whole-cell patch recordings from XII motoneurons were used to measure membrane currents and synaptic events. Application of the mu-opioid receptor agonist, DAMGO, to the XII nucleus depressed the output of inspiratory XII motoneurons via presynaptic inhibition of excitatory glutamatergic transmission. Ampakines (CX614 and CX717 alleviated DAMGO-induced depression of XII MN activity through postsynaptic actions on XII motoneurons. CONCLUSIONS/SIGNIFICANCE: The inspiratory-depressant actions of opioid analgesics include presynaptic inhibition of XII motoneuron output. Ampakines counteract mu-opioid receptor-mediated depression of XII motoneuron inspiratory activity. These results suggest that ampakines may be beneficial in countering opiate

  3. Nicotine protects rat hypoglossal motoneurons from excitotoxic death via downregulation of connexin 36

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    Corsini, Silvia; Tortora, Maria; Rauti, Rossana; Nistri, Andrea

    2017-01-01

    Motoneuron disease including amyotrophic lateral sclerosis may be due, at an early stage, to deficit in the extracellular clearance of the excitatory transmitter glutamate. A model of glutamate-mediated excitotoxic cell death based on pharmacological inhibition of its uptake was used to investigate how activation of neuronal nicotinic receptors by nicotine may protect motoneurons. Hypoglossal motoneurons (HMs) in neonatal rat brainstem slices were exposed to the glutamate uptake blocker DL-threo-β-benzyloxyaspartate (TBOA) that evoked large Ca2+ transients time locked among nearby HMs, whose number fell by about 30% 4 h later. As nicotine or the gap junction blocker carbenoxolone suppressed bursting, we studied connexin 36 (Cx36), which constitutes gap junctions in neurons and found it largely expressed by HMs. Cx36 was downregulated when nicotine or carbenoxolone was co-applied with TBOA. Expression of Cx36 was preferentially observed in cytosolic rather than membrane fractions after nicotine and TBOA, suggesting protein redistribution with no change in synthesis. Nicotine raised the expression of heat shock protein 70 (Hsp70), a protective factor that binds the apoptotic-inducing factor (AIF) whose nuclear translocation is a cause of cell death. TBOA increased intracellular AIF, an effect blocked by nicotine. These results indicate that activation of neuronal nicotinic receptors is an early tool for protecting motoneurons from excitotoxicity and that this process is carried out via the combined decrease in Cx36 activity, overexpression of Hsp70 and fall in AIF translocation. Thus, retarding or inhibiting HM death may be experimentally achieved by targeting one of these processes leading to motoneuron death. PMID:28617431

  4. 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.

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

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    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.

  6. Epibulbar schwannoma in a 12-year-old boy: A case report and review of literature

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    Akshay Gopinathan Nair

    2015-01-01

    Full Text Available Schwannomas are benign, encapsulated, primary neurilemmal tumors composed of proliferating Schwann cells. Schwannomas are commonly seen in the orbit, but are rare on the epibulbar surface. Herein, we report a case of a 12-year-old boy who presented to us with a slow-growing painless subconjunctival mass in the left eye. There was no intraocular extension of the mass and intra-operatively, the mass could be clearly delineated and was excised off the underlying sclera. Histopathological examination of the mass showed typical features of schwannoma and immunohistochemistry helped to confirm the diagnosis. There was no recurrence of the lesion observed at follow-up 26 months after surgery. Here, we describe this uncommon tumor and review the available literature. Although rare, an epibulbar schwannoma should be considered in the differential diagnosis of an amelanotic, painless subconjunctival nodular mass. Excision of the lesion is the recommended treatment.

  7. 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.

  8. A giant vagal schwannoma with unusual extension from skull base to the mediastinum

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    Shenoy S Vijendra

    2015-01-01

    Full Text Available Cervical vagal schwannoma is an extremely rare neoplasm. Middle aged people are usually affected. These tumors usually present as asymptomatic masses. These tumors are almost always benign. Preoperative diagnosis of these lesions is important due to the morbidity associated with its excision. Preoperative tissue diagnosis is not accurate. The imaging modality can be done to assess the extent and for planning the treatment. Surgical excision with preservation of neural origin is the treatment option. Giant vagal schwannomas are extremely rare. Only one case has been reported in the literature till date. There has no reported case of extensive vagal schwannoma from skull base to the mediastinum. Here, we describe the asymptomatic presentation of an unusual appearing giant cervical vagal schwannoma with an extension from skull base to the mediastinum.

  9. Triad of Intraspinal Meningioma, Schwannoma, and Ependymoma: Report of an Extremely Rare Case.

    Science.gov (United States)

    Rasheed, Faiza; Fatima, Saira; Ahmad, Zubair

    2016-02-01

    Mixed tumors composed of schwannoma and meningioma are extremely rare and are usually associated with neurofibromatosis type 2. So far, all the cases reported have involved the cerebellopontine angle. Only 3 reported cases did not have a clear association with neurofibromatosis type 2. We report a mixed tumor comprising schwannoma admixed with meningioma and ependymoma in the cervical spinal cord of a 22-year-old male. © The Author(s) 2015.

  10. Contribution of p75NTR to Schwannoma Growth and Therapeutic Responses

    Science.gov (United States)

    2016-05-01

    NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: a. REPORT b. ABSTRACT c. THIS PAGE 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES...Hanemann CO, Karajannis MA. 2010. ErbB/HER receptor activation and pre- clinical efficacy of lapatinib in vestibular schwannoma. Neuro -oncology 12: 834–843...the site of origin of cochleovestibular schwannomas? Audiol Neuro -otol 17:121–125. Rouleau GA, Merel P, Lutchman M, Sanson M, Zucman J, Marineau C

  11. Tongue base schwannoma: differential diagnosis and imaging features with a case presentation

    OpenAIRE

    2016-01-01

    Schwannomas are slow growing, encapsulated neoplasms that arise from the nerve sheath. A vast majority of these benign neoplasms occur in the head and neck region, most commonly involving the 8th cranial nerve. Schwannomas arising from the base of tongue are very rare and, thus, can easily escape the list of differential diagnosis for a posterior tongue mass. A systematic approach is recommended for diagnosis of a posterior tongue mass, with neoplastic, infectious, and congenital categories. ...

  12. Schwannoma of the tongue: two case reports and review of the literature.

    Science.gov (United States)

    Cohen, Marc; Wang, Marilene B

    2009-11-01

    The aim of this study was to describe clinicopathologic and radiographic features of two cases of schwannoma involving the oral tongue and to review the literature of this unusual clinical entity. Case reports with review of the pathologic, radiologic and clinical data for two patients with schwannoma of the tongue are reported. Review of the literature of case reports of schwannomas (neurilemmomas) of the tongue from 1955 to 2006 with analysis of the patient's age, gender, presenting symptom(s), tumor size, and surgical approach was undertaken. The two patients in our series presented with painless swelling of the tongue. Transoral excision was performed and pathologic examination confirmed the diagnosis of schwannoma in both the cases. A total of 126 cases of schwannoma of the tongue have been reported in the English literature over the past 51 years. Schwannomas of the tongue typically present in the third decade of life (33%), display no gender predilection (52.8% female; 47.2% male) and often present as a painless mass (69.6%). Schwannomas are likely to elicit distressing symptoms when they occur in the posterior one-third of the tongue (63.2 vs. 13.5%) or approach 3 cm in greatest dimension (33.0 vs. 18.2 mm). The vast majority of cases have been treated with transoral excision (94.8%). Recurrence after surgical excision has not been reported. Schwannoma of the tongue is a relatively rare tumor of the head and neck. Transoral resection allows for removal of this tumor in a manner that precludes recurrence, avoids causing morbidity of tongue function, and remains the standard approach for the treatment of the vast majority of these tumors.

  13. Extracranial sources of S100B do not affect serum levels.

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    Nancy Pham

    Full Text Available S100B, established as prevalent protein of the central nervous system, is a peripheral biomarker for blood-brain barrier disruption and often also a marker of brain injury. However, reports of extracranial sources of S100B, especially from adipose tissue, may confound its interpretation in the clinical setting. The objective of this study was to characterize the tissue specificity of S100B and assess how extracranial sources of S100B affect serum levels. The extracranial sources of S100B were determined by analyzing nine different types of human tissues by ELISA and Western blot. In addition, brain and adipose tissue were further analyzed by mass spectrometry. A study of 200 subjects was undertaken to determine the relationship between body mass index (BMI and S100B serum levels. We also measured the levels of S100B homo- and heterodimers in serum quantitatively after blood-brain barrier disruption. Analysis of human tissues by ELISA and Western blot revealed variable levels of S100B expression. By ELISA, brain tissue expressed the highest S100B levels. Similarly, Western blot measurements revealed that brain tissue expressed high levels of S100B but comparable levels were found in skeletal muscle. Mass spectrometry of brain and adipose tissue confirmed the presence of S100B but also revealed the presence of S100A1. The analysis of 200 subjects revealed no statistically significant relationship between BMI and S100B levels. The main species of S100B released from the brain was the B-B homodimer. Our results show that extracranial sources of S100B do not affect serum levels. Thus, the diagnostic value of S100B and its negative predictive value in neurological diseases in intact subjects (without traumatic brain or bodily injury from accident or surgery are not compromised in the clinical setting.

  14. Unusual cause of non-discogenic sciatica: Foraminal lumbar root schwannoma

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    C Karekezi

    2014-01-01

    Full Text Available Background: Schwannomas are tumors of peripheral nerves that develop from the nerve sheath. Foraminal schwannomas are rare and account for 1-5% of all spinal schwannomas. The lumbosacral root schwannoma is a rare cause of sciatica and may raise confusion in diagnosis with late discovery of the tumor. Case Description: We report the case of a patient 30 years of age with chronic left sciatica in whom lumbosacral magnetic resonance imaging (MRI revealed a  tumor involving the S1 nerve root. The excision of the tumor was simple. Histological examination revealed a benign schwannoma. The evolution was favorable postoperative with no neurological deficit, which confirms the good prognosis of this tumor. Conclusion: Nerve root schwannomas should be considered in the differential diagnosis of sciatica, especially when signs and symptoms of sciatica cannot be simply explained by prolapsed disc syndrome, which can often delay the diagnosis. Through this case presentation, the authors try to discuss the clinical and radiological features of this condition.

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

    Science.gov (United States)

    Arthurs, Benjamin J; Lamoreaux, Wayne T; Giddings, Neil A; Fairbanks, Robert K; Mackay, Alexander R; Demakas, John J; Cooke, Barton S; Lee, Christopher M

    2009-12-18

    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. 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.

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

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    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.

  18. Glomus jugulare tumor with intra- and extracranial extension. A case report with MRI study

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    Morisako, Toshitaka; Goya, Tomokazu; Wakisaka, Shinichiro; Kinoshita, Kazuo

    1987-11-01

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C/sub 2/. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension

  19. The relationship between lingual and hypoglossal nerve function and quality of life in head and neck cancer.

    Science.gov (United States)

    Elfring, T; Boliek, C A; Winget, M; Paulsen, C; Seikaly, H; Rieger, J M

    2014-02-01

    Sensorimotor impairment of the tongue has the potential to affect speech and swallowing. The purpose of this study was to critically examine the effects of nerve preservation and reinnervation after reconstruction of the base of tongue on patient-perceived outcomes of quality of life (QoL) related to speech and swallowing through completion of the EORTC QLQ-H&N35 standardised questionnaire. Thirty participants with a diagnosis of base of tongue cancer underwent primary resection and reconstruction with a radial forearm free flap, which may or may not have included nerve repair to the lingual nerve, hypoglossal nerve or both. Eight QoL domains sensitive to changes in motor and sensory nerve function were included in the analysis. Transected lingual and hypoglossal nerves were associated with difficulty in swallowing, social eating, dry mouth and social contact. There were fewer problems reported when these nerves were either repaired or left intact. There were no significant differences between patient nerve status and QoL outcomes for speech, sticky saliva and use of feeding tubes. This study was the first to examine the impact of sensory or motor nerve transection and reconstruction on health-related QoL outcomes. © 2013 John Wiley & Sons Ltd.

  20. 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. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Nerve cuff electrode using embedded magnets and its application to hypoglossal nerve stimulation

    Science.gov (United States)

    Seo, Jungmin; Hye Wee, Jee; Hoan Park, Jeong; Park, Pona; Kim, Jeong-Whun; Kim, Sung June

    2016-12-01

    Objective. A novel nerve cuff electrode with embedded magnets was fabricated and developed. In this study, a pair of magnets was fully embedded and encapsulated in a liquid crystal polymer (LCP) substrate to utilize magnetic force in order to replace the conventional installing techniques of cuff electrodes. In vitro and in vivo experiments were conducted to evaluate the feasibility of the magnet-embedded nerve cuff electrode (MENCE). Lastly, several issues pertaining to the MENCE such as the cuff-to-nerve diameter ratio, the force of the magnets, and possible concerns were discussed in the discussion section. Approach. Electrochemical impedance spectrum and cyclic voltammetry assessments were conducted to measure the impedance and charge storage capacity of the cathodal phase (CSCc). The MENCE was installed onto the hypoglossal nerve (HN) of a rabbit and the movement of the genioglossus was recorded through C-arm fluoroscopy while the HN was stimulated by a pulsed current. Main results. The measured impedance was 0.638 ∠ -67.8° kΩ at 1 kHz and 5.27 ∠ -82.1° kΩ at 100 Hz. The average values of access resistance and cut-off frequency were 0.145 kΩ and 3.98 kHz, respectively. The CSCc of the electrode was measured as 1.69 mC cm-2 at the scan rate of 1 mV s-1. The movement of the genioglossus contraction was observed under a pulsed current with an amplitude level of 0.106 mA, a rate of 0.635 kHz, and a duration of 0.375 ms applied through the MENCE. Significance. A few methods to close and secure cuff electrodes have been researched, but they are associated with several drawbacks. To overcome these, we used magnetic force as a closing method of the cuff electrode. The MENCE can be precisely installed on a target nerve without any surgical techniques such as suturing or molding. Furthermore, it is convenient to remove the installed MENCE because it requires little force to detach one magnet from the other, enabling repeatable installation and removal. We

  2. Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

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    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.

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

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

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    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.

  5. Extracranial aneurysms of the distal posterior inferior cerebellar artery: Resection and primary reanastomosis as the preferred management approach.

    Science.gov (United States)

    Chwajol, Markus; Hage, Ziad A; Amin-Hanjani, Sepideh; Charbel, Fady T

    2013-01-01

    Extracranial aneurysms of the posterior inferior cerebellar artery (PICA) are rare, with only 22 reported cases in the English literature. For saccular extracranial distal PICA aneurysms not amenable to coiling, a surgically placed clip is not protected by the cranium postoperatively, and can be subject to movement in the mobile cervical region. Furthermore, fusiform or complex aneurysms cannot be clipped primarily. Resection and primary reanastomosis is a useful surgical approach not previously described for these extracranial lesions. We report three cases of extracranially located distal PICA aneurysms successfully treated with this surgical strategy at our center. One patient harboring a broad necked saccular aneurysm originally underwent successful primary clipping of the aneurysm but sustained a second subarachnoid hemorrhage (SAH) on postoperative day 25 due to clip dislodgement from vigorous neck movement. The other two patients were found to have fusiform and complex aneurysms, respectively. All three patients were ultimately treated with resection and end-to-end PICA anastomosis, which successfully obliterated their aneurysms. Resection and primary reanastomosis of extracranial distal PICA aneurysms averts the risk of clip dislodgement due to neck movement and/or compression by soft tissues in the upper cervical region. It is a safe and efficacious technique, which we propose as the preferred management strategy for these rare vascular lesions.

  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...

  7. 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...

  8. 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.

  9. 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...

  10. 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...

  11. Emotional intelligence in association with quality of life in patients recently diagnosed with vestibular schwannoma.

    Science.gov (United States)

    van Leeuwen, Bibian M; Borst, Jacoba M; Putter, Hein; Jansen, Jeroen C; van der Mey, Andel G L; Kaptein, Adrian A

    2014-10-01

    The objective of this study was two-fold. First, to examine the levels of emotional intelligence in patients recently diagnosed with vestibular schwannoma, in comparison to those of healthy individuals and patients with other physical illness. Second, to evaluate the correlation between Emotional Intelligence and quality of life. Cross sectional study in a university tertiary referral center. Consecutive patients (mean age [range], 56.4 [17-85] yr) diagnosed with vestibular schwannoma between April 2011 and October 2012 (N = 254). Sociodemographic characteristics, clinical characteristics, disease-specific quality of life (PANQOL), and Emotional Intelligence (TEIQue-SF) were assessed by questionnaire before the start of medical treatment. Levels of Emotional Intelligence in patients with vestibular schwannoma (N = 178; response rate 70.1%) were significantly lower compared with healthy individuals and patients with cancer. Emotional Intelligence was highly positively correlated to disease-specific quality of life. Balance disorders and cranial nerve dysfunction made a significant negative contribution to the quality of life. For educational level, a significant positive contribution was found as well. The substantial impact of a vestibular schwannoma-diagnosis on a psychological measure (i.e., Emotional Intelligence) in the affected patients as demonstrated in our study has important clinical and research implications when developing guidelines about counselling of these patients. This also has to be taken into account when making clinical decisions about the proposed treatment. Addressing Emotional Intelligence may be helpful in the development of a self-management program for patients with vestibular schwannoma.

  12. 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.

  13. Brain metastasis in pediatric extracranial solid tumors: survey and literature review.

    Science.gov (United States)

    Kebudi, Rejin; Ayan, Inci; Görgün, Omer; Ağaoğlu, Fulya Yaman; Vural, Sema; Darendeliler, Emin

    2005-01-01

    Brain is a rare site of metastasis in most extracranial pediatric solid tumors. The aim of this study is to investigate the incidence, treatment, prognosis of brain metastasis in extracranial pediatric malignant tumors in a single institution and to review the literature. From September 1989 to December 2002, 1100 children Pediatric Oncology, Oncology Institute, Istanbul University. Patients with parenchymal metastases in the brain were assessed. Sixteen (10 female, 6 male) of 1100 patients (1.45%) with extracranial solid tumors developed brain metastases. The median age of the patients was 10.5 (1-16) years. The diagnosis was sarcomas in 12 patients: 5 osteosarcomas, 4 Ewing's sarcoma family tumors, 1 rhabdomyosarcoma, 1 clear cell sarcoma of the soft tissue, 1 alveolar soft part sarcoma. Two patients had Wilms' tumor and two had germ cell tumors. Four patients (25%) had brain metastasis at diagnosis. Twelve (75%) developed brain metastasis during therapy or relapse at a median duration of 16 (1-70) months from initial diagnosis. All patients had metastases to various sites, mostly lung, at the time the brain metastases were detected. Treatment included surgery, followed by postoperative radiotherapy (RT) and chemotherapy (CT) in 1, S and RT in 1, S in 1, RT and CT in 6, RT in 1, CT in 1 and no treatment in 5. Only one patient with alveolar soft part sarcoma is alive with disease 20 months from diagnosis of brain metastasis. All other patients died at a median time of 2 months (2 days-6 months) from the time of brain metastasis. Children with metastatic cancer who develop headaches or any other neurologic symptom should be investigated for possible brain metastasis. Although, the outcome for these patients is dismal in this series and in the literature; reports of long term survival in a few cases with Wilms' tumor, osteosarcoma and alveolar soft part sarcoma who had isolated brain metastasis, suggest that a subset of patients may benefit from therapy.

  14. The baboon (Papio anubis extracranial carotid artery: An anatomical guide for endovascular experimentation

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    Laufer Ilya

    2001-12-01

    Full Text Available Abstract Background As novel endovascular strategies are developed for treating neurological disease, there is an increasing need to evaluate these techniques in relevant preclinical models. The use of non-human primates is especially critical given their structural and physiological homology with humans. In order to conduct primate endovascular studies, a comprehensive understanding of the carotid anatomy is necessary. We therefore performed a detailed examination of the vessel lengths, lumen diameters and angles of origin of the baboon extracranial carotid system. Methods We characterized the extracranial carotid system often male baboons (Papio anubis, range 15.1–28.4 kg by early post-mortem dissection. Photographic documentation of vessel lengths, lumen diameters, and angles of origin were measured for each segment of the carotid bilaterally. Results The common carotid arteries averaged 94.7 ± 1.7 mm (left and 87.1 ± 1.6 mm (right in length. The average minimal common carotid lumen diameters were 3.0 ± 0.3 mm (left and 2.9 ± 0.2 mm (right. Each animal had a common brachiocephalic artery arising from the aorta which bifurcated into the left common carotid artery and right braciocephalic artery after 21.5 ± 1.6 mm. The vascular anatomy was found to be consistent among animals despite a wide range of animal weights. Conclusions The consistency in the Papio anubis extracranial carotid system may promote the use of this species in the preclinical investigation of neuro-interventional therapies.

  15. Intracranial cerebral artery stenosis with associated coronary artery and extracranial carotid artery stenosis in Turkish patients

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, Ozlem [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey)], E-mail: yalinozlem@hotmail.com; Kizilkilic, Osman; Yildirim, Tulin [Department of Radiology, Baskent University, Faculty of Medicine, Ankara (Turkey); Atalay, Hakan [Department of Cardiovascular Surgery, Baskent University, Faculty of Medicine, Ankara (Turkey)

    2009-09-15

    Purpose: Although it has been demonstrated that there is a high prevalence of extracranial carotid artery stenosis (ECAS) in patients with severe coronary artery disease, intracranial cerebral artery stenosis (ICAS) is rarely mentioned. We evaluated the prevalence of ICAS in patients with ECAS having elective coronary artery bypass grafting (CABG) surgery to determine the relations between ICAS, ECAS and atherosclerotic risk factors. Methods: We retrospectively reviewed the digital subtraction angiography findings of 183 patients with ECAS {>=} 50% preparing for CABG surgery. The analyses focused on the intracranial or extracranial location and degree of the stenosis. The degree of extracranial stenoses were categorized as normal, <50%, 50-69%, 70-89%, and 90-99% stenosis and occluded. The degree of intracranial stenosis was classified as normal or {<=}25%, 25-49%, and {>=}50% stenosis and occluded. Traditional atherosclerotic risk factors were recorded. Results: ECAS < 70% in 42 patients and ECAS {>=} 70% in 141 patients. ICAS was found in 51 patients and ICAS {>=} 50% in 30 patients. Regarding risk factors, we found hypertension in 135 patients, diabetes mellitus in 91 patients, hyperlipidemia in 84 patients, and smoking in 81 patients. No risk factor was significant predictors of intracranial atherosclerosis. The severity of ICAS was not significantly associated with that of the ECAS. Conclusions: We found ICAS in 27.8% of the patients with ECAS > 50% on digital subtraction angiography preparing for CABG. Therefore a complete evaluation of the neck vessels with magnetic resonance or catheter angiography seems to be indicated as well as intracranial circulation for the risk assessment of CABG.

  16. Short-term results of carotid stenting for the treatment of extracranial carotid occlusive disease

    Institute of Scientific and Technical Information of China (English)

    FU Wei-guo; ZHU Ting; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zhen-yu

    2006-01-01

    @@ Carotid artery angioplasty and stenting (CAS) has been performed with increasing frequency for the treatment of extracranial carotid occlusive diseases (ECOD) in recent years. Its feasibility and safety are supported by the Stenting and Angioplasty with Protection in Patient at High Risk for Endarterectomy (SAPPHIRE) trial,1 which revealed a lower incidence of death, stroke and myocardial infarction compared with carotid endarterectomy (CEA) in high-risk patients. However, it is a pity that up to now, initial results of this endovascular procedure have yet been infrequently documented in China. This retrospective study was to analyze the short-term results of CAS to treat ECOD in a single medical center.

  17. Extracranial internal carotid artery stenting in Moya-Moya syndrome: a case report.

    Science.gov (United States)

    Casana, R; Tolva, V; Guy Bianchi, P; Dalainas, I

    2012-12-01

    A 58-year-old Caucasian lady presented for severe left internal carotid artery (ICA) stenosis. Two months before she was operated for right carotid endarterectomy (CEA) in another Institution, complicated with internal carotid artery thrombosis and development of transient hemiplegia and aphasia. Postoperative selective DSA showed the development of an abnormal basal meshwork of collateral vessels with typical evidence for moyamoya disease. Preoperative workup in our Institution included cerebral MRI witch showed two ischemic right frontal and parietal lesions. The patient underwent successful stenting of the left ICA. This is the first report of extracranial ICA stenting in a patient with moyamoya syndrome.

  18. Childhood extracranial neoplasms: the role of imaging in drug development and clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Fowkes, Lucy A.; Koh, Dow-Mu; MacVicar, David [Royal Marsden NHS Foundation Trust, Department of Radiology, Sutton, Surrey (United Kingdom); Collins, David J.; Jerome, Neil P. [Institute of Cancer Research, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Chua, Sue C. [Royal Marsden NHS Foundation Trust, Nuclear Medicine and PET Department, Sutton, Surrey (United Kingdom); Pearson, Andrew D.J. [Royal Marsden NHS Foundation Trust, Paediatric Drug Development Unit, Children and Young People' s Unit, Sutton, Surrey (United Kingdom)

    2015-10-15

    Cancer is the leading cause of death in children older than 1 year of age and new drugs are necessary to improve outcomes. Imaging is crucial to the drug development process and assessment of therapeutic response. In adults, tumours are often assessed with CT using size criteria. Unfortunately, techniques established in adults are not necessarily applicable in children due to differing pathophysiology, ability to cooperate and increased susceptibility to ionising radiation. MRI, in particular quantitative MRI, has to date not been fully utilised in children with extracranial neoplasms. The specific challenges of imaging in children, the potential for functional imaging techniques to inform upon and their inclusion in clinical trials are discussed. (orig.)

  19. Multiple Spontaneous Intracranial-Extracranial Arterial Dissections in a Patient with Osteogenesis Imperfecta

    Directory of Open Access Journals (Sweden)

    Mehmet Kolukısa

    2017-01-01

    Full Text Available A 40-year-old male with osteogenesis imperfecta (OI was admitted to the hospital with an acute right monoparesis. Diffusion-weighted MRI showed infarction in the territory of the left anterior cerebral artery (ACA and in the left posterior cerebral artery (PCA. In his vascular imaging, occlusion of the left vertebral artery (VA starting from V2 segment was consistent with dissection and pseudoaneurysm in the right ACA. We presented this case because of the presence of spontaneous and simultaneous occurrence of both intracranial and extracranial arterial dissections in OI.

  20. Vascular reconstruction of a ruptured and infected aneurysm of extracranial carotid artery

    Institute of Scientific and Technical Information of China (English)

    SONG Jin-qiu; ZHANG Jian; YIN Ming-di; SHAN Shao-yin; WU Bin; DUAN Zhi-quan; XIN Shi-jie

    2008-01-01

    @@ Extracranial carotid artery aneurysm represents an uncommon vascular condition with relatively higher incidence in China than in the West.1 The complication with infection and rupture is even rarer,but potentially lethal.Management of mis condition is challenging but urgent because of high risks for embolization,generalized sepsis,further expansion,rupture,and life threatening.1,2 We present an exceptional case of carotid aneurysm at bifurcation complicated with rupture and infection and discuss the Dathogenesis and vailOUS aspects of diagnosis and surgical management.

  1. Routine surveillance imaging after end of therapy for pediatric extracranial tumors: A retrospective analysis.

    Science.gov (United States)

    Lakkis, Farah; Alaiwi, Sarah Abou; Naffaa, Lena; Atweh, Lamya; Khoury, Nabil; Abboud, Miguel; Muwakkit, Samar; Tarek, Nidale; El Solh, Hassan; Saab, Raya

    2017-07-20

    Frequent surveillance imaging is routine practice for pediatric patients after cancer therapy. This retrospective study evaluated the follow-up of 301 children with extracranial tumors diagnosed between 2002 and 2012, at a tertiary pediatric cancer center in Beirut, Lebanon. Recurrence occurred in 15% of patients, at a median of 12 months after end of primary therapy. Outcome was not different comparing patients with recurrence detected via imaging surveillance versus clinically. False positive findings in 55 patients led to further interventions. These results raise important questions regarding benefit of current surveillance practices as standard care, especially in countries with limited resources. © 2017 Wiley Periodicals, Inc.

  2. A case of primary extracranial meningioma of the forearm with bone invasion

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Hideki [Self-Defense Force Fuji Hospital, Division of Orthopaedic Surgery, Oyama-cho, Sunto-gun, Shizuoka (Japan); Takahashi, Mitsuru; Takagi, Tatsuya; Katagiri, Hirohisa [Shizuoka Cancer Center Hospital, Division of Orthopaedic Oncology, Nagaizumi-cho, Sunto-gun, Shizuoka (Japan); Ito, Ichiro [Shizuoka Cancer Center Hospital, Division of Pathology, Nagaizumi-cho, Sunto-gun, Shizuoka (Japan); Ishida, Tsuyoshi [Kohnodai Hospital, Department of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Ichikawa, Chiba (Japan)

    2007-06-15

    We report here a rare case of primary extracranial meningioma in a 73-year-old woman with an asymptomatic mass located in the left distal-dorsal forearm. MRI revealed the lesion to be poorly circumscribed and unclear, with iso-signal intensity to muscle on T1 and with a relatively high signal intensity on T2-weighted imaging. The histopathology of the specimen from incision biopsy was typical of meningioma, showing bland spindle cell proliferation with a whorling pattern. Immunohistochemically, the tumor cells were positive for epithelial membrane antigen and vimentin, and negative for S-100 expression. (orig.)

  3. Achados fonoaudiológicos em pacientes submetidos a anastomose hipoglosso facial Phonoaudiological findings in patients submitted to hypoglossal-facial anastomosis

    Directory of Open Access Journals (Sweden)

    Elisabete C. C. F. Silva

    2003-06-01

    Full Text Available A anastomose hipoglosso-facial (AHF tem sido realizada em pacientes com lesão dos segmentos mais proximais do nervo facial em que outros procedimentos cirúrgicos não foram possíveis ou não obtiveram êxito. OBJETIVO: O objetivo atual da pesquisa é verificar as alterações na mobilidade dos órgãos fonoarticulatórios, quanto à função da fala, mastigação e da deglutição, em pacientes submetidos a AHF. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram avaliados 8 pacientes, com paralisia facial periférica (PFP, submetidos a AHF, na UNIFESP/EPM, no período de 1998 a 2000, sendo 6 do sexo feminino e 2 do sexo masculino, idades entre 21 e 71 anos e mediana de 50 anos. Desses, 5 pós-exerése do Schwannoma do Nervo Vestibular, 1 pós-exerése de Fibrossarcoma, 1 pós-ferimento por arma de fogo e 1 pós-paralisia facial idiopática de má evolução. Na avaliação fonoaudiológica, o protocolo consta de: dados de identificação; classificação da recuperação do nervo facial; tratamentos realizados; simetria facial no repouso e no movimento voluntário; sincinesias para olho, boca, nariz e bochechas; distúrbios fonoarticulatórios e da motricidade da língua; alteração na mastigação e do paladar, e questionário referente ao parecer dos respectivos distúrbios para serem respondidos pelo paciente. RESULTADO: O grau de paralisia pós-anastomose e reabilitação variou para os olhos entre II e V e para a boca entre III e V (House & Brackemann, 1985. Concluímos que recuperação foi satisfatória e importante, mas a expectativa de melhora foi inferior ao esperado pelos pacientes. Foram observados: imprecisão articulatória, disfunção mastigatória, escape bucal de alimentos e disfagia.The hypoglossal-facial anastomosis (HFA have been related in patients with facial nerve lesion where proximal segment more other surgical produceres had been faited or had not been possible success. AIM: The objective of the

  4. STATE ANXIETY, SUBJECTIVE IMBALANCE AND HANDICAP IN VESTIBULAR SCHWANNOMA

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    Yougan Saman

    2016-07-01

    Full Text Available ABSTRACTEvidence is emerging of a significant clinical and neuro-anatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety and there is a relationship between increased state anxiety and worsening balance function. Aims1.To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit.2.To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. MethodsTwo separate cohorts Vestibular Schwannoma (VS patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials and caloric responses and questionnaire assessment (Vertigo handicap Questionnaire, Vertigo Symptom Scale, State Trait Anxiety InventoryFifteen post resection Vestibular schwannoma patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1. Forty-five patients with VS in-situ and with preserved vestibular function formed the cohort for Experiment 2 (Aim 2. Experiment 1: VS subjects (N=15 with a complete post-resection unilateral vestibular deafferentation completed a State anxiety questionnaire before caloric assessment and again afterwards with the point of maximal vertigo as the reference (Aim 1. Experiment 2: State anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of presenting with balance symptoms (Group 1 N=26 and without balance symptoms (Group 2 N=11 (Aim 2. The presence of balance symptoms was defined as having a positive score on the VSS-VER.ResultsIn experiment 1, a significant difference (p<0.01 was found when comparing

  5. 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.

  6. 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

  7. An Unusual Presentation of a Posterior Mediastinal Schwannoma Associated with Traumatic Hemothorax

    Directory of Open Access Journals (Sweden)

    Ruchi Amin

    2015-01-01

    Full Text Available Schwannomas of the thoracic cavity are typically an asymptomatic, benign neurogenic neoplasm of the posterior mediastinum. In this case, we present a traumatic hemothorax as the initial presentation for a previously undiscovered mediastinal mass. The patient presented with shortness of breath and right-sided chest pain after being struck in the chest with a soccer ball. An operative exploration was pursued due to persistent hemothorax with hemodynamic instability despite resuscitation and adequate thoracostomy tube placement. The intraoperative etiology of bleeding was discovered to be traumatic fracture of a large hypervascular posterior mediastinal schwannoma. Surgical resection is the treatment of choice for these tumors. Specific serological markers do not exist for this tumor, and radiographic findings can be variable, so tissue diagnosis is of importance in differentiating benign from malignant schwannomas, as well as other posterior mediastinal tumors. However, most patients have excellent survival following complete resection.

  8. 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."

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. [Maxillary trigeminal schwannoma. Presentation of a case and review of literature].

    Science.gov (United States)

    Madrid-Sánchez, Alejandro Jacob; Castillo-Rangel, Carlos; Contreras-Ayala, Myriam Leticia; Ruiz-García, Edgardo; Castillo-Castro, Ana Karen; Ramírez-Aguilar, Ricardo

    2016-12-30

    Schwannomas are benign tumours that are relatively common in the head, however the involvement of the sinunasal region is rare and there are only 5 cases reported in the maxilla in current literature, representing less than 1% of bone tumours. We report the case of a woman with a right maxillary schwannoma who underwent a complete resection of the lesion. Emphasis is placed on the rarity of the lesion in terms of its location and includes a review of clinical behaviour, diagnosis and current treatment options. Maxillary trigeminal schwannoma must be suspected if vague sinunasal symptoms, paranasal mass or, as in this case, trigeminal neuralgia present. Surgical treatment is indicated, and approaches vary according to location and tumour size. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  12. 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.

  13. Retroperitoneal schwannoma mimicking metastatic seminoma:case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Shi-Qiang Zhang; Song Wu; Kai Yao; Pei Dong; Yong-Hong Li; Zhi-Ling Zhang; Xian-Xin Li

    2013-01-01

    If a testicular cancer pat ient has a mass in the retroperitoneum,a metastasis is often the first suspicion,probably leading to improper diagnosis and overtreatment.Here we report a case of retroperitoneal schwannoma mimicking metastatic seminoma.A 29-year-old man,who had a history of seminoma,presented with a single retroperitoneal mass suspected to be a metastasis.Because the patient refused radiotherapy,3 cycles of cisplatin,etoposide,and bleomycin were offered.Post-chemotherapy computed tomography scan revealed persistence of the retroperitoneal mass,with no change in tumor size or characteristics.Subsequently,retroperitoneal lymph node dissection was performed.The dissected tissue contained negative lymph nodes but a single mass in the attached fat.Pathology revealed retroperitoneal schwannoma,which was confirmed by immunohistochemistry.Thus,clinicians should be aware of retroperitoneal schwannoma and its distinction from metastatic seminoma to avoid misdiagnosis and ensure proper treatment.

  14. 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.

  15. Reporting success rates in the treatment of vestibular schwannomas: are we accounting for the natural history?

    Science.gov (United States)

    Miller, Timothy; Lau, Tsz; Vasan, Rohit; Danner, Christopher; Youssef, A Samy; van Loveren, Harry; Agazzi, Siviero

    2014-06-01

    Stereotactic radiosurgery is generally accepted as one of the best treatment options for vestibular schwannomas. We question whether growth control is an accurate measure of success in vestibular schwannoma treatment. We aim to clarify the success rate of stereotactic radiosurgery and adjust the reported results to the benign natural history of untreated tumors. All articles were taken from a PubMed search of the English literature from the years 2000-2011. Inclusion criteria were articles containing the number of patients treated, radiation technique, average tumor size, follow-up time, and percentage of tumors growing during follow-up. Data were extracted from 19 articles. Success rates were adjusted using published data that 17% to 30% of vestibular schwannomas grow. The average reported success rate for stereotactic radiosurgery across all articles was 95.5%. When considering 17% or 30% natural growth without intervention, the adjusted success rates became 78.2% and 86.9% respectively. These rates were obtained by applying the natural history growth percentages to any tumors not reported to be growing before radiosurgical intervention. Success in the treatment of vestibular schwannomas with stereotactic radiosurgery is often defined as lack of further growth. Recent data on the natural growth history of vestibular schwannomas raise the question of whether this is the best definition of success. We have identified a lack of continuity regarding the reporting of success and emphasize the importance of the clarification of the success of radiosurgery to make informed decisions regarding the best treatment options for vestibular schwannoma.

  16. Extracranial Venous abnormalities: A true pathological finding in patients with multiple sclerosis or an anatomical variant?

    Energy Technology Data Exchange (ETDEWEB)

    Torres, Carlos; Chakraborty, Santanu; Nguyen, Thanh; Thornhill, Rebecca; Lum, Cheemun [University of Ottawa, Department of Radiology, Ottawa, ON (Canada); The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON (Canada); Ottawa Hospital Research Institute OHRI, Ottawa, ON (Canada); Hogan, Matthew; Freedman, Mark [Ottawa Hospital Research Institute OHRI, Ottawa, ON (Canada); University of Ottawa, Department of Medicine, Ottawa, ON (Canada); The Ottawa Hospital, Division of Neurology, Ottawa, ON (Canada); Patro, Satya [University of Ottawa, Department of Radiology, Ottawa, ON (Canada); The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON (Canada); Bussiere, Miguel [University of Alberta, Department of Medicine, Division of Neurology, Edmonton (Canada); Dabirzadeh, Hamid [University of Saskatchewan, Neuroradiologist, Department of Radiology, Saskatoon (Canada); Schwarz, Betty Anne; Belanger, Stefanie; Legault-Kingstone, Lysa [The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON (Canada); Schweitzer, Mark [Stony Brook School of Medicine, Department of Radiology, Stony Brook, NY (United States)

    2017-01-15

    To evaluate the extracranial venous anatomy with contrast-enhanced MR venogram (CE-MRV) in patients without multiple sclerosis (MS), and assess the prevalence of various venous anomalies such as asymmetry and stenosis in this population. We prospectively recruited 100 patients without MS, aged 18-60 years, referred for contrast-enhanced MRI. They underwent additional CE-MRV from skull base to mediastinum on a 3T scanner. Exclusion criteria included prior neck radiation, neck surgery, neck/mediastinal masses or significant cardiac or pulmonary disease. Two neuroradiologists independently evaluated the studies to document asymmetry and stenosis in the jugular veins and prominence of collateral veins. Asymmetry of internal jugular veins (IJVs) was found in 75 % of subjects. Both observers found stenosis in the IJVs with fair agreement. Most stenoses were located in the upper IJV segments. Asymmetrical vertebral veins and prominence of extracranial collateral veins, in particular the external jugular veins, was not uncommon. It is common to have stenoses and asymmetry of the IJVs as well as prominence of the collateral veins of the neck in patients without MS. These findings are in contrast to prior reports suggesting collateral venous drainage is rare except in MS patients. (orig.)

  17. 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.

  18. 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.

  19. [A paraneoplastic Sharp syndrome reversible after resection of a benign schwannoma: a paraneoplastic syndrome?].

    Science.gov (United States)

    Slimani, S; Sahraoui, M; Bennadji, A; Ladjouze-Rezig, A

    2014-08-01

    Paraneoplastic syndromes commonly occur in malignancies and often precede the first symptoms of the tumor. By definition, paraneoplastic syndromes are only associated with malignancies although some exceptions have been reported, occurring with benign tumors. We report a patient presenting with a clinical and serological Sharp syndrome, followed a few months later by a cervical schwannoma. Curative surgical resection of the mass resulted in a clinical and serological healing from the Sharp syndrome. To our knowledge, this is the first report of a benign schwannoma complicated by a possible paraneoplastic Sharp syndrome.

  20. 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.

  1. Schwannoma of the vagus nerve, a rare middle mediastinal neurogenic tumor: case report

    Directory of Open Access Journals (Sweden)

    Foroulis Christophoros N

    2009-11-01

    Full Text Available Abstract Schwannoma originating from the vagus nerve within the mediastinum is a rare, usually benign tumor. A 44-year old male was presented with chest pain. Chest radiography, CT scan and MRI showed a well circumscribed mass, 5 × 4 cm located in the aortopulmonary window. The mass was found at surgery to be in close proximity with the aortic arch and the left pulmonary hilum, alongside the left vagus nerve. The encapsulated tumor was completely resected through a left thoracotomy incision and it was found to be a benign schwannoma in pathology. The patient is free of recurrence 6 years after surgery.

  2. 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,...

  3. Cecal Schwannoma: A Rare Cause of Gastrointestinal Bleeding in a Young Woman with Review of Literature

    Directory of Open Access Journals (Sweden)

    Kalyan Kanneganti

    2011-01-01

    Full Text Available Schwannomas are rare mesenchymal tumors of the gastrointestinal tract. Occurrence of these tumors is more common in the stomach than in the large intestine. These tumors usually present as polypoidal intraluminal lesions and based on their location can present with rectal bleeding, colonic obstruction, and abdominal pain or defecation disorders. We present a case of a thirty-five-year-old woman who presented with abdominal pain and melena. Patient was diagnosed with a nonobstructing superficially ulcerated mass in the cecum on colonoscopy and required right hemicolectomy. A very rare pathological diagnosis of cecal schwannoma was made postoperatively.

  4. Mandibular intraosseous schwannoma in a child: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Neda Kargahi

    2012-01-01

    Full Text Available Intraosseous schwannomas is a very rare neoplasm, and less than 50 cases have been reported in the medical literature. In this article, the clinical, radiographic and histopathologic appearances of a rare case of intraosseous schwannomas are presented. The importance of this case is that other benign central lesions such as odontogenic tumors and cysts might be included in differential diagnosis. This case was recognized in a 9-year-old child, which is a very rare occurrence. The diagnosis was confirmed by immunohistochemical staining with S100 protein.

  5. 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-demographic...... of socio-demographic areas elaborated by Demarks Statistic. RESULTS: The mean national incidence increased almost linearly over the time period from 6.1 per million per year in the first period from 1976 to 1984, to 22.1 per million per year in the last period from 2003 to 2012. There was a lower incidence...... at the end of the period in the remote areas compared with the other socio-demographic areas (1976-1984, p = 0.05 and 2003-2011, p = 0.001). The mean age at diagnosis increased during the period, from 52.6 years in the first period to 58.6 years in the last period. There was no significant difference...

  6. Results achieved in the treatment of patients with vestibular schwannoma.

    Science.gov (United States)

    Freigang, Bernd; Rudolf, Jan

    2004-01-01

    Personal experience gathered with the treatment of 264 vestibular schwannoma (VS) at the Magdeburg University ENT Hospital is analysed. ABR Audiometry is useful as a screening, even though it yielded false-negative values in 12.7% (n = 33) for intrameatal VS and 16.9% for all VS, despite accurate evaluation. Latency increases of Waves I, III and V and their intraaural comparison exhibited a statistically significant difference for the VS levels proposed by TOS. The mean of intrameatal VS too was found to have longer latencies compared with the normal-hearing ears of the patients. In the individual case, with threshold hearing normal, anamnestic findings as well as otoneurological evidence provide an early indication for enhanced MRI, CISS imaging, or individual 3D reconstruction of the pontocerebellar cisterna. Adopting intraoperative monitoring of the facial nerve and the cochlea as well as the Pars acustica by means of far-field and near-field electrodes, a good facial 'mobility' was achieved in 95.3%, and a useful audition (AAO-HNS Types A and B) in 60%. Monitoring is beneficial as it enhances the reliability and improves the subtle preparation during surgery. The power of hearing improved postoperatively within six months and remained at a good level over two years. From our perspective, otorhinolaryngologists are the right specialists to attend to VS.

  7. 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.

  8. 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.

  9. Intraoperative auditory monitoring in vestibular schwannoma surgery: new trends.

    Science.gov (United States)

    Schmerber, Sébastien; Lavieille, Jean-Pierre; Dumas, Georges; Herve, Thierry

    2004-01-01

    To investigate the efficiency of a new method of brainstem auditory-evoked potential (BAEP) monitoring during complete vestibular schwannoma (VS) resection with attempted hearing preservation. Dedicated software providing near real-time recording was developed using a rejection strategy of artifacts based on spectral analysis. A small sample number (maximum 200) is required and results are obtained within 10 s. Fourteen consecutive patients with hearing class A operated on for VS, in an attempt to preserve hearing, participated in the investigation. Postoperatively, 7 patients (50%) had useful hearing (hearing class A, 4/14; hearing class B, 3/14) on the operated side. Seven patients (50%) were reduced to hearing class D. Drilling of the internal auditory canal (IAC) and tumor removal at the lateral end of the IAC were identified as the two most critical steps for achieving hearing preservation. Intraoperative BAEP monitoring was sensitive in detecting auditory damage with useful feedback but its effectiveness in preventing irreversible hearing impairment was not demonstrated in this study. Combined BAEP and direct auditory nerve monitoring using the same equipment will be performed in the future in an attempt to enhance the chances of preventing irreversible hearing damage, and possibly to improve the hearing outcome significantly.

  10. 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.

  11. [Changes in taste ability in patients with vestibular schwannoma].

    Science.gov (United States)

    Boessert, P; Grüttner, C; van Ewijk, R; Haxel, B

    2014-07-01

    Vestibular schwannomas (VS) are rare tumors that can cause different symptoms due to their anatomical relationship to the cranial nerves in the inner auditory canal. So far little data is known to the effect of VS on the somatosensory function of the intermediate nerve. This study aimed to investigate the taste function of patients suffering from single sided VS. Therefore the well validated psychophysical test "Taste Strips" has been used. 26 patients who consulted our outpatient clinic at a university hospital could be included in the study. All patients were asked carefully for their medical history. A full ENT examination was done. Each side of the anterior two thirds of the tongue was tested separately using the Taste Strips. The average age was 52 years with both gender equally represented. Throughout all age groups the taste score was lower on the tumor vs. the non affected side. Testing for significance just failed the level of 0.05. No correlation between tumor size and location of the tumor with the taste score could be detected. Only 2 patients complained of taste dysfunction. They had a taste score below the 10. percentile of their age group on tumor while normal scores on the non affected side. To sum up a decreased taste score on the tumor side vs. the non affected side could be confirmed. Only 8% of the patients complained of taste disturbance as a symptom. That supports the observation that taste is a whole mouth experience and dysfunction can be compensated.

  12. Facilitation of distinct inhibitory synaptic inputs by chemical anoxia in neurons in the oculomotor, facial and hypoglossal motor nuclei of the rat.

    Science.gov (United States)

    Takagi, Satoshi; Kono, Yu; Nagase, Masashi; Mochio, Soichiro; Kato, Fusao

    2017-04-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by the selective loss of motor neurons in the brainstem and spinal cord. Clinical studies have indicated that there is a distinct region-dependent difference in the vulnerability of motor neurons. For example, the motor neurons in the facial and hypoglossal nuclei are more susceptible to neuronal death than those in the oculomotor nucleus. To understand the mechanism underlying the differential susceptibility to cell death of the neurons in different motor nuclei, we compared the effects of chemical anoxia on the membrane currents and postsynaptic currents in different motor nuclei. The membrane currents were recorded from neurons in the oculomotor, facial and hypoglossal nuclei in brain slices of juvenile Wistar rats by using whole-cell recording in the presence of tetrodotoxin that prevents action potential-dependent synaptic transmission. NaCN consistently induced an inward current and a significant increase in the frequency of spontaneous synaptic inputs in neurons from these three nuclei. However, this increase in the synaptic input frequency was abolished by strychnine, a glycine receptor antagonist, but not by picrotoxin in neurons from the hypoglossal and facial nuclei, whereas that in neurons from the oculomotor nucleus was abolished by picrotoxin, but not by strychnine. Blocking ionotropic glutamate receptors did not significantly affect the NaCN-induced release facilitation in any of the three motor nuclei. These results suggest that anoxia selectively facilitates glycine release in the hypoglossal and facial nuclei and GABA release in the oculomotor nucleus. The region-dependent differences in the neurotransmitters involved in the anoxia-triggered release facilitation might provide a basis for the selective vulnerability of motor neurons in the neurodegeneration associated with ALS. Copyright © 2017. Published by Elsevier Inc.

  13. Schwannomas no vestibulares de cabeza y cuello: Presentación de 6 casos clínicos

    OpenAIRE

    Celedón L,Carlos; Pardo J,Javiera; Abarca A,Alfredo; Délano R,Paul H

    2011-01-01

    Introducción: Los schwannomas no vestibulares de cabeza y cuello son tumores benignos, de baja frecuencia, que pueden producir gran morbilidad dependiendo de su ubicación. Objetivo: Describir la experiencia del Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile en el manejo de schwannomas no vestibulares de cabeza y cuello. Material y método: Estudio retrospectivo, descriptivo de los casos de schwannomas no vestibulares de cabeza y cuello diagnosticados entre los...

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

    Science.gov (United States)

    Inoue, Takuro; Shima, Ayako; Hirai, Hisao; Suzuki, Fumio; Matsuda, Masayuki

    2015-11-01

    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 radiologic reduction in size at 15-month follow-up. Because Gamma Knife can manage trochlear nerve schwannomas well, surgical excision should be reserved for large ones and limited to subcapsular or subtotal removal with the expectation of possible recovery of neurologic dysfunction.

  15. An Individual with Gastric Schwannoma with Pathologically Malignant Potential Surviving Two Years after Laparoscopy-Assisted Partial Gastrectomy

    Directory of Open Access Journals (Sweden)

    Akira Watanabe

    2011-08-01

    Full Text Available Schwannomas are a kind of neurogenic tumor. They are generally benign and originate primarily from the central and peripheral nerve. They rarely develop in the gastrointestinal tract: gastric schwannomas make up 0.2% of gastric neoplasms. A malignant gastric schwannoma is a comparatively rare tumor, a few cases have been reported until now. We present the case of a 34-year-old male patient diagnosed during medical examination. The patient was treated with surgical resection, and 2 years passed without recurrence.

  16. Substance P content in the cerebrospinal fluid and fluid perfusing cerebral ventricles during elicitation and inhibition of trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, Maria; Janecka, Anna

    2002-06-21

    The aim of this study was to establish whether tooth pulp and periaqueductal central gray (PAG) stimulation affects the release of substance P (SP) into the fluid perfusing the cerebral ventricles in rats. The content of substance P in the cerebrospinal fluid and fluid perfusing cerebral ventricles was determined during incisor pulp stimulation with electrical impulses inducing nociceptive trigemino-hypoglossal reflex and then during inhibition of the reflex by stimulation of PAG. Perfusion of the cerebral ventricles was carried out using artificial cerebrospinal fluid (aCSF). SP-like immunoreactivity (SP-LI) was determined in the samples by radioimmunoassay. Samples were collected in four groups: first group-cerebrospinal fluid (CSF); second group-aCSF perfusates without stimulation; third group-aCSF perfusates during incisor pulp stimulation; fourth group-aCSF perfusates during incisor pulp stimulation and simultaneous inhibition of trigemino-hypoglossal reflex by PAG stimulation. It was shown that incisor pulp stimulation led to the increased release of SP-LI into the fluid perfusing cerebral ventricles. Stimulation of PAG reduced the release of SP-LI into the cerebro-ventricular system to the values obtained before the tooth pulp stimulation. The results indicate that PAG significantly inhibits the release of SP-LI into the rat cerebral ventricular system and may be involved in the inhibition of trigemino-hypoglossal reflex.

  17. 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.

  18. The CT and Magnetic Resonance Imaging Features of Transotic Schwannoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Kwon; Choe, Mi Sun [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-04-15

    Transotic schwannoma is a condition extremely rare, and we herein report the CT, MRI, and pathologic findings of a transotic schwannoma case in a 38-year-old woman. The lesion was identified as an expansile mass in the internal auditory canal (IAC) and a mass in the middle ear cavity (MEC) on the high-resolution, bone algorithm, temporal bone CT. It was shown as the following: the hypointense masses of the cerebellopontine angle (CPA)-IAC and MEC, and the hypointense replacement of the normal high-signal intensity fluid of the cochlea, vestibule, and semicircular canals on the 3-dimensional (3D) fast imaging, employing the steady-state acquisition (FIESTA) sequence; and the intensely enhancing masses of the CPA-IAC and MEC, and the intense enhancement of the cochlea, vestibule, and semicircular canals on the 3D gadolinium-enhanced spoiled gradient-recalled echo (SPGR) sequence. The mass was removed via a transotic approach. The pathologic findings were consistent with schwannoma. The assessment of the extent of transotic schwannoma may be enhanced by the 3D FIESTA and the gadolinium-enhanced SPGR sequences.

  19. 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

  20. 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.

  1. Late Malignant Transformation of a Vestibular Schwannoma without Association to NFII or Radiotherapy

    DEFF Research Database (Denmark)

    Bashir, Asma; Poulsgaard, Lars; Broholm, Helle

    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...

  2. 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...

  3. Dumbbell trigeminal schwannoma in a child: complete removal by a one-stage pterional surgical approach.

    NARCIS (Netherlands)

    Verstappen, C.C.P.; Beems, T.; Erasmus, C.E.; Lindert, E.J. van

    2005-01-01

    OBJECTIVE: The objective was to describe a rare case of a trigeminal schwannoma in a child and the surgical procedure performed for therapy. PATIENT AND METHODS: A 6-year-old girl presented with tiredness, dysarthric speech and cerebellar symptoms. Imaging studies revealed a unilateral dumbbell-shap

  4. Association between intraosseous schwannoma occurrence and the position of the intraosseous nutrient vessel: A case report.

    Science.gov (United States)

    Suzuki, Kayo; Yasuda, Taketoshi; Watanabe, Kenta; Kanamori, Masahiko; Kimura, Tomoatsu

    2016-05-01

    Intraosseous schwannoma is a rare benign bone tumor that originates from Schwann cells of the nerve sheath. The majority of intraosseous schwannomas arise in the mandible and sacrum, but an intraosseous schwannoma involving the ulna is described in the present case report. Radiologically, the current case presented as a well-defined lytic lesion, with a pathological fracture and no intralesional calcification, in the proximal metaphysis of the left ulna. Using magnetic resonance imaging, an intraosseous mass spreading out from the cortical defect was observed. The lesion appeared isointense to skeletal muscle on T1-weighted images, and hyperintense or heterogeneous on T2-weighted images. The differential diagnosis comprised benign bone tumors, including bone cyst, aneurysmal bone cyst, giant cell tumor and fibrous dysplasia. Based on the results of a needle biopsy, a schwannoma involving the ulnar bone was diagnosed, and tumor marginal resection followed by artificial bone grafting and fixation was performed. A total of one year subsequent to surgery, the patient exhibits no symptoms, and there is no evidence of disease recurrence.

  5. Ethmoidal air cell schwannoma presented as a fronto-ethmoidal mucocele.

    Science.gov (United States)

    Bassily, Ramy; Wallace, Daniel; Liolios, Vasilis; Prinsely, Peter; Beigi, Bijan

    2013-06-01

    To report a rare case of a fronto-ethmoidal mucocele secondary to an ethmoidal schwannoma. To our knowledge this is the first reported case of an ethmoidal schwannoma, a tumour of the peripheral nerve sheath originating from an area not believed to contain peripheral nerves that has presented as a fronto-ethmoidal mucocele. Our patient is a 23-year-old male presented with a one-year history of progressive proptosis and vertical diplopia with restriction of upgaze. Orbital imaging demonstrated a mass in the right medial ethmoidal air cells extending to the frontal sinus and orbit, consistent with a mucocele. Patient underwent endonasal decompression of the right fronto-ethmoidal mucocele. Histology confirmed a schwannoma and repeat imaging post-operatively revealed residual mass originating from the ethmoidal air cells. A right upper eyelid skin crease approach anterior orbitotomy was performed to successfully excise the mass via the lamina papyracea. Post-operatively the patient's proptosis and diplopia resolved, with a full range of ocular movements. Post-operative imagining at 3 months did not show any residual tumour. Mucocele formation may be secondary to an underlying schwannoma obstructing the fronto-ethmoidal foramen. In such cases we recommend an open-sky technique for full visualisation and improved chance of total removal.

  6. 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...

  7. 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

    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.

  8. 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.

  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

  10. 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 th...

  11. Schwannoma of the tongue in a paediatric patient: a case report and 20-year review.

    Science.gov (United States)

    Bhola, Nitin; Jadhav, Anendd; Borle, Rajiv; Khemka, Gaurav; Bhutekar, Umesh; Kumar, Sanatan

    2014-01-01

    Schwannomas (Neurilemmomas) are benign, encapsulated, slow-growing, and usually solitary tumours originating from Schwann cells of the peripheral nerve sheath with uncertain etiology. Approximately 25-48% of cases are seen in the head and neck region, of which 1% appears in the oral cavity. Lingual schwannoma can affect all age groups with peak incidence between the third and sixth decade. We report a rare case of lingual schwannoma in a 14-year-old girl complaining of asymptomatic swelling over lateral border of tongue since two years. Clinical examination revealed a nodule 1.5 × 1 cm in size, rubbery, nontender, smooth at right lateral border of tongue covered by normal mucosa, with no cervical lymphadenopathy. Excisional biopsy of the lesion was done under local anaesthesia. The histological sections spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence-free after one year.

  12. Schwannoma of the Tongue in a Paediatric Patient: A Case Report and 20-Year Review

    Directory of Open Access Journals (Sweden)

    Nitin Bhola

    2014-01-01

    Full Text Available Schwannomas (Neurilemmomas are benign, encapsulated, slow-growing, and usually solitary tumours originating from Schwann cells of the peripheral nerve sheath with uncertain etiology. Approximately 25–48% of cases are seen in the head and neck region, of which 1% appears in the oral cavity. Lingual schwannoma can affect all age groups with peak incidence between the third and sixth decade. We report a rare case of lingual schwannoma in a 14-year-old girl complaining of asymptomatic swelling over lateral border of tongue since two years. Clinical examination revealed a nodule 1.5×1 cm in size, rubbery, nontender, smooth at right lateral border of tongue covered by normal mucosa, with no cervical lymphadenopathy. Excisional biopsy of the lesion was done under local anaesthesia. The histological sections spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma was readily identifiable. The patient was recurrence-free after one year.

  13. 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

  14. Surgery for jugular foramen schwannomas via a pure endoscopic transoral approach%内镜经口入路颈静脉孔区神经鞘瘤切除术

    Institute of Scientific and Technical Information of China (English)

    张秋航; 鲍遇海; 郭宏川; 王振霖; 吕海丽; 姬巍; 孔锋; 李茗初; 陈革; 梁建涛

    2012-01-01

    目的 探讨内镜经口入路切除颈静脉孔区神经鞘瘤的可行性及效果.方法 采用单纯内镜经口入路切除9例颈静脉孔区神经鞘瘤,其中男3例,女6例;年龄15 ~61岁;临床表现:舌下神经麻痹8例次,迷走神经麻痹6例次,舌咽神经麻痹3例次,面神经麻痹1例次,听力下降1例次.结果 9例颈静脉孔区神经鞘瘤均获得完全切除,且保留了该区域的颅神经功能.除1例患者术后出现暂时性吞咽困难及患侧迷走神经麻痹的并发症外,未见其他并发症发生.9例患者术后随访4-29个月,平均14.3个月,所有患者迷走神经和舌咽神经麻痹均得到了改善和恢复,面神经麻痹和听力下降得到了恢复,舌肌运动获得了改善,但半舌萎缩无明显变化.结论 内镜经口人路可以安全、彻底、微创地切除颈静脉孔区神经鞘瘤,并且能够保留和改善后组颅神经功能.%Objective To report a new approach,endoscopic transoral approach for the resection of jugular foramen schwannoma.Methods Nine patients with jugular foramen schwannoma ( three males and six females,ranging in age from 15 to 61 years old ) were treated by direct surgery via a pure endoscopic transoral approach to the jugular foramen. Eight patients complained of hypoglossal nerve palsy with hemiatrophy of the tongue; six cases complained of vagus nerve palsy. Three cases complained of glossopharyngeal nerve palsy,one case complained of facial nerve palsy and hearing loss.Results The nerves in this area were preserved and radical intracapsular removal of the tumor was performed via endoscopic transoral approach in the nine cases.Tumor removal,as assessed by intraoperative endoscopic inspection,postoperative magnetic resonance imaging and clinical evaluation,revealed all tumors were completely removed.One patient suffered from temporary swallowing difficulties and temporary right vagus palsy Ⅰ day after surgery.There were no others intraoperative and

  15. Extracranial to intracranial bypass for the treatment of cerebral aneurysms in the pediatric population.

    Science.gov (United States)

    Strickland, Ben A; Attenello, Frank; Russin, Jonathan J

    2016-12-01

    Cerebral aneurysms are rare in the pediatric population, making a definitive treatment algorithm difficult. Microsurgical clipping is the first choice for treatment but is not always feasible, while high recurrence rates and radiation exposure make endovascular options less favorable. Extracranial-intracranial (EC-IC) bypass, though not commonly performed in the pediatric aneurysm population, has been reported in a small number of studies to be both safe and effective for the management of cerebral aneurysms. The authors present the case of a child with a distal middle cerebral artery (MCA) aneurysm in eloquent territory, successfully treated with a superficial temporal artery (STA) to MCA bypass and trapping. A review of the current literature on pediatric EC-IC bypass in the treatment of intracranial aneurysms is presented. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Endovascular Management of Extra-cranial Supra-aortic Vascular Injuries

    Energy Technology Data Exchange (ETDEWEB)

    Almazedi, Bahir, E-mail: b.almazedi@doctors.org.uk; Lyall, Harpreet; Bhatnagar, Priya [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary (United Kingdom); Kessel, David; McPherson, Simon; Patel, Jai V.; Puppala, Sapna [The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Department of Vascular and Interventional Radiology (United Kingdom)

    2013-02-08

    Supra-aortic vessel injuries are uncommon but can be life-threatening and surgically challenging. Trauma to these vessels may be blunt or penetrating, including iatrogenic trauma following the insertion of central venous lines, which may be preventable. Recent advances in technology have resulted in endovascular therapy becoming a common first-line treatment, and interventional radiologists now play a major role in the management of these vascular injuries. We review the literature on the endovascular management of these types of injuries and describe a spectrum of case-based extra-cranial supra-aortic vascular injuries managed at our institution and the range of imaging appearances, including active contrast extravasation, traumatic vessel occlusion, true aneurysms, pseudoaneurysms, and arteriovenous fistulae.

  17. Hyperhomocysteinemia Presenting with Complete Unilateral Intracranial and Extracranial Carotid Occlusion in a Young Patient.

    Science.gov (United States)

    Niazi, Farheen; Rahman, Abdul; Batool, Uzma

    2017-09-01

    Hyperhomocysteinemia has been associated with premature peripheral vascular, cerebrovascular, and coronary artery disease. It has been associated with vascular diseases including cerebrovascular disease, particularly in subjects with significant carotid stenosis. However, hyperhomocysteinemia causing unilateral complete occlusion of whole of internal carotid, common carotid, and external carotid has been rarely reported. We report a case of an adult patient aged 35-year with complete occlusion of right common carotid, internal carotid, both intracranial and extracranial part, presented with recurrent TIAs and stroke and was found to be having hyperhomocysteinemia as the cause of this complete occlusion and showed marked clinical recovery with appropriate treatment. Prompt identification and treatment of hyperhomocysteinemia, as a vascular risk factor especially in young, is of utmost importance especially when its treatment is cost-effective and can save major disability from stroke.

  18. Telescoping Dual Covered Stent Graft Construct for Endovascular Treatment of a Giant Extracranial Carotid Artery Pseudoaneurysm.

    Science.gov (United States)

    Ding, Dale; Starke, Robert M; Moriarty, Maurice; Brew, Stefan

    2016-12-01

    Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA) pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA) bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA). The patient underwent endovascular intervention, during which a balloon-expandable covered stent was deployed within a heparin-bonded covered stent, such that the overall construct spanned from the CCA to the lower cervical ICA. The employment of a telescoping dual covered stent technique can successfully treat appropriately selected patients with large or giant ECCA pseudoaneurysms, with the concomitant goals of excluding the pseudoaneurysm and restoring the luminal caliber of the parent artery.

  19. Rhythmic Components in Extracranial Brain Signals Reveal Multifaceted Task Modulation of Overlapping Neuronal Activity.

    Directory of Open Access Journals (Sweden)

    Roemer van der Meij

    Full Text Available Oscillatory neuronal activity is implicated in many cognitive functions, and its phase coupling between sensors may reflect networks of communicating neuronal populations. Oscillatory activity is often studied using extracranial recordings and compared between experimental conditions. This is challenging, because there is overlap between sensor-level activity generated by different sources, and this can obscure differential experimental modulations of these sources. Additionally, in extracranial data, sensor-level phase coupling not only reflects communicating populations, but can also be generated by a current dipole, whose sensor-level phase coupling does not reflect source-level interactions. We present a novel method, which is capable of separating and characterizing sources on the basis of their phase coupling patterns as a function of space, frequency and time (trials. Importantly, this method depends on a plausible model of a neurobiological rhythm. We present this model and an accompanying analysis pipeline. Next, we demonstrate our approach, using magnetoencephalographic (MEG recordings during a cued tactile detection task as a case study. We show that the extracted components have overlapping spatial maps and frequency content, which are difficult to resolve using conventional pairwise measures. Because our decomposition also provides trial loadings, components can be readily contrasted between experimental conditions. Strikingly, we observed heterogeneity in alpha and beta sources with respect to whether their activity was suppressed or enhanced as a function of attention and performance, and this happened both in task relevant and irrelevant regions. This heterogeneity contrasts with the common view that alpha and beta amplitude over sensory areas are always negatively related to attention and performance.

  20. 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

  1. Plexiform schwannoma of the clitoris in a young girl: a case report.

    Science.gov (United States)

    Azurah, Abdul Ghani Nur; Grover, Sonia; McGregor, Duncan

    2013-01-01

    Schwannoma (neurilemoma) is a benign, slow-growing tumor of the nerve sheath. These tumors are rarely found in the female genitalia and to date only 1 case of clitoral schwannoma has been reported in a young girl. We report here the second case of schwannoma of the clitoris. A 6-year-old girl presented with an enlarging clitoris. An alteration in her clitoral appearance had first been noted at 2 years of age. However, the size had further increased in the year prior to presentation. On examination her clitoris was normal in size but beneath the clitoral hood, predominantly on the left, there was a 3 x 2 cm irregular mobile mass. Her karyotype revealed normal 46XX female genotype. Magnetic resonance imaging of the abdomen and pelvis showed an isolated finding of diffuse enlargement of the clitoris with edema of the mons pubis. Surgical excision of the paraclitoral mass was performed. Intraoperatively the clitoral tip and shaft did not appear to be involved. However, the mass was found to be more diffuse, less well-defined, and more extensive than the clinical findings had suggested. On histology long spindle cells with nuclear palisading and focal Verocay body-like structures were found. There was mild to moderate pleomorphism. No mitotic figures were identified. There was diffuse staining of interweaving bundles for S100 protein and glial fibrillary acidic protein without staining for actin, desmin, or neurofilament. These features are consistent with a plexiform schwannoma. Although benign schwannomas rarely occur in the clitoris, we suggest that it should be considered as differential diagnosis for any young girl with clitoral or paraclitoral asymmetrical irregular mass.

  2. 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

  3. Long-term results for trigeminal schwannomas treated with gamma knife surgery.

    Science.gov (United States)

    Hasegawa, Toshinori; Kato, Takenori; Iizuka, Hiroshi; Kida, Yoshihisa

    2013-12-01

    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). 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(3). The median maximum and marginal doses were 28 Gy and 14 Gy, respectively. 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. 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 treated with GKS when necessary. Copyright © 2013

  4. 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....

  5. Preservation of auditory and vestibular function after surgical removal of bilateral vestibular schwannomas in a patient with neurofibromatosis type 2

    Science.gov (United States)

    Black, F. O.; Brackmann, D. E.; Hitselberger, W. E.; Purdy, J.

    1995-01-01

    The outcome of acoustic neuroma (vestibular schwannoma) surgery continues to improve rapidly. Advances can be attributed to several fields, but the most important contributions have arisen from the identification of the genes responsible for the dominant inheritance of neurofibromatosis types 1 (NF1) and 2 (NF2) and the development of magnetic resonance imaging with gadolinium enhancement for the early anatomic confirmation of the pathognomonic, bilateral vestibular schwannomas in NF2. These advances enable early diagnosis and treatment when the tumors are small in virtually all subjects at risk for NF2. The authors suggest that advising young NF2 patients to wait until complications develop, especially hearing loss, before diagnosing and operating for bilateral eighth nerve schwannomas may not always be in the best interest of the patient. To the authors' knowledge, this is the first reported case of preservation of both auditory and vestibular function in a patient after bilateral vestibular schwannoma excision.

  6. 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

  7. Ancient schwannoma of the oral floor and ventricular portion of the tongue: a case report and review of the literature.

    Science.gov (United States)

    Nakayama, H; Gobara, R; Shimamoto, F; Kajihara, H

    1996-06-01

    We report a case of ancient schwannoma, which is a rare benign neoplasm of the oral floor and ventricular portion of the tongue. Only two cases have previously been reported in the English literature. The present tumor, measuring 5.5 x 3.0 x 3.0 cm, was the largest of the three. To differentiate ancient schwannoma from schwannoma with malignant transformation, it is important to confirm the absence of abrupt transition between areas of apparently typical schwannoma and areas composed of atypical large cells with pleomorphic and hyperchromatic nuclei, as well as the absence of mitoses, necrosis, and invasiveness. In the present case, calcification was not detected, nor was hyalinization extensive, although many of the neoplastic Schwann cells showed degenerative nuclear atypia.

  8. 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

  9. Testing the Role of p21-Activated Kinases in Schwannoma Formation Using a Novel Genetically Engineered Murine Model that Closely Phenocopies Human NF2 Disease

    Science.gov (United States)

    2015-06-01

    Kinases in Schwannoma Formation Using a Novel Genetically Engineered Murine Model that Closely Phenocopies Human NF2 Disease The views, opinions and...TITLE AND SUBTITLE Testing the Role of p21-Activated Kinases in Schwannoma Formation Using a Novel Genetically Engineered Murine Model that Closely...1.20 calendar Testing the Role of p21 Activated Kinases in Schwannoma Formation Using a Novel Genetically Engineered Murine Model that Closely

  10. Merlin/NF2 Regulates Angiogenesis in Schwannomas through a Rac1/Semaphorin 3F-Dependent Mechanism

    Directory of Open Access Journals (Sweden)

    Hon-Kit Wong

    2012-02-01

    Full Text Available Neurofibromatosis type 2 (NF2 is an autosomal-dominant multiple neoplasia syndrome that results from mutations in the NF2 tumor suppressor gene. Patients with NF2 develop hallmark schwannomas that require surgery or radiation, both of which have significant adverse effects. Recent studies have indicated that the tumor microenvironment—in particular, tumor blood vessels—of schwannomas may be an important therapeutic target. Furthermore, although much has been done to understand how merlin, the NF2 gene product, functions as a tumor suppressor gene in schwannoma cells, the functional role of merlin in the tumor microenvironment and the mechanism(s by which merlin regulates angiogenesis to support schwannoma growth is largely unexplored. Here we report that the expression of semaphorin 3F (SEMA3F was specifically downregulated in schwannoma cells lacking merlin/NF2. When we reintroduced SEMA3F in schwannoma cells, we observed normalized tumor blood vessels, reduced tumor burden, and extended survival in nude mice bearing merlin-deficient brain tumors. Next, using chemical inhibitors and gene knockdown with RNA interference, we found that merlin regulated expression of SEMA3F through Rho GTPase family member Rac1. This study shows that, in addition to the tumor-suppressing activity of merlin, it also functions to maintain physiological angiogenesis in the nervous system by regulating antiangiogenic factors such as SEMA3F. Restoring the relative balance of proangiogenic and antiangiogenic factors, such as increases in SEMA3F, in schwannoma microenvironment may represent a novel strategy to alleviate the clinical symptoms of NF2-related schwannomas.

  11. 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....

  12. Effect of galanin on substance P- and vasoactive intestinal polypeptide-induced nociceptive trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Janecka, A

    2007-09-01

    Substance P (SP), vasoactive intestinal polypeptide (VIP) and galanin (GAL), present in primary sensory neurons, are involved in transmission of nociceptive signaling from the peripheral to central nervous system. In this study we investigated the effect of GAL on SP-induced or VIP-induced evoked tongue jerks (ETJ) in response to noxious tooth pulp stimulation during perfusion of the cerebral ventricles with SP or VIP solutions. The experiments were carried out on rats under chloralose anesthesia. It was shown that both, SP and VIP, perfused through the cerebral ventricles enhanced the ETJ amplitude as compared with control, but the effect produced by SP was stronger. The intracerebroventricular perfusion of GAL 5 minutes before SP caused a dose-dependent inhibition of SP-induced ETJ, whereas GAL perfused through the cerebral ventricles 5 minutes before VIP did not reduce the excitatory effect of VIP on ETJ. These results indicate that the antinociceptive effect of GAL perfused through the cerebral ventricles, tested on the trigemino-hypoglossal reflex in rats, is specifically mediated by the SP-ergic system.

  13. Inhibition of trigemino-hypoglossal reflex in rats by oxytocin is mediated by mu and kappa opioid receptors.

    Science.gov (United States)

    Zubrzycka, Maria; Fichna, Jakub; Janecka, Anna

    2005-02-21

    Recent studies showed that oxytocin plays an important role in the modulation of pain at different levels of the central nervous system. The present study was undertaken to investigate the effect of oxytocin on trigemino-hypoglossal reflex in rats. With the experimental settings used in this study, we have demonstrated that oxytocin showed significant analgesic effect after intracerebroventricular administration in rats, as assayed by the amplitude of the retractory movements of the tongue after tooth pulp stimulation. Antinociceptive effect of oxytocin was inhibited by subsequent perfusion of cerebral ventricles with oxytocin antagonist, [deamino-Cys1-D-Tyr(OEt)2-Thr4-Orn8]-oxytocin, atosiban. An involvement of opioid system in the oxytocin-induced analgesia was studied after intracerebroventricular administration of different opioid antagonists: non-selective naloxone, mu-selective beta-funaltrexamine, delta-selective naltrindole, and kappa-selective nor-binaltorphimine. It was shown that inhibition of antinociceptive effects was mediated through mu and kappa opioid receptors, indicating that there is a synergy between oxytocin and opioid systems in transmitting and modulating pain stimuli. Co-administration of oxytocin and a mu-selective endogenous opioid ligand endomorphin-2 did not significantly increase the antinociceptive activity of endomorphin-2.

  14. Power spectral analysis of hypoglossal nerve activity during intermittent hypoxia-induced long-term facilitation in mice.

    Science.gov (United States)

    ElMallah, Mai K; Stanley, David A; Lee, Kun-Ze; Turner, Sara M F; Streeter, Kristi A; Baekey, David M; Fuller, David D

    2016-03-01

    Power spectral analyses of electrical signals from respiratory nerves reveal prominent oscillations above the primary rate of breathing. Acute exposure to intermittent hypoxia can induce a form of neuroplasticity known as long-term facilitation (LTF), in which inspiratory burst amplitude is persistently elevated. Most evidence indicates that the mechanisms of LTF are postsynaptic and also that high-frequency oscillations within the power spectrum show coherence across different respiratory nerves. Since the most logical interpretation of this coherence is that a shared presynaptic mechanism is responsible, we hypothesized that high-frequency spectral content would be unchanged during LTF. Recordings of inspiratory hypoglossal (XII) activity were made from anesthetized, vagotomized, and ventilated 129/SVE mice. When arterial O2 saturation (SaO2) was maintained >96%, the XII power spectrum and burst amplitude were unchanged for 90 min. Three, 1-min hypoxic episodes (SaO2 = 50 ± 10%), however, caused a persistent (>60 min) and robust (>400% baseline) increase in burst amplitude. Spectral analyses revealed a rightward shift of the signal content during LTF, with sustained increases in content above ∼125 Hz following intermittent hypoxia and reductions in power at lower frequencies. Changes in the spectral content during LTF were qualitatively similar to what occurred during the acute hypoxic response. We conclude that high-frequency content increases during XII LTF in this experimental preparation; this may indicate that intermittent hypoxia-induced plasticity in the premotor network contributes to expression of XII LTF.

  15. Dorsal dumb-bell melanotic schwannoma operated on by posterior and anterior approach: case report and a review of the literature.

    Science.gov (United States)

    De Cerchio, Leonardo; Contratti, Filiberto; Fraioli, Mario F

    2006-10-01

    The schwannomas are benign tumors originating from Schwann cells which constitute the nerve sheath. The dorsal pigmented type of schwannomas is relatively rare (Goldstein in Am J Med Genet 86:62-65, 2004; Kurtkaya-Yapicier in Histol Histopathol 18(3):925-934, 2003). There are two distinct types of melanotic schwannoma: the sporadic melanotic schwannomas and the psammomatous melanotic schwannomas of Carney complex. We report a case of a patient harboring a right dorsal dumb-bell melanotic schwannoma and left adrenal mass. The patient underwent a surgical procedure for en bloc total removal of the mass by a posterior and anterior approach. Histopathological examination revealed the diagnosis of melanotic schwannoma. At present, we have no reliable marker of histopathological malignancy of melanotic schwannoma so the follow-up period ought to continue for a period of more than 5 years. As the total removal of the melanotic neurinomas is mandatory to prevent possible malignant transformation of the tumor recurrence or regrowth, we believe that the posterior and trans-thoracic approach are the most suitable one for the dorsal dumb-bell schwannoma.

  16. Nonenhanced hybridized arterial spin labeled magnetic resonance angiography of the extracranial carotid arteries using a fast low angle shot readout at 3 Tesla

    National Research Council Canada - National Science Library

    Ioannis Koktzoglou; Matthew T Walker; Joel R Meyer; Ian G Murphy; Robert R Edelman

    2016-01-01

    ... (MRA) of the extracranial carotid arteries using a fast low angle shot (FLASH) readout at 3 Tesla. Methods In this retrospective, institutional review board-approved and HIPAA-compliant study, we evaluated the image quality...

  17. Surgical management of vestibular schwannomas after failed radiation treatment.

    Science.gov (United States)

    Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Friedman, Allan H; Cunningham, Calhoun D; Zomorodi, Ali R

    2016-04-01

    Increasing numbers of patients with vestibular schwannoma (VS) have been treated with focused-beam stereotactic radiation treatment (SRT) including Gamma knife, CyberKnife, X-knife, Novalis, or proton beam therapy. The purpose of this study was to document the incidence of tumor regrowth or symptoms that worsened or first developed following SRT and to discuss surgical strategies for patients who have failed SRT for VS. A consecutive series of 39 patients with SRT failed VS were surgically treated. Clinical symptoms, tumor regrowth at follow-up, intraoperative findings, and surgical outcome were evaluated. There were 15 males and 24 females with a mean age of 51.8 years. Thirty-six patients (92.3%) demonstrated steady tumor growth after SRT. Two (5.1%) patients with slight increase of the mass underwent surgical resection because of development of unbearable facial pain. Symptoms that worsened or newly developed following SRT in this series were deafness (41%), dizziness (35.9%), facial numbness (25.6%), tinnitus (20.5%), facial nerve palsy (7.7%), and facial pain (7.7%). Intraoperative findings demonstrated fibrous changes of the tumor mass, cyst formation, and brownish-yellow or purple discoloration of the tumor capsule. Severe adhesions between the tumor capsule and cranial nerves, vessels, and the brainstem were observed in 69.2%. Additionally, the facial nerve was more fragile and irritable in all cases. Gross total resection (GTR) was achieved in 33.3% of patients, near-total resection (NTR) in 35.9%, and subtotal resection (STR) in 30.8% of patients. New facial nerve palsy was seen in seven patients (19.4%) postoperatively. Our findings suggest that patients with VS who fail SRT with either tumor progression or worsening of clinical symptoms will have an increased rate of adhesions to the neurovascular structures and may have radiation-influenced neuromalacia. Salvage surgery of radiation-failed tumors is more difficult and will have a higher risk of

  18. Trigeminal neuralgia and neuropathy in large sporadic vestibular schwannomas.

    Science.gov (United States)

    Neff, Brian A; Carlson, Matthew L; O'Byrne, Megan M; Van Gompel, Jamie J; Driscoll, Colin L W; Link, Michael J

    2017-01-13

    OBJECTIVE The aim of this study was to evaluate the incidence, presentation, and treatment outcomes of trigeminal nerve-mediated symptoms secondary to large vestibular schwannomas (VSs) with trigeminal nerve contact. Specifically, the symptomatic results of pain, paresthesias, and numbness after microsurgical resection or stereotactic radiosurgery (SRS) were examined. METHODS The authors conducted a retrospective review of a database for concomitant diagnosis of trigeminal neuralgia (TN) or trigeminal neuropathy and VS between 1994 and 2014 at a tertiary academic center. All patients with VS with TN or neuropathy were included, with the exception of those patients with neurofibromatosis Type 2 and patients who elected observation. Patient demographic data, symptom evolution, and treatment outcomes were collected. Population data were summarized, and outcome comparisons between microsurgery and SRS were analyzed at last follow-up. RESULTS Sixty (2.2%) of 2771 total patients who had large VSs and either TN or neuropathy symptoms met inclusion criteria. The average age of trigeminal symptom onset was 53.6 years (range 24-79 years), the average age at VS diagnosis was 54.4 years (range 25-79 years), and the average follow-up for the microsurgery and SRS groups was 30 and 59 months, respectively (range 3-132 months). Of these patients, 50 (83%) had facial numbness, 16 (27%) had TN pain, and 13 (22%) had paresthesias (i.e., burning or tingling). Subsequently, 50 (83%) patients underwent resection and 10 (17%) patients received SRS. Treatment of VS with SRS did not improve trigeminal symptoms in any patient. This included 2 subjects with unimproved facial numbness and 4 patients with worsened numbness. Similarly, SRS worsened TN pain and paresthesias in 5 patients and failed to improve pain in 2 additional patients. The Barrow Neurological Institute neuralgia and hypesthesia scale scores were significantly worse for patients undergoing SRS compared with microsurgery

  19. Predictors of Preoperative Tinnitus in Unilateral Sporadic Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Georgios Naros

    2017-08-01

    Full Text Available ObjectiveNearly two-thirds of patients with vestibular schwannoma (VS are reporting a significantly impaired quality of life due to tinnitus. VS-associated tinnitus is attributed to an anatomical and physiological damage of the hearing nerve by displacing growth of the tumor. In contrast, the current pathophysiological concept of non-VS tinnitus hypothesizes a maladaptive neuroplasticity of the central nervous system to a (hidden hearing impairment resulting in a subjective misperception. However, it is unclear whether this concept fits to VS-associated tinnitus. This study aims to determine the clinical predictors of VS-associated tinnitus to ascertain the compatibility of both pathophysiological concepts.MethodsThis retrospective study includes a group of 478 neurosurgical patients with unilateral sporadic VS evaluated preoperatively regarding the occurrence of ipsilateral tinnitus depending on different clinical factors, i.e., age, gender, tumor side, tumor size (T1–T4 according to the Hannover classification, and hearing impairment (Gardner–Robertson classification, GR1–5, using a binary logistic regression.Results61.8% of patients complain about a preoperative tinnitus. The binary logistic regression analysis identified male gender [OR 1.90 (1.25–2.75; p = 0.002] and hearing impairment GR3 [OR 1.90 (1.08–3.35; p = 0.026] and GR4 [OR 8.21 (2.29–29.50; p = 0.001] as positive predictors. In contrast, patients with large T4 tumors [OR 0.33 (0.13–0.86; p = 0.024] and complete hearing loss GR5 [OR 0.36 (0.15–0.84; p = 0.017] were less likely to develop a tinnitus. Yet, 60% of the patients with good clinical hearing (GR1 and 25% of patients with complete hearing loss (GR5 suffered from tinnitus.ConclusionThese data are good accordance with literature about non-VS tinnitus indicating hearing impairment as main risk factor. In contrast, complete hearing loss appears a negative predictor for tinnitus. For the first

  20. Primary extra-cranial meningioma of head and neck: clinical, histopathological and immunohistochemical study of three cases.

    Science.gov (United States)

    Possanzini, P; Pipolo, C; Romagnoli, S; Falleni, M; Moneghini, L; Braidotti, P; Salvatori, P; Paradisi, S; Felisati, G

    2012-10-01

    Extracranial meningiomas of the head and neck region are rare neoplasms, the majority being a secondary location of a primary intracranial tumour. We herewith report three rare cases of extracranial meningiomas, located in the temporal muscle, parotid gland and nasal cavity, together with complete pathological, immunohistochemical and ultrastructural studies. Prognosis of this tumour is generally excellent. Surgical excision is the treatment of choice, with no need for further treatment; nevertheless, differential diagnosis must consider other more common tumours of the head and neck and be based on histopathologic examination and relative techniques, including examination of frozen sections. This procedure is particularly useful assessing surgical treatment and should be performed whenever possible to exclude the malignant nature of the lesion and avoid over-treatment. All three patients underwent surgery and are alive and disease-free.

  1. Extrapulmonary small cell sarcinoma: involvement of the brain without evidence of extracranial malignancy by serial PET/CT scans

    Directory of Open Access Journals (Sweden)

    Havlioglu Necat

    2008-09-01

    Full Text Available Abstract Background Extrapulmonary small cell carcinoma (EPSCC involving the brain is a rare manifestation of an uncommon tumor type. Case presentation We report a 59 year-old Caucasian female diagnosed with an EPSCC involving the left parietal lobe without detectable extracranial primary tumor followed by serial positron emission tomography/computed tomography (PET/CT imaging. Histopathological examination at both initial presentation and recurrence revealed small cell carcinoma. Serial PET/CT scans of the entire body failed to reveal any extracranial [18F]2-fluoro-2-deoxy-D-glucose (FDG avid lesions at either diagnosis or follow-up. Conclusion Chemotherapy may show a transient response in the treatment of EPSCC. Further studies are needed to help identify optimal treatment strategies. Combination PET/CT technology may be a useful tool to monitor EPSCC and assess for an occult primary malignancy.

  2. SU-E-T-517: Investigation of Factors Contributing to Extracranial Radiation Doses From Leksell Gamma Knife

    Energy Technology Data Exchange (ETDEWEB)

    Kon, D [The University of Tokyo Graduate school of Medicine, Tokyo, JP (Japan); Kameda Medical Centre, Chiba, JP (Japan); Nakano, M [The University of Tokyo Graduate school of Medicine, Tokyo, JP (Japan); Nawa, K; Haga, A; Nakagawa, K [University of Tokyo Hospital, Tokyo, JP (Japan)

    2015-06-15

    Purpose The purpose of this study is to investigate dominant factors for doses to extracranial sites in treatment with Leksell Gamma Knife (LGK). Methods Monte Carlo simulation was implemented using EGS5 version 1.4.401. The simulation was divided into two major steps for the purpose of efficiency. As the first step, phase-space files were obtained at a scoring plane located just below patient-side surface of the collimator helmet of LGK. Scored particles were classified into three groups, primary, leakage and scatter, using their history information until their arrival to the scoring plane. Then classification was used at the following second step simulation to investigate which type of particle is dominant in the deposited energy at extra-cranial sites. In the second stage, a cylindrical phantom with a semisphere shaped head was modeled such that the geometrical center of the phantom’s head corresponds to the unit center point (UCP) of LGK. Scoring regions were arranged at 10 cm intervals from the UCP to 70 cm away on the central axis of the phantom. Energy deposition from each type of particles and location of interaction were recorded. Results The dominant factor of deposited energy depended on the collimator size. In the case of smaller collimator size, leakage was dominant. However, contribution of leakage was relatively small in the case of larger collimator size. The contribution of internal scatter varied with the distance from the UCP. In the proximal areas, internal scatter was dominant, whereas in the distal areas, particles interacting with machine components became dominant factor. Conclusion The Result of this study indicates that the dominant factor to dose to an extracranial site can vary with the distance from UCP and with collimator size. This means that the variation of this contribution must be considered for modeling of the extracranial dose especially in the distal area. This work was partly supported by the JSPS Core-to-Core Program (No

  3. Importance of Extracranial Disease Status and Tumor Subtype for Patients Undergoing Radiosurgery for Breast Cancer Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Dyer, Michael A.; Kelly, Paul J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Pinnell, Nancy E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Claus, Elizabeth B. [Harvard Medical School, Boston, MA (United States); Department of Neurosurgery, Brigham and Women' s Hospital, Boston, MA (United States); Yale University School of Medicine, New Haven, CT (United States); Lee, Eudocia Q. [Harvard Medical School, Boston, MA (United States); Center for Neuro-Oncology, Dana-Farber/Brigham and Women' s Center, Boston, MA (United States); Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Arvold, Nils D. [Harvard Radiation Oncology Program, Boston, MA (United States); Lin, Nancy U. [Harvard Medical School, Boston, MA (United States); Department of Medical Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Alexander, Brian M., E-mail: bmalexander@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States)

    2012-07-15

    Purpose: In this retrospective study, we report on outcomes and prognostic factors for patients treated with stereotactic radiosurgery (SRS) for breast cancer brain metastases. Methods and Materials: We identified 132 consecutive patients with breast cancer who were treated with SRS for brain metastases from January 2000 through June 2010. We retrospectively reviewed records of the 51 patients with adequate follow-up data who received SRS as part of the initial management of their brain metastases. Overall survival (OS) and time to central nervous system (CNS) progression from the date of SRS were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Results: Triple negative subtype was associated with CNS progression on univariate analysis (hazard ratio [HR] = 5.0, p = 0.008). On multivariate analysis, triple negative subtype (HR = 8.6, p = 0.001), Luminal B subtype (HR = 4.3, p = 0.03), and omission of whole-brain radiation therapy (HR = 3.7, p = 0.02) were associated with CNS progression. With respect to OS, Karnofsky Performance Status (KPS) {<=} 80% (HR = 2.0, p = 0.04) and progressive extracranial disease (HR = 3.1, p = 0.002) were significant on univariate analysis; KPS {<=} 80% (HR = 4.1, p = 0.0004), progressive extracranial disease (HR = 6.4, p < 0.0001), and triple negative subtype (HR = 2.9, p = 0.04) were significant on multivariate analysis. Although median survival times were consistent with those predicted by the breast cancer-specific Graded Prognostic Assessment (Breast-GPA) score, the addition of extracranial disease status further separated patient outcomes. Conclusions: Tumor subtype is associated with risk of CNS progression after SRS for breast cancer brain metastases. In addition to tumor subtype and KPS, which are incorporated into the Breast-GPA, progressive extracranial disease may be an important prognostic factor for OS.

  4. Feasibility of using intermediate x-ray energies for highly conformal extracranial radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Peng; Yu, Victoria; Nguyen, Dan; Demarco, John; Low, Daniel A.; Sheng, Ke, E-mail: ksheng@mednet.ucla.edy [Department of Radiation Oncology, University of California Los Angeles, California 90095 (United States); Woods, Kaley; Boucher, Salime [RadiaBeam Technologies, Santa Monica, California 90404 (United States)

    2014-04-15

    Purpose: To investigate the feasibility of using intermediate energy 2 MV x-rays for extracranial robotic intensity modulated radiation therapy. Methods: Two megavolts flattening filter free x-rays were simulated using the Monte Carlo code MCNP (v4c). A convolution/superposition dose calculation program was tuned to match the Monte Carlo calculation. The modeled 2 MV x-rays and actual 6 MV flattened x-rays from existing Varian Linacs were used in integrated beam orientation and fluence optimization for a head and neck, a liver, a lung, and a partial breast treatment. A column generation algorithm was used for the intensity modulation and beam orientation optimization. Identical optimization parameters were applied in three different planning modes for each site: 2, 6 MV, and dual energy 2/6 MV. Results: Excellent agreement was observed between the convolution/superposition and the Monte Carlo calculated percent depth dose profiles. For the patient plans, overall, the 2/6 MV x-ray plans had the best dosimetry followed by 2 MV only and 6 MV only plans. Between the two single energy plans, the PTV coverage was equivalent but 2 MV x-rays improved organs-at-risk sparing. For the head and neck case, the 2MV plan reduced lips, mandible, tongue, oral cavity, brain, larynx, left and right parotid gland mean doses by 14%, 8%, 4%, 14%, 24%, 6%, 30% and 16%, respectively. For the liver case, the 2 MV plan reduced the liver and body mean doses by 17% and 18%, respectively. For the lung case, lung V20, V10, and V5 were reduced by 13%, 25%, and 30%, respectively. V10 of heart with 2 MV plan was reduced by 59%. For the partial breast treatment, the 2 MV plan reduced the mean dose to the ipsilateral and contralateral lungs by 27% and 47%, respectively. The mean body dose was reduced by 16%. Conclusions: The authors showed the feasibility of using flattening filter free 2 MV x-rays for extracranial treatments as evidenced by equivalent or superior dosimetry compared to 6 MV plans

  5. Electrical Stimulation of the Human Cerebral Cortex by Extracranial Muscle Activity: Effect Quantification With Intracranial EEG and FEM Simulations

    Science.gov (United States)

    Lahr, Jacob; Vorwerk, Johannes; Lucka, Felix; Aertsen, Ad; Wolters, Carsten Hermann; Schulze-Bonhage, Andreas; Ball, Tonio

    2017-01-01

    Objective Electric fields (EF) of approx. 0.2 V/m have been shown to be sufficiently strong to both modulate neuronal activity in the cerebral cortex and have measurable effects on cognitive performance. We hypothesized that the EF caused by the electrical activity of extracranial muscles during natural chewing may reach similar strength in the cerebral cortex and hence might act as an endogenous modality of brain stimulation. Here, we present first steps toward validating this hypothesis. Methods Using a realistic volume conductor head model of an epilepsy patient having undergone intracranial electrode placement and utilizing simultaneous intracranial and extracranial electrical recordings during chewing, we derive predictions about the chewing-related cortical EF strength to be expected in healthy individuals. Results We find that in the region of the temporal poles, the expected EF strength may reach amplitudes in the order of 0.1–1 V/m. Conclusion The cortical EF caused by natural chewing could be large enough to modulate ongoing neural activity in the cerebral cortex and influence cognitive performance. Significance The present study lends first support for the assumption that extracranial muscle activity might represent an endogenous source of electrical brain stimulation. This offers a new potential explanation for the puzzling effects of gum chewing on cognition, which have been repeatedly reported in the literature. PMID:27448334

  6. Electrical Stimulation of the Human Cerebral Cortex by Extracranial Muscle Activity: Effect Quantification With Intracranial EEG and FEM Simulations.

    Science.gov (United States)

    Fiederer, Lukas Dominique Josef; Lahr, Jacob; Vorwerk, Johannes; Lucka, Felix; Aertsen, Ad; Wolters, Carsten Hermann; Schulze-Bonhage, Andreas; Ball, Tonio

    2016-12-01

    Electric fields (EF) of approx. 0.2 V/m have been shown to be sufficiently strong to both modulate neuronal activity in the cerebral cortex and have measurable effects on cognitive performance. We hypothesized that the EF caused by the electrical activity of extracranial muscles during natural chewing may reach similar strength in the cerebral cortex and hence might act as an endogenous modality of brain stimulation. Here, we present first steps toward validating this hypothesis. Using a realistic volume conductor head model of an epilepsy patient having undergone intracranial electrode placement and utilizing simultaneous intracranial and extracranial electrical recordings during chewing, we derive predictions about the chewing-related cortical EF strength to be expected in healthy individuals. We find that in the region of the temporal poles, the expected EF strength may reach amplitudes in the order of 0.1-1 V/m. The cortical EF caused by natural chewing could be large enough to modulate ongoing neural activity in the cerebral cortex and influence cognitive performance. The present study lends first support for the assumption that extracranial muscle activity might represent an endogenous source of electrical brain stimulation. This offers a new potential explanation for the puzzling effects of gum chewing on cognition, which have been repeatedly reported in the literature.

  7. Gene expression, signal transduction pathways and functional networks associated with growth of sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Sass, Hjalte Christian Reeberg; Borup, Rehannah; Alanin, Mikkel

    2017-01-01

    The objective of this study was to determine global gene expression in relation to Vestibular schwannomas (VS) growth rate and to identify signal transduction pathways and functional molecular networks associated with growth. Repeated magnetic resonance imaging (MRI) prior to surgery determined...... of signal transduction pathways and functional molecular networks associated with tumor growth. In total 109 genes were deregulated in relation to tumor growth rate. Genes associated with apoptosis, growth and cell proliferation were deregulated. Gene ontology included regulation of the cell cycle, cell...... differentiation and proliferation, among other functions. Fourteen pathways were associated with tumor growth. Five functional molecular networks were generated. This first study on global gene expression in relation to vestibular schwannoma growth rate identified several genes, signal transduction pathways...

  8. Intraosseous Schwannoma of Rib With Severe Back Pain and Characteristic Pathological Findings.

    Science.gov (United States)

    Yao, Takahide; Otsuka, Hajime; Koezuka, Satoshi; Makino, Takashi; Hata, Yoshinobu; Ishiwatari, Takao; Shibuya, Kazutoshi; Iyoda, Akira

    2016-08-01

    A 44-year-old man was admitted to our hospital with severe back pain continuing for 12 years. Computed tomography of the chest revealed a 14 mm diameter tumor with calcification located in the right seventh rib. We performed right seventh rib and sixth to seventh intercostal muscle partial resection. Microscopically, the tumor showed typical features of a schwannoma composed of Antoni A and Antoni B tissues. The tumor had positive immunohistochemical staining for S-100 protein. The pathological diagnosis was intraosseous schwannoma. The patient's severe back pain disappeared and there was no recurrence or metastasis of the tumor during a 1-year follow up. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. 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

  10. Synchronous occurrence of colon adenocarcinoma and gastric schwannoma: case report and review of the literature.

    Science.gov (United States)

    Di Cataldo, Antonio; Trombatore, Claudia; Cocuzza, Aldo; Latino, Rosalia; Li Destri, Giovanni; Petrillo, Giuseppe

    2013-01-01

    Riportiamo il caso di un uomo di 66 anni con uno schwannoma gastrico scoperto casualmente durante l’iter diagnostico per cancro del colon. Alla TC preoperatoria eseguita per la stadiazione del tumore del colon è stata incidentalmente evidenziata la presenza di una tumefazione nodulare tra il fegato e la parete dello stomaco. Una “wedge resection” di questa tumefazione è stata eseguita in unico tempo con l’intervento di emicolectomia sinistra. L’esame istopatologico della tumefazione ha evidenziato un quadro dirimente per schwannoma gastrico. La diagnosi preoperatoria degli schwannomi gastrointestinali è difficile ma non impossibile, benché essi siano in genere asintomatici ed il quadro clinico e i reperti radiologici siano aspecifici. A causa dell’incertezza diagnostica il trattamento di scelta è la resezione chirurgica completa; trattandosi di lesioni benigne la prognosi a distanza è eccellente.

  11. 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.

  12. 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.

  13. Large Dumbbell-Shaped C1 Schwannoma Presenting as a Foramen Magnum Mass

    Science.gov (United States)

    Helms, Jody; Michael, Lattimore Madison

    2012-01-01

    Schwannomas involving the foramen magnum commonly originate from the lower cranial nerves, but they are rarely found arising from the first cervical root. To date, very few cases have been described in the literature. The majority involve either the intradural or extradural compartment but not both. We report the second case of a dumbbell-shaped schwannoma arising from the first cervical root. Our patient presented with hemisensory deficits secondary to brainstem compression at the level of the foramen magnum. The patient underwent a far lateral approach, and a gross total resection was achieved. Preoperative suspicion of the diagnosis is helpful in anticipating displacement and avoiding damage to the surrounding neurovascular structures. PMID:23946923

  14. 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.

  15. 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.

  16. 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 t...... targets the angiogenic process by investigation of tumor expression of MMP-2, MMP-9, and tissue inhibitors of metalloproteinase (TIMP)-1. A possible correlation with gender, patient age, symptom duration, tumor size, and the absolute and relative growth rate is explored....

  17. 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.

  18. 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.

  19. ERbB2 Trafficking and Signaling in Human Vestibular Schwannomas

    Science.gov (United States)

    2011-10-01

    patients with macular degeneration and respiratory syncytial virus infections (37). A miR-21Yspecific RNA interference knockdown could be achieved...International Conference on Vestibular Schwannomas and Other CPA Lesions, Barcelona, Spain , June 2007 8 Brown, KD, Clark, J, Hansen MR. Differential...Wallerian degeneration . J Neurosci 1997;17: 1642Y59. 11. Frohnert PW, Stonecypher MS, Carroll SL. Constitutive activation of the neuregulin-1/ErbB receptor

  20. A Rare Cause of Acute Urinary Retention: Retroperitoneal Ganglioneuroma and Concurrent Mediastineal Schwannoma

    Directory of Open Access Journals (Sweden)

    Salih Budak

    2013-04-01

    Full Text Available The underlying prior cause at the old male patients refered with acute urinary retention is frequently benign prostatic hypertrophy and urethral pathologies. Acute urinary retention can develop with obstruction as well as neurogenic causes. Neurogenic tumors develops from the cells which takes its origin from the neural crest and they can be seen every neural tissue. In this study rarely seen retroperitoneal ganglioneuroma which causes acute urinary retention and coexisting asymptomatic mediastineal schwannoma case is presented.

  1. Smell and taste in patients with vascular malformation of the extracranial head and neck region.

    Science.gov (United States)

    Steinbach, Silke; Fasunla, Ayotunde J; Lahme, Carolin M E; Schäfers, Sophia P; Hundt, Walter; Wolf, Petra; Mandic, Robert; Werner, Jochen A; Eivazi, Behfar

    2014-01-01

    Olfactory and gustatory functions have not been investigated in patients with vascular malformation of the extracranial head and neck region with validated smell and taste tests. Although olfactory and gustatory deficiencies are often not outwardly apparent, they substantially affect daily life. Smell and taste tests using sniffin sticks and taste strips were administered in 40 patients. For all age groups and both sexes, odor threshold (THR) values were, on average, lower in patients than in healthy individuals; whereas, values of odor identification and discrimination were not significantly lower. Regarding odor THR, 33 (82.5%) patients were hyposmic. Taste values (sweet, sour, salty, bitter, and total taste) were, on average, lower in patients than in healthy individuals; 21 (52.5%) patients were hypogeusic. Disease duration did not correlate with smell and taste test values. Patients with and without tongue involvement had decreased odor threshold and taste values. No significant differences were identified when taste values on the left and right sides of the tongue were compared in patients without tongue involvement and with unilateral and bilateral tongue involvement. Patients with venous malformations had lower smell test values, and patients with lymphatic malformations had lower taste test values than patients with other malformations. Patients exhibit significantly reduced olfactory and gustatory function even when the nose and/or tongue are not malformed. Patients should be tested with validated smell and taste tests to adequately inform and advise them about overcoming smell and taste deficits.

  2. Impact of Intra-Extracranial Hemodynamics on Cerebral Ischemia by Arterial Hypertension (Part 1

    Directory of Open Access Journals (Sweden)

    Alexander G. Kruglov, PhD, ScD

    2012-06-01

    Full Text Available The present study was conducted to examine the interaction of biochemical parameters within the blood flow, their effect on the cerebral blood flow, as well as the mechanisms of cerebral ischemia by stable arterial hypertension. The hemodynamics and biochemical indicators of cerebral blood flow without the additives of the extracranial blood were obtained by the catheterization method via a probe wedged at the level of the bulb of the superior jugular vein. Sampling of the arterial blood was done in the thoracic aorta. Correlation and factor analysis of the relationship of the biochemical substances within the blood flow, and of the hemodynamic indicators of the cerebral inflow and outflow of blood were conducted by stable arterial hypertension compared with similar data of the control group. The differences thus identified led to the conclusion that by stable arterial hypertension, there is a loss of the homeostatic control of the factors determining the rheological and thrombogenic properties of the blood involved in the formation of cerebral ischemic events.

  3. Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease.

    Science.gov (United States)

    Ricotta, John J; Aburahma, Ali; Ascher, Enrico; Eskandari, Mark; Faries, Peter; Lal, Brajesh K

    2011-09-01

    Management of carotid bifurcation stenosis is a cornerstone of stroke prevention and has been the subject of extensive clinical investigation, including multiple controlled randomized trials. The appropriate treatment of patients with carotid bifurcation disease is of major interest to the community of vascular surgeons. In 2008, the Society for Vascular Surgery published guidelines for treatment of carotid artery disease. At the time, only one randomized trial, comparing carotid endarterectomy (CEA) and carotid stenting (CAS), had been published. Since that publication, four major randomized trials comparing CEA and CAS have been published, and the role of medical management has been re-emphasized. The current publication updates and expands the 2008 guidelines with specific emphasis on six areas: imaging in identification and characterization of carotid stenosis, medical therapy (as stand-alone management and also in conjunction with intervention in patients with carotid bifurcation stenosis), risk stratification to select patients for appropriate interventional management (CEA or CAS), technical standards for performing CEA and CAS, the relative roles of CEA and CAS, and management of unusual conditions associated with extracranial carotid pathology. Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be management as the first-line therapy.

  4. Management of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion.

    Science.gov (United States)

    Serbinenko, F A; Filatov, J M; Spallone, A; Tchurilov, M V; Lazarev, V A

    1990-07-01

    Nine patients with giant internal carotid artery (ICA) aneurysms (greater than 2.5 cm in diameter) were subjected to a combined extracranial-intracranial (EC-IC) bypass procedure and endovascular ICA occlusion during 1987 and 1988. The procedures were performed under one anesthetic. In all cases the collateral circulation had been judged insufficient on the basis of a strict preoperative testing protocol including: cerebral panangiography, electroencephalography, somatosensory potential recording, and cerebral blood flow monitoring during manual compression of the ICA in the neck. There were four intracavernous ICA aneurysms, four carotid-ophthalmic artery aneurysms, and one supraclinoid ICA aneurysm. All patients showed symptoms and signs of compression of the surrounding nervous structures. In the five cases of intradural lesions, the artery was occluded at the level of the aneurysm neck, so the ophthalmic artery had to be occluded. There was, nevertheless, no case of worsening of vision following surgery, and all nine patients showed significant improvement following the combined procedure. A combined EC-IC bypass procedure and endovascular ICA occlusion allows for immediate verification of the surgical results and appears to be a worthwhile method for treating giant intracranial aneurysms.

  5. Assessment of extracranial-intracranial bypass patency with 64-slice multidetector computerized tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Thines, Laurent [Lille University Hospital, Department of Neurosurgery, Lille (France); Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Agid, Ronit; Da Costa, Leodante; Terbrugge, Karel G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Dehdashti, Amir R.; Wallace, M.C.; Tymianski, Michael [Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada)

    2009-08-15

    Extracranial-intracranial (EC/IC) bypass is a useful procedure for the treatment of cerebral vascular insufficiency or complex aneurysms. We explored the role of multidetector computed tomography angiography (MDCTA), instead of digital subtraction angiography (DSA), for the postoperative assessment of EC/IC bypass patency. We retrospectively analyzed a consecutive series of 21 MDCTAs from 17 patients that underwent 25 direct or indirect EC/IC bypass procedures between April 2003 and November 2007. Conventional DSA was available for comparison in 13 cases. MDCTA used a 64-slice MDCT scanner (Aquilion 64, Toshiba). The proximal and distal patencies were analyzed independently on MDCTA and DSA by a neuroradiologist and a neurosurgeon. The bypass was considered patent when the entire donor vessel was opacified without discontinuity from proximal to distal ends and was visibly in contact with the recipient vessel. MDCTA depicted the patency status in every patient. Bypasses were patent in 22 cases, stenosed in one, and occluded in two. DSA always confirmed the results of the MDCTA (sensitivity = 100%, 95% CI = 0.655-1.0; specificity 100%, 95% CI = 0.05-1.0). MDCTA is a non-invasive and accurate exam to assess the postoperative EC/IC bypass patency and is a promising technique in routine follow-up. (orig.)

  6. Telescoping dual covered stent graft construct for endovascular treatment of a giant extracranial carotid artery pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Dale Ding

    2016-01-01

    Full Text Available Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA. The patient underwent endovascular intervention, during which a balloon-expandable covered stent was deployed within a heparin-bonded covered stent, such that the overall construct spanned from the CCA to the lower cervical ICA. The employment of a telescoping dual covered stent technique can successfully treat appropriately selected patients with large or giant ECCA pseudoaneurysms, with the concomitant goals of excluding the pseudoaneurysm and restoring the luminal caliber of the parent artery.

  7. Homozygosity for moyamoya disease risk allele leads to moyamoya disease with extracranial systemic and pulmonary vasculopathy.

    Science.gov (United States)

    Fukushima, Hiroyuki; Takenouchi, Toshiki; Kosaki, Kenjiro

    2016-09-01

    Moyamoya disease is characterized by diffuse distal intracranial stenosis. Recently, RNF213 has been identified as a susceptibility gene in the development of this condition. Pulmonary hypertension is a rare progressive vasculopathy with an unknown etiology. The co-occurrence of pulmonary hypertension and Moyamoya disease has been described in four patients; however, whether this co-occurrence represents a chance association or a common vascular pathology has remained unknown. Here, we report two unrelated male patients who presented during their childhood with dyspnea on exertion. Systemic vascular imaging studies revealed the presence of pulmonary hypertension and Moyamoya disease in both patients. Medical exome sequencing revealed that both patients had a homozygous mutation for p.Arg4810Lys in RNF213. We suggest that homozygosity in RNF213 may lead to a novel entity involving the brain and lung. Interestingly, when present in a heterozygous state, this mutation causes a classic cerebral vascular disease, Moyamoya disease. In the homozygous state, the exact same mutation led to Moyamoya disease with extracranial systemic vasculopathy in at least two patients. From a clinical standpoint, cerebrovascular or pulmonary vascular investigations may be warranted in patients with pulmonary hypertension or Moyamoya disease, respectively. © 2016 Wiley Periodicals, Inc.

  8. Is a Swine Model of Arteriovenous Malformation Suitable for Human Extracranial Arteriovenous Malformation? A Preliminary Study

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Ming-ming, E-mail: lvmingming001@163.com [Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China); Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Radiology (China); Su, Li-xin, E-mail: sulixin1975@126.com [Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Shanghai Key Laboratory of Stomatology (China)

    2013-10-15

    Objective: A chronic arteriovenous malformation (AVM) model using the swine retia mirabilia (RMB) was developed and compared with the human extracranial AVM (EAVM) both in hemodynamics and pathology, to see if this brain AVM model can be used as an EAVM model. Methods: We created an arteriovenous fistula between the common carotid artery and the external jugular vein in eight animals by using end-to-end anastomosis. All animals were sacrificed 1 month after surgery, and the bilateral retia were obtained at autopsy and performed hematoxylin and eosin staining and immunohistochemistry. Pre- and postsurgical hemodynamic evaluations also were conducted. Then, the blood flow and histological changes of the animal model were compared with human EAVM. Results: The angiography after operation showed that the blood flow, like human EAVM, flowed from the feeding artery, via the nidus, drained to the draining vein. Microscopic examination showed dilated lumina and disrupted internal elastic lamina in both RMB of model and nidus of human EAVM, but the thickness of vessel wall had significant difference. Immunohistochemical reactivity for smooth muscle actin, angiopoietin 1, and angiopoietin 2 were similar in chronic model nidus microvessels and human EAVM, whereas vascular endothelial growth factor was significant difference between human EAVM and RMB of model. Conclusions: The AVM model described here is similar to human EAVM in hemodynamics and immunohistochemical features, but there are still some differences in anatomy and pathogenetic mechanism. Further study is needed to evaluate the applicability and efficacy of this model.

  9. Schwannomas in the head and neck: retrospective analysis of 21 patients and review of the literature

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    Erwin Langner

    Full Text Available CONTEXT AND OBJECTIVE: Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. According to their cellularity, they can be subdivided into Antoni A or Antoni B types. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25% of the cases, and may be associated with Von Recklinghausen's disease. The present study retrospectively analyzed some data on this disease in the head and neck region and reviewed the literature on the subject. DESIGN AND SETTING: Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. METHODS: Data on 21 patients between 1980 and 2003 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and association with neurofibromatosis were evaluated. RESULTS: The patients' ages ranged from 16 to 72 years. Four patients had a positive past history of type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial and cervical plexuses, vagus nerve, sympathetic chain and lingual or recurrent laryngeal nerve. The nerve of origin was not identified in six cases. Tumor enucleation was performed in 16 patients; the other five required more extensive surgery. CONCLUSION: Schwannomas and neurofibromas both derive from Schwann cells, but are different entities. They are solitary lesions, except in Von Recklinghausen's disease. They are generally benign, and rarely recur. The recommended surgical treatment is tumor enucleation.

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

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    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.

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

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    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.

  12. Long-term control of vestibular schwannoma after a translabyrinthine complete removal.

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    Schmerber, Sébastien; Palombi, Olivier; Boubagra, Kamel; Charachon, Robert; Chirossel, Jean-Paul; Gay, Emmanuel

    2005-10-01

    The goal of this study was to determine the rate of recurrent vestibular schwannoma after a total removal via the translabyrinthine approach. Between 1973 and 1995, 346 patients were operated on by a translabyrinthine approach. Ninety-one patients were included in a retrospective study for follow-up of 5 years or longer. The mean follow-up period for magnetic resonance imaging (MRI) examination was obtained after mean of 11 years in 91 patients. None of the 91 patients experienced a recurrent vestibular schwannoma on MRI. The translabyrinthine approach is a safe procedure for total definitive removal of a vestibular schwannoma and permitted the absence of tumoral recurrence in our series of 91 patients. A single gadolinium-enhanced MRI scan 5 years after surgery is advised in case of total removal. In case of any doubt about the quality of the tumoral removal, a proposed MRI follow-up schedule within 2 years and 5 years of surgery is an initial baseline pattern, and possibly thereafter repeated MRI examinations on clinical grounds.

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

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    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.

  14. mTORC1 inhibition delays growth of neurofibromatosis type 2 schwannoma

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    Giovannini, Marco; Bonne, Nicolas-Xavier; Vitte, Jeremie; Chareyre, Fabrice; Tanaka, Karo; Adams, Rocky; Fisher, Laurel M.; Valeyrie-Allanore, Laurence; Wolkenstein, Pierre; Goutagny, Stephane; Kalamarides, Michel

    2014-01-01

    Background Neurofibromatosis type 2 (NF2) is a rare autosomal dominant genetic disorder, resulting in a variety of neural tumors, with bilateral vestibular schwannomas as the most frequent manifestation. Recently, merlin, the NF2 tumor suppressor, has been identified as a novel negative regulator of mammalian target of rapamycin complex 1 (mTORC1); functional loss of merlin was shown to result in elevated mTORC1 signaling in NF2-related tumors. Thus, mTORC1 pathway inhibition may be a useful targeted therapeutic approach. Methods We studied in vitro cell models, cohorts of mice allografted with Nf2−/− Schwann cells, and a genetically modified mouse model of NF2 schwannoma in order to evaluate the efficacy of the proposed targeted therapy for NF2. Results We found that treatment with the mTORC1 inhibitor rapamycin reduced the severity of NF2-related Schwann cell tumorigenesis without significant toxicity. Consistent with these results, in an NF2 patient with growing vestibular schwannomas, the rapalog sirolimus induced tumor growth arrest. Conclusions Taken together, these results constitute definitive evidence that justifies proceeding with clinical trials using mTORC1-targeted agents in selected patients with NF2 and in patients with NF2-related sporadic tumors. PMID:24414536

  15. Hybrid neurofibroma/schwannoma is overrepresented among schwannomatosis and neurofibromatosis patients.

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    Harder, Anja; Wesemann, Martin; Hagel, Christian; Schittenhelm, Jens; Fischer, Susan; Tatagiba, Marcos; Nagel, Christoph; Jeibmann, Astrid; Bohring, Axel; Mautner, Victor-Felix; Paulus, Werner

    2012-05-01

    We analyzed the histologic features of peripheral nerve sheath tumors occurring in 14 patients with schwannomatosis. Among a total of 31 tumors, 19 tumors (61%) showed schwannoma-like nodules within a neurofibroma-like tumor, corresponding to hybrid neurofibroma/schwannoma. At least 1 hybrid tumor occurred in 10 of 14 (71%) schwannomatosis patients. We then retrieved cases of hybrid tumors without documented relation to schwannomatosis from our database and identified 41 tumors arising in 23 patients. More than half of these patients (14/23) were reported to suffer from multiple peripheral nerve sheath tumors, favoring a tumor syndrome. Indeed, analysis of clinical records revealed the diagnosis of neurofibromatosis type 2 (NF2) in 26% (6/23), neurofibromatosis type 1 (NF1) in 9% (2/23), definite schwannomatosis in 4% (1/23), and possible schwannomatosis in 13% (3/23) of patients with multiple nerve sheath tumors. Our findings suggest that hybrid neurofibroma/schwannoma represents a common tumor type in schwannomatosis and shows a striking association with neurofibromatoses.

  16. Incidental diagnosis of a retroperitoneal schwannoma in a patient with chronic leukemia undergoing prostatic biopsy.

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    Autieri, Domenico; Pastore, Antonio Luigi; Silvestri, Luigi; Leto, Antonino; Ripoli, Andrea; Palleschi, Giovanni; Porta, Natale; Petrozza, Vincenzo; Carbone, Antonio

    2012-12-30

    We present a case of retroperitoneal schwannoma incidentally diagnosed in a patient undergoing surgical drainage of a pelvic abscess as a complication of a prostatic biopsy. A 50-year-old male, suffering from lymphatic leukemia, came to our observation due to lichen ruber planus and ejaculatory pain. The patient underwent a trans-perineal ultrasound-guided biopsy of the right seminal vesicle and of a hypoechoic area documented by ultrasonography. 48 hours after the procedure, the patient had developed: cold sores, shortness of breath with dyspnea, and high fever (40°C). The patient was hospitalized, underwent an emergency CT which documented a right presacral and pararectal liquid mass (abscess). The patient underwent emergency laparotomy and drainage of the abscess. The lesion histological examination revealed a retroperitoneal schwannoma with inflammatory phenomena and hyperplasic lymphadenitis. The retroperitoneal schwannoma is a silent disease whose only clinical manifestation coincides with the compression of adjacent anatomical structures. In many cases, the symptoms, even if present, as in this case (ejaculatory pain with compression of the seminal vesicle), are non-specific, thus delaying diagnosis and the therapeutic approach.

  17. Schwannoma of Upper Lip: Report of a Rare Case in a Rare Age Group.

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    Hajong, Ranendra; Hajong, Debobratta; Naku, Narang; Sharma, Girish; Boruah, Manash

    2016-08-01

    Schwannoma is a benign, encapsulated perineural tumour originating from the schwann cells of the neural sheath of peripheral motor and sensory nerves. It may develop at any age but is extremely rare in paediatric age group. The tumour is frequently located on the head and neck region, the tongue being the most common site followed by the palate, floor of mouth, buccal mucosa, lips and jaws. Schwannomas rarely occur in the lip area and it is exceedingly rare in the upper lip. The lesion is usually solitary but can be multiple when associated with neurofibromatosis. The diagnosis is usually confirmed after biopsy and anti-S100 protein immuno-histochemical staining is usually used to identify the tumour. In the present study the patient was a 14-year-old young girl with the schwannoma on the upper lip which is probably the third such case in a paediatric age group being reported and was excised without any recurrence at 2 year after excision.

  18. Lingual schwannoma involving the posterior lateral border of the tongue in a young individual: case report.

    Science.gov (United States)

    Pereira, Luciano José; Pereira, Patrícia Peres Iucif; dos Santos, João de Paula; Reis Filho, Viator Ferreira; Dominguete, Paulo Roberto; Pereira, Alessandro A Costa

    2008-01-01

    A schwannoma, also called neurilemmoma, is a benign, encapsulated, slow growing tumor arising from the neural sheath's Schwann cells of the peripheral, cranial or autonomic nerves. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25-48% of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The current case reports a schwannoma of the tongue, found in a 12 year-old boy. The lesion was present for 6 months. The clinical examination revealed a 1.5x1.0 cm, sessile, rubbery, non-tender non-ulcerated mass on the right posterior lateral border of the tongue. An excisional biopsy was performed under local anesthesia. The histological sections showed a circumscribed submucosal nodule composed of spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence free after one year.

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

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    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)

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

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    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.

  1. Gamma Knife radiosurgery in the treatment of abducens nerve schwannomas: a retrospective study.

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    Prasad, Govindaraju Lakshmi; Sharma, Manish Singh; Kale, Shashank S; Agrawal, Deepak; Singh, Manmohan; Sharma, Bhawani Shankar

    2016-10-01

    OBJECTIVE Of the intracranial schwannomas, those arising from the vestibular nerves are the most common. Abducens nerve (AN) schwannomas are very rare, and there is limited literature on their optimal management. Therapeutic options include surgery and/or stereotactic radiosurgery. The aim of this study was to evaluate the role of Gamma Knife radiosurgery (GKRS) in these sixth cranial nerve (CN) schwannomas. METHODS The authors performed a retrospective analysis of patients who had undergone GKRS for intracranial tumors at their institute in the period from 2003 to 2010. Inclusion criteria were as follows: isolated AN paresis on presentation, a lesion along the course of the sixth CN, and imaging features characteristic of a schwannoma. Patients with other CN deficits and neurofibromatosis Type 2 were excluded. Symptomatic improvement was defined as the resolution of or an improvement in diplopia noted on a subjective basis or as an improvement in lateral eyeball excursion noted objectively on follow-up. A reduction in tumor volume by at least 20%, as noted by comparing the pre- and post-GKRS images, was deemed significant. RESULTS Six patients with a mean age of 37.1 years (range 17-55 years) underwent primary GKRS. There were 2 prepontine cistern, 3 cavernous sinus, and 1 cisterno-cavernous tumor. The mean duration of symptoms was 6.1 months (range 3-12 months). The mean tumor volume was 3.3 cm(3) (range 1.5-4.8 cm(3)). The mean tumor margin radiation dose was 12.5 Gy (range 12-14 Gy), while the median margin dose was 12 Gy (50% isodose line). The median number of isocenters used was 5 (range 4-8). The brainstem received an average 8.35-Gy radiation dosage (range 5.5-11 Gy). The mean follow-up duration was 44.3 months (range 24-78 months). Symptoms remained stable in 1 patient, improved in 3, and resolved in 2 (total improvement 83%). Magnetic resonance imaging at the last follow-up showed a stable tumor size in 3 patients (50%) and a reduction in the other 3

  2. Pancreatic schwannoma: Case report and an updated 30-year review of the literature yielding 47 cases

    Institute of Scientific and Technical Information of China (English)

    Toshiyuki Moriya; Wataru Kimura; Ichiro Hirai; Akiko Takeshita; Koji Tezuka; Toshihiro Watanabe; Masaomi Mizutani

    2012-01-01

    Pancreatic schwannomas are rare neoplasms.Authors briefly describe a 64-year-old female patient with cystic pancreatic schwannoma mimicking other cystic tumors and review the literature.Databases for PubMed were searched for English-language articles from 1980 to 2010 using a list of keywords,as well as references from review articles.Only 41 articles,including 47 cases,have been reported in the English literature.The mean age was 55.7 years (range 20-87 years),with 45% of patients being male.Mean tumor size was 6.2 cm (range 1-20 cm).Tumor location was the head (40%),head and body (6%),body (21%),body and tail (15%),tail (4%),and uncinate process (13%).Thirty-four percent of patients exhibited solid tumors and 60% of patients exhibited cystic tumors.Treatment included pancreaticoduodenectomy (32%),distal pancreatectomy (21%),enucleation (15%),unresectable (4%),refused operation (2%) and the detail of resection was not specified in 26% of patients.No patients died of disease with a mean follow-up of 15.7 mo (range 3-65 mo),although 5 (11%) patients had a malignancy.The tumor size was significantly related to malignant tumor (13.8 ± 6.2 cm for malignancy vs 5.5 ± 4.4 cm for benign,P =0.001)and cystic formation (7.9 ± 5.9 cm for cystic tumor vs 3.9± 2.4 cm for solid tumor,P =0.005).The preoperative diagnosis of pancreatic schwannoma remains difficult.Cystic pancreatic schwannomas should be considered in the differential diagnosis of cystic neoplasms and pseudocysts.In our case,intraoperative frozen section confirmed the diagnosis of a schwannoma.Simple enucleation may be adequate,if this is possible.

  3. Hypoglossal-Facial Nerve Reconstruction Using a Y-Tube-Conduit Reduces Aberrant Synkinetic Movements of the Orbicularis Oculi and Vibrissal Muscles in Rats

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    Yasemin Kaya

    2014-01-01

    Full Text Available The facial nerve is the most frequently damaged nerve in head and neck trauma. Patients undergoing facial nerve reconstruction often complain about disturbing abnormal synkinetic movements of the facial muscles (mass movements, synkinesis which are thought to result from misguided collateral branching of regenerating motor axons and reinnervation of inappropriate muscles. Here, we examined whether use of an aorta Y-tube conduit during reconstructive surgery after facial nerve injury reduces synkinesis of orbicularis oris (blink reflex and vibrissal (whisking musculature. The abdominal aorta plus its bifurcation was harvested (N = 12 for Y-tube conduits. Animal groups comprised intact animals (Group 1, those receiving hypoglossal-facial nerve end-to-end coaptation alone (HFA; Group 2, and those receiving hypoglossal-facial nerve reconstruction using a Y-tube (HFA-Y-tube, Group 3. Videotape motion analysis at 4 months showed that HFA-Y-tube group showed a reduced synkinesis of eyelid and whisker movements compared to HFA alone.

  4. Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years.

    Science.gov (United States)

    Dalla Toffola, Elena; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

    2014-01-01

    Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XIIVII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable.

  5. Prognostic factors in breast cancer with extracranial oligometastases and the appropriate role of radiation therapy

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    Yoo, Gyu Sang; Yu, Jeong Il; Park, Won; Huh, Seung Jae; Choi, Doo Ho [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    To identify prognostic factors for disease progression and survival of patients with extracranial oligometastatic breast cancer (EOMBC), and to investigate the role of radiation therapy (RT) for metastatic lesions. We retrospectively reviewed the medical records of 50 patients who had been diagnosed with EOMBC following standard treatment for primary breast cancer initially, and received RT for metastatic lesions, with or without other systemic therapy between January 2004 and December 2008. EOMBC was defined as breast cancer with five or less metastases involving any organs except the brain. All patients had bone metastasis (BM) and seven patients had pulmonary, hepatic, or lymph node metastasis. Median RT dose applied to metastatic lesions was 30 Gy (range, 20 to 60 Gy). The 5-year tumor local control (LC) and 3-year distant progression-free survival (DPFS) rate were 66.1% and 36.8%, respectively. High RT dose (> or =50 Gy10) was significantly associated with improved LC. The 5-year overall survival (OS) rate was 49%. Positive hormone receptor status, pathologic nodal stage of primary cancer, solitary BM, and whole-lesion RT (WLRT), defined as RT whose field encompassed entire extent of disease, were associated with better survival. On analysis for subgroup of solitary BM, high RT dose was significantly associated with improved LC and DPFS, shorter metastasis-to-RT interval (< or =1 month) with improved DPFS, and WLRT with improved DPFS and OS, respectively. High-dose RT in solitary BM status and WLRT have the potential to improve the progression-free survival and OS of patients with EOMBC.

  6. Management of blunt extracranial traumatic cerebrovascular injury: a multidisciplinary survey of current practice

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    Cava Luis P

    2011-04-01

    Full Text Available Abstract Background Extracranial traumatic cerebrovascular injury (TCVI is present in 1-3% of all blunt force trauma patients. Although options for the management of patients with these lesions include anticoagulation, antiplatelet agents, and endovascular treatment, the optimal management strategy for patients with these lesions is not yet established. Objective Multidisciplinary survey of clinicians about current management of TCVI. Methods A six-item multiple-choice survey was sent by electronic mail to a total of 11,784 neurosurgeons, trauma surgeons, stroke neurologists, and interventional radiologists. The survey included questions about their choice of imaging, medical management, and the use of endovascular techniques. Survey responses were analyzed according to stated specialty. Results Seven hundred eighty-five (6.7% responses were received. Overall, a total of 325 (42.8% respondents favored anticoagulation (heparin and/or warfarin, 247 (32.5% favored antiplatelet drugs, 130 (17.1% preferred both anticoagulation and antiplatelet drugs, and 57 (7.5% preferred stenting and/or embolization. Anticoagulation was the most commonly preferred treatment among vascular surgeons (56.9%, neurologists (50.2% and neurosurgeons (40.7%, whereas antiplatelet agents were the most common preferred treatment among trauma surgeons (41.5%. Overall, 158 (20.7% of respondents recommended treatment of asymptomatic dissections and traumatic aneurysms, 211 (27.7% did not recommend it, and 39.4% recommended endovascular treatment only if there is worsening of the lesion on follow-up imaging. Conclusions These data demonstrate the wide variability of physicians' management of traumatic cerebrovascular injury, both on an individual basis, and between specialties. These findings underscore the need for multicenter, randomized trials in this field.

  7. Quantitative analysis of continuous intracranial pressure recordings in symptomatic patients with extracranial shunts.

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    Eide, P K

    2003-02-01

    To explore the outcome of management of possible shunt related symptoms using intracranial pressure (ICP) monitoring, and to identify potential methodological limitations with the current strategies of ICP assessment. The distribution of persistent symptoms related to extracranial shunt treatment was compared before and after management of shunt failure in 69 consecutive hydrocephalic cases. Management was heavily based on ICP monitoring (calculation of mean ICP and visual determination of plateau waves). After the end of patient management, all ICP curves were re-evaluated using a quantitative method and software (Sensometrics pressure analyser). The ICP curves were presented as a matrix of numbers of ICP elevations (20 to 35 mm Hg) or depressions (-10 to -5 mm Hg) of different durations (0.5, 1, or 5 minutes). The numbers of ICP elevations/depressions standardised to 10 hours recording time were calculated to allow comparisons of ICP between individuals. After ICP monitoring and management of the putative shunt related symptoms, the symptoms remained unchanged in as many as 58% of the cases, with the highest percentages in those patients with ICP considered normal or too low at the time of ICP monitoring. The quantitative analysis revealed a high frequency of ICP elevations (20 to 35 mm Hg lasting 0.5 to 1 minute) and ICP depressions (-10 to -5 mm Hg lasting 0.5, 1, or 5 minutes), particularly in patients with ICP considered normal. The value of continuous ICP monitoring with ICP analysis using current criteria appears doubtful in the management of possible shunt related symptoms. This may reflect limitations in the strategies of ICP analysis. Calculation of the exact numbers of ICP elevations and depressions may provide a more accurate description of the ICP profile.

  8. Comparison of Morphometric Aspects of Light and Electron Microscopy of the Hypoglossal Nerve between Young and Aged Male Wistar Rats

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    Mohsen Pourghasem

    2012-01-01

    Full Text Available Objective: Age-related changes occur in many different systems of the body. Many elderlypeople show dysphagia and dysphonia. This research was conducted to evaluatequantitatively the morphometrical changes of the hypoglossal nerve resulting from theaging process in young and aged rats.Materials and Methods: Through an experimental study ten male wistar rats (4 months: 5rats, 24 months: 5 rats were selected randomly from a colony of wistars in the UWC. Aftera fixation process and preparation of samples of the cervical portion of the hypoglossalnerve of these rats, light and electron microscopic imaging were performed. These imageswere evaluated according to the numbers and size of myelinated nerve fibers, nucleoli ofSchwann cells, myelin sheath thickness, axon diameter, and g ratio. All data were analyzedby Mann-Whitney, a non-parametric statistical test.Results: In light microscope, numbers of myelinated nerve fibers, the mean entire nerveperimeters, the mean entire nerve areas and the mean entire nerve diameters in youngand aged rats’ were not significantly different between the two groups.In electron microscope, numbers of myelinated axons, numbers of Schwann cell nucleoliand the mean g ratios of myelinated axon to Schwann cell in young and aged rats werenot significantly different. The myelinated fiber diameters, the myelin sheath thicknesses,myelinated axon diameters and the mean g ratio of axon diameter to myelinated fiberdiameter in young and aged fibers were significantly differentConclusion: The mean g ratio of myelinated nerve fibers of peripheral nerves stabilizes atthe level of 0.6 after maturation and persists without major change during adulthood. Thisratio of axon diameter to fiber diameter (0.6 is optimum for normal conduction velocity ofneural impulses. Our study indicated that the g ratio of myelinated nerve fiber of the hypoglossalnerve decreased prominently in aged rats and can be a cause of impairment innerve function in

  9. Schwannoma maligno do palato mole: a propósito de um caso clínico

    OpenAIRE

    2011-01-01

    Os Schwannomas são tumores benignos das células de Schwann das bainhas dos nervos periféricos. Podem ter origem em diferentes tipos de nervos e podem ser encontrados na porção intra, extra, ou transcraniana. Uma local ização rara é a cavidade oral. O prognóstico do schwannoma é bastante favorável e a remoção cirúrgica conservadora é o tratamento de eleição. A transformação maligna de schwannomas benignos é rara e apesar de indicada a quimioterapia e radioterapia pósoperatória, o s...

  10. Stent Graft-in-Stent Graft as a Rescue Technique for Endovascular Treatment of Giant Extracranial Internal Carotid Aneurysm

    Science.gov (United States)

    Jeha, Salim Abdon Haber

    2016-01-01

    Endovascular treatment of a giant extracranial internal carotid aneurysm by a stent graft implantation was unsuccessful due to a high flow leak directly through the stent graft's coating. The problem was solved deploying a second stent graft inside the previously implanted one resulting in complete exclusion of the aneurysmal sac and patent carotid lumen preservation. The review of the literature did not provide a case using this endovascular strategy. Follow-up for more than 12 months, using CT angiography, showed confirmed aneurysmal exclusion and carotid patency and no clinical complications have been detected. PMID:27752387

  11. 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.

  12. Imaging recommendation of extracranial glioblastoma%颅外胶质母细胞瘤的影像学检查方法推荐

    Institute of Scientific and Technical Information of China (English)

    武春雪; 马军

    2015-01-01

    Extracranial glioblastoma should draw enough attention due to its inlfuences on patient management and prognosis. In this article, a wide spectrum of extracranial manifestations of glioblastoma and recommendation for the imaging evaluation of extracranial glioblastoma are reviewed, for the purpose of advisory for related research and clinical practice.%颅外胶质母细胞瘤影像诊断影响治疗与预后,应给予足够的重视。作者对颅外胶质母细胞瘤的疾病谱及其影像学特征做一归纳,也对其各种颅外胶质母细胞瘤的影像学方法做了讨论,旨在对相关研究和临床工作有一定帮助。

  13. 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

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

    OpenAIRE

    S. Cortés; 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,...

  15. 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

  16. 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

  17. 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.

  18. Auditory midbrain implant: a combined approach for vestibular schwannoma surgery and device implantation.

    Science.gov (United States)

    Samii, Amir; Lenarz, Minoo; Majdani, Omid; Lim, Hubert H; Samii, Madjid; Lenarz, Thomas

    2007-01-01

    The lateral suboccipital approach is a well-established route for safe removal of vestibular schwannomas in neurofibromatosis Type 2 (NF2) patients. The goal of this study was to assess if this approach can be extended to a lateral supracerebellar infratentorial approach to enable insertion of an auditory midbrain implant (AMI) penetrating array along the tonotopic gradient of the inferior colliculus central nucleus (ICC). The AMI is a new auditory prosthesis designed for penetrating stimulation of the ICC in patients with neural deafness. The initial candidates are NF2 patients who, because of the growth and/or surgical removal of bilateral acoustic neuromas, develop neural deafness and are unable to benefit from cochlear implants. The ideal surgical approach in NF2 patients must first enable safe removal of vestibular schwannomas and then provide sufficient exposure of the midbrain for AMI implantation. This study was performed on formalin-fixed and fresh cadaver specimens. Computed tomography scan and magnetic resonance imaging were used to study the heads of the specimens and for surgical navigation. The lateral suboccipital craniotomy enabled sufficient exposure of the cerebellopontine angle and internal auditory canal for tumor removal. It could then be extended to a lateral supracerebellar infratentorial approach that provided good exposure of the dorsolateral aspect of the tentorial hiatus and mesencephalon for implantation of the AMI along the tonotopic gradient of the ICC. This approach did not endanger the trochlear nerve or any major midline venous structures in the quadrigeminal cistern. This modified lateral suboccipital approach ensures safe removal of large vestibular schwannomas and provides sufficient exposure of the inferior colliculus for ideal AMI implantation.

  19. Evaluation of Reported Malignant Transformation of Vestibular Schwannoma: De Novo and After Stereotactic Radiosurgery or Surgery.

    Science.gov (United States)

    Maducdoc, Marlon M; Ghavami, Yaser; Linskey, Mark E; Djalilian, Hamid R

    2015-09-01

    To critically analyze each reported case of malignant transformation of vestibular schwannoma (VS) after either stereotactic radiosurgery (SRS) or microsurgery (MS). We searched the Pubmed/Medline database using the relevant key words vestibular schwannoma, acoustic neuroma, malignant, transformation, radiation, induced, stereotactic, radiosurgery, malignancy, GammaKnife, and CyberKnife and combinations thereof. Inclusion criteria for malignant transformation of VS after SRS included histopathology of initially benign VS, subsequent histopathology confirming malignant VS, reasonable latency period between malignancy and benign diagnoses. A neurotologist and a skull base neurosurgeon independently assessed each case report for quality, entry, exclusion criteria, and comparability of extracted data. We calculated median age, latency times, and survival times for each case report. Malignant transformation has been documented to occur after either SRS or MS. Eight cases were included that showed histopathologic evidence of malignant transformation after SRS and MS. Four cases of malignant transformation were included that demonstrated malignant transformation after MS only. Malignant transformation of VS can also occur de novo, and de novo malignant VSs are also encountered, which can confound a causal inference from either SRS or MS. Eighteen cases of primary malignant VS were included. Studies that were identified but not included in the review are summarized and tabulated. We found 12 studies of malignant transformation associated with NF2. The potential mechanism leading to malignant transformation of VS seems more obvious for SRS and is less understood for MS. Given a low incidence of de novo malignant schwannoma, the possibility that these are spontaneous events in either setting cannot be ruled out. Risk of malignant transformation of VS after either SRS or MS is not zero; however, the magnitude of this risk is probably minimal based on the evidence from eight

  20. Lack of NF1 gene expression in a sporadic schwannoma from a patient without neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Norton, K.K.; Dowton, B. [St. Louis Childrens Hospital, MO (United States); Silow-Santiago, I. [Washington Univ. School of Medicine, St. Louis, MO (United States)] [and others

    1994-09-01

    The neurofibromatosis type 1 (NF1) gene encodes a tumor suppressor protein, neurofibromin, which is expressed at high levels in Schwann cells and other adult tissues. Loss of NF1 gene expression has been reported in Schwann cell tumors (neurofibrosarcomas) from patients with NF1 and its loss is associated with increased proliferation of these cells. We examined one spinal schwannoma from a patient without clinical features of neurofibromatosis type 1 or 2. The tumor was a typical schwannoma confirmed by standard neuropathologic criteria and expressed S100 by immunocytochemistry. NF1 gene expression in this tumor was examined by in situ hybridization using an NF1-specific riboprobe, Northern blot analysis and reverse-transcribed (RT) PCR. Little or no expression of NF1 RNA could be detected using these methods whereas abundant expression of S100, cyclophilin and beta-action RNA was found in the tumor. Fibroblast and Schwann cells were then individually cultured from this schwannoma and the RNA extracted for Northern blot and RT-PCR analysis. In these cultured Schwann cells both from early and late passages, abundant expression of NF1 RNA could be detected. It is unlikely that our culture technique preferentially expanded {open_quotes}normal{close_quotes} Schwann cells, since NF1 acts as a tumor suppressor gene and its presence would not confer any growth advantage over the tumor-derived, neurofibromin-negative Schwann cells which presumably have an increased proliferation rate. Similarly, the conditions used to expand these Schwann cells do not result in increased NF1 gene expression as shown in previous studies. These results suggest that, in some tumors, expression of the NF1 gene can be downregulated by factors produced within the tumor and that this type of tumor suppressor gene downregulation may represent another mechanism other than mutation for turning off the expression of these growth-suppressing genes and allowing for cell proliferation in tumors.

  1. 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.

  2. 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.”

  3. 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.

  4. Schwannoma intralaberíntico. Descripción de un caso

    OpenAIRE

    2016-01-01

    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 sí...

  5. Isolated spinal accessory neuropathy and intracisternal schwannomas of the spinal accessory nerve

    Directory of Open Access Journals (Sweden)

    Abdullah M. Al-Ajmi

    2015-03-01

    Full Text Available We report a 40-year-old female patient presenting with isolated left spinal accessory neuropathy that developed insidiously over 6 years. She complained of ill-defined deep neck and shoulder pain. On examination, prominent sternocleidomastoid and trapezoid muscle weakness and atrophy, shoulder instability, and lateral scapular winging were observed. MRI identified a small mass of the cisternal portion of the spinal accessory nerve. Its appearance was typical of schwannoma. Surgical treatment was not offered because of the small tumor size, lack of mass effect and the questionable functional recovery in the presence of muscular atrophy.

  6. Schwannoma of the tongue in a ten-year old child.

    Science.gov (United States)

    Husain, Salina; Husain, Salima; Yunus, Mohammad Razif Muhammad; Yunus, Mohammad Razif Mohammad; Ramli, Roszalina; Ramli, Rozalina; Athar, Primuharsa Putra Sabir Husin

    2011-05-01

    The case of a 10-year-old girl is presented who had a slow-growing, painless swelling on the left side of the tongue since six months. This was associated with disturbances in mastication and phonation. Examination revealed a 5 cm x 4 cm. globular smooth, mobile mass on left side of the tongue. There was no neurological deficit and no neck nodes palpable. She underwent excision of the mass under general anaesthesia. Complete enucleation with primary closure was carried out. The patient had an uneventful postoperative recovery and histological evaluation was consistent with schwannoma. The patient was recurrence free after one year.

  7. Submandibular approach for excision of a large schwannoma in the base of the tongue.

    Science.gov (United States)

    de Bree, R; Westerveld, G J; Smeele, L E

    2000-01-01

    A 24-year-old Turkish woman is described, who gradually developed progressive swallowing problems over 6 months due to a tumor in the base of the tongue. Magnetic resonance imaging showed a large well-circumscribed solid mass. Histopathological examination of an incisional biopsy showed a schwannoma. The tumor was completely removed through a submandibular approach. The postoperative course was uneventful and her complaints disappeared. The submandibular approach used gave an excellent exposure of the base of tongue with a less obvious scar than a lip-splitting incision.

  8. Aortic arch and intra-/extracranial cerebral arterial atherosclerosis in patients suffering acute ischemic strokes

    Institute of Scientific and Technical Information of China (English)

    郭毅; 姜昕; 陈实; 张少文; 赵宏文; 吴瑛

    2003-01-01

    Objective To determine the distribution of aortic arch and intra/extracranial cerebral arterial atherosclerosis in Chinese patients who had suffered acute ischemic strokes. Methods Eighty-nine patients with acute ischemic strokes were included in this study. Transesophageal echocardiography (TEE) was used to evaluate potential sources of embolisms in the aortic arch and in the heart; duplex ultrasound was used for the carotid artery; and intracranial Doppler (TCD) imaging was used for the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). An atherosclerotic lesion in the aortic arch was defined as normal (0); mild plaque (1); moderate plaque (2); and protruding plaque or mobile plaque (3). A lesion in the carotid artery was considered a plaque if the maximal carotid plaque thickness was 1.2 mm. TCD results were deemed abnormal if flow velocity was either greater or lower than normal, and, in the case of the MCA, if an asymmetry index above 21% was measured. Results Of the 89 patients, 52 (58.43%) patients showed evidence of aortic arch atherosclerosis (AAA), including 11 (12.36%) patients graded mild, 18 (20.22%) patients graded moderate, and 23 (25.84%) patients graded severe. Of the 23 patients with severe AAA, AAA was determined to be an important potential embolic source in 14 patients. Forty-nine (50.56%) patients had carotid arterial plaques (CAPs). The incidence of carotid plaques was higher among patients with AAA than among patients without AAA (71.15% vs 21.62%, OR=3.291, 95% CI=1.740-6.225, P<0.001). TCD abnormalities affecting the MCA were found in 54 (60.67%) patients. Differences in incidence of TCD abnormalities between patients with AAA and without AAA (69.23% vs 48.65%) were not significant (OR=1.423, 95% CI=0.976-2.076, P=0.05). There was a higher incidence of AAA in older, male patients with a history of diabetes and smoking. Conclusions AAA is an important potential source of

  9. Extracranial metastasizing solitary fibrous tumors (SFT) of meninges: histopathological features of a case with long-term follow-up.

    Science.gov (United States)

    Gessi, Marco; Gielen, Gerrit H; Roeder-Geyer, Eva-Dorette; Sommer, Clemens; Vieth, Michael; Braun, Veit; Kuchelmeister, Klaus; Pietsch, Torsten

    2013-02-01

    Extrapleural solitary fibrous tumors are uncommon mesenchymal neoplasms frequently observed in middle-aged adults and are classified, according to the WHO classification of soft tissue tumors, as part of the hemangiopericytoma tumor group. However, these two entities remain separated in the WHO classification of tumors of the central nervous system. In fact, meningeal solitary fibrous tumors are believed to be benign lesion and only in a minority of cases local relapses have been described, although detailed survival clinical studies on solitary fibrous tumors of meninges are rare. In contrast to hemangiopericytoma, which frequently shows distant extracranial metastases, such an event is exceptional in patients with meningeal solitary fibrous tumors and has been clinically reported in a handful of cases only and their histopathological features have not been investigated in detail. In this report, we describe the detailed clinico-pathological features of a meningeal solitary fibrous tumor presenting during a 17-year follow-up period, multiple intra-, extracranial relapses and lung metastases.

  10. Schwannoma benigno do mediastino posterior com desenvolvimento em ampulheta para a traquéia Benign schwannoma of the posterior mediastinum with a dumbbell-shaped lesion traversing the trachea

    Directory of Open Access Journals (Sweden)

    FERNANDO LUIZ WESTPHAL

    2002-06-01

    Full Text Available O schwannoma benigno é um dos tumores mais comuns do mediastino posterior, sendo que durante o seu crescimento pode haver envolvimento do canal medular em forma de ampulheta e, mais raramente, isso pode ocorrer na árvore traqueobrônquica. É relatado um caso de uma mulher de 45 anos, portadora de schwannoma benigno de mediastino posterior, com padrão de desenvolvimento em ampulheta para a parede póstero-lateral direita da traquéia. O tratamento foi realizado por meio da ressecção endoscópica da porção intratraqueal e a tumoração mediastinal foi ressecada por toracotomia. Oito meses após o procedimento não foi evidenciada recidiva da lesão.Benign schwannoma tumors are the most common primary tumors of the posterior mediastinum. They may develop into a dumbbell-shaped involvement of the medullar channel, but rarely reach the tracheobronchial tree. The authors report a case of a 45-year-old female patient with a benign schwannoma in the posterior mediastinum, with a dumbbell-shaped lesion that traverses the intercartilaginous septa of the trachea. The tumor was resected by endoscopy in the endotracheal portion and afterwards by thoracotomy of the mediastinal tumor. Eight months after the surgery, there has been no recurrence of the lesion.

  11. 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

  12. 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

  13. 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.

  14. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease

    Directory of Open Access Journals (Sweden)

    Patrick Scott

    2016-05-01

    Full Text Available 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.

  15. 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

  16. 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

  17. Angiosarcoma arising in schwannoma of cerebellopontine angle and later associating with meningioma in a patient with neurofibromatosis type 2.

    Science.gov (United States)

    Sakai, Yasuhiro; Hirose, Takanori; Tomono, Ayako; Kawakami, Fumi; Nakai, Tokiko; Ohbayashi, Chiho; Mizowaki, Takashi; Tanaka, Kazuhiro; Kohmura, Eiji; Itoh, Tomoo

    2014-10-01

    Here, we describe an extremely rare case of angiosarcoma arising in schwannoma of the cerebellopontine angle and later associating with meningioma in a patient with neurofibromatosis type 2. A 33-year-old disabled Japanese man with right drop foot after surgery for an unspecified tumor demonstrated multiple tumors, suspected to be schwannoma, in the bilateral cerebellopontine angles, the cervical and lumbar spinal cord, and on the right nuchal skin. Also present were several tumors in the medulla and thoracic spinal cord suspected to be ependymoma or astrocytoma. The patient was diagnosed with neurofibromatosis type 2 according to the diagnostic criteria by the U.S. National Institutes of Health. The bilateral tumors in the cerebellopontine angle were resected to reduce symptoms and brain stem compression. Histopathological analysis revealed angiosarcoma arising in schwannoma of the bilateral tumors, and angiosarcoma was proportionally larger in the right tumor than in the left. At age 36, the patient underwent a second resection of the regrown tumor in the left cerebellopontine angle, and histopathology demonstrated mixed angiosarcoma and meningioma. That angiosarcoma arises in schwannoma is a pathogenesis within the realm of conjecture, especially that the phenomenon of mixed meningioma and angiosarcoma has not been reported to date.

  18. 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

  19. 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.

  20. 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....