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Sample records for schwannoma detected incidentally

  1. [Gastric schwannoma: a "typical" clinical course?].

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    Kessler, W; Schreiber, A; Glitsch, A; Evert, M; Puls, R; Patrzyk, M; Heidecke, C-D

    2009-01-01

    Intra-abdominal schwannoma is a rare tumor entity. Although often detected incidentally, its diagnosis and surgical planning are difficult-as with all intramural intra-abdominal tumors. Puncturing is often not satisfying due to the inhomogeneous proliferation rates of different regions of the tumor. We describe the procedure using the example of a gastric schwannoma that was found incidentally. The leading symptom was perforation of a peptic stomach ulcer.

  2. Retroperitoneal schwannoma

    OpenAIRE

    Kapan, M; ?nder, A; G?m??, M; G?m??, H; Girgin, S

    2011-01-01

    Retroperitoneal schwannomas are rare tumors and a correct pre-operative diagnosis is often not possible. They are usually identified incidentally via cross-sectional imaging. Diagnosis is based on histopathologic examination and immunohistochemistry. A 57-year-old man with a retroperitoneal schwannoma, as an unusual localisation, is presented.

  3. Retroperitoneal schwannomas

    OpenAIRE

    Veliovits, Dousan; Fiska, Aliki; Zorbas, Georgios; Tentes, Antonios-Apostolos K.

    2012-01-01

    Summary Background: Retroperitoneal schwannomas are very rare and are usually found incidentally. Cases Report: Two rare cases of retroperitoneal schwannomas are reported. Both were incidentally found during US scans for non-specific epigastric pain and were initially diagnosed as non-secreting retroperitoneal tumors. The diagnosis was confirmed by CT scan. In both patients the tumors were resected. The definitive diagnosis was possible by histopathology. Conclusions: Although the preoperativ...

  4. Adrenal Schwannomas: Rare Tumor of the Retroperitoneum

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    Emanuele Grasso

    2015-01-01

    Full Text Available Schwannoma is a benign neurogenic tumor originating from Schwann cells. These produce the myelin sheath that covers peripheral nerves that are often affected. This latter localization is extremely rare, and only a few case reports can be found in the medical literature. Studies have shown that approximately 0.5% to 5% of schwannomas are retroperitoneal, constituting 0.2% of adrenal incidental tumors. These usually present as incidental findings, nonsecreting adrenal masses in asymptomatic patients. Diagnosis of a schwannoma is based on detection of spindle cells with Antoni A and Antoni B regions in histological sections and positive staining for S-100 protein by immunohistochemical analysis. We report a case of an incidentally identified during an abdominal ultrasound examination with schwannoma localized in the left adrenal gland.

  5. Retroperitoneal Schwannoma: A Rare Case

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    Murat Kalaycı

    2011-01-01

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

  6. Clinical and CT manifestation of pleural schwannoma

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    Hu, Shudong [Department of Radiology, The Affiliated Renmin Hospital, Jiangsu University, Zhenjiang, Jiangsu (China); Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai (China); Chen, Yerong; Wang, Yafei [Department of Radiology, The Affiliated Renmin Hospital, Jiangsu University, Zhenjiang, Jiangsu (China); Chen, Ke Min; Song, Qi [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai (China)], E-mail: anchorzjrj@yahoo.cn

    2012-12-15

    Background. A schwannoma arising from the pleura is rare. The computer tomography (CT) features, however, have seldom been disclosed in the English literature. Purpose. To retrospectively assess the role of CT in the diagnosis of pleural schwannomas. Material and Methods. Eleven patients with pathologically confirmed pleural schwannomas were included in the study. CT images and clinical data were analyzed. The CT features emphasized included the location of the neoplasm, as well as its diameter, origin, margin, shape, attenuation, enhancement pattern, and extent and invasion into adjacent structures, all of which were observed and recorded. Results. Seven patients were men, while four were women; patients were aged 21-60 years, with a mean age of 45 years. Most cases were incidentally detected. Seven cases involved neoplasms located in the right hemithorax whereas four cases involved neoplasms in the left hemithorax. The mean tumor diameter was 4.4 cm (range, 2.3-6.4 cm). All of the tumors were solitary and well-defined ovoid (n = 7) or round (n = 4) in shape. The schwannomas showed isoattenuation (four cases) or mild hypoattenuation (seven cases) to the chest wall muscle on unenhanced CT. All cases showed minimal enhancement on contrast-medium-enhanced CT. Two bony erosions of the rib were also observed. Conclusion. CT findings may suggest the diagnosis of pleural schwannoma preoperatively. Pleural schwannoma should be included in the differential diagnosis of solid, solitary, and well-defined pleural tumors.

  7. An Incidentally Detected Right Ventricular Pseudoaneurysm

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    Vamsi C. Gaddipati

    2017-01-01

    Full Text Available Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

  8. Gastric Schwannoma: A Benign Tumor Often Misdiagnosed as Gastrointestinal Stromal Tumor.

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    Shah, Apurva S; Rathi, Pravin M; Somani, Vaibhav S; Mulani, Astha M

    2015-09-28

    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.

  9. 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.

  10. Retroperitoneal ancient schwannoma: Two cases and review of literature

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    Ranganath Ratnagiri

    2014-01-01

    Full Text Available Ancient Schwannomas are rare variants of tumors which arise from the peri-neural Schwann cells. These tumors are termed "ancient" because of the degenerative features acquired with increasing age in these tumors. They are benign, slow growing and usually detected only incidentally or due to local symptoms. Some tumors may demonstrate nuclear atypia, and may be mistakenly termed malignant. Malignant change is usually associated with von Recklinghausen′s syndrome in 5% to 18% of cases. Retroperitoneal schwannomas account for only 0.5% to 5% of all cases and are extremely uncommon. They are well encapsulated and recurrences following complete surgical excision are uncommon.

  11. Hybrid schwannoma-perineurioma of the gastrointestinal tract: a clinicopathologic study of 2 cases and reappraisal of perineurial cells in gastrointestinal schwannomas.

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    Agaimy, Abbas; Michal, Michal

    2011-10-01

    Soft tissue neoplasms with features of both schwannoma and perineurioma (hybrid schwannoma-perineurioma) have been increasingly recognized in recent years. To date, only a single case of this entity has been documented in the gastrointestinal tract (sigmoid colon). We herein describe 2 new cases of this entity. For comparison, we reevaluated 12 classic gastrointestinal schwannomas for the perineurial cell component. The 2 hybrid schwannoma-perineuriomas were detected incidentally in the gastric antrum and the vermiform appendix in a 50-year-old woman and a 17-year-old man during surgery for gastric GIST and appendicitis-like symptoms, respectively. None of the patients had neurofibromatosis 1 or 2. Patients were alive with no evidence of recurrence or new tumors at 8 and 12 months, respectively. The tumors measured 1.2 cm and 1.5 cm in size. Histologically, they showed prominent storiform, lamellar, and fascicular patterns. Notably, both lacked peripheral lymphoid cuffs and the trabecular pattern of gastrointestinal schwannomas. Both tumors coexpressed protein S100 (≥80%), CD34 (80%), and the perineurial cell markers (20% to 40% of tumor cells). The perineurial cell component formed alternating fascicles with S100-positive cells throughout the neoplasm. Reevaluation of 12 classic gastrointestinal schwannomas showed isolated claudin-1/epithelial membrane antigen-positive cells. However, 4 schwannomas (33%) strongly expressed glucose transporter-1 in most of the tumor cells indicating its limited specificity in this setting. Compared with gastrointestinal schwannomas, CD34 expression was stronger and more diffuse in hybrid schwannoma-perineuriomas. We conclude that hybrid schwannoma-perineuriomas are distinct from gastrointestinal schwannoma, both histologically and immunohistochemically.

  12. 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.

  13. Retroperitoneal schwannoma

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    Somnath Gooptu

    2015-01-01

    Full Text Available Schwannomas are rare tumors that arise from the Schwann sheath of nerves. They are commonly seen in the head and neck region and in both extremities. However, retroperitoneal schwannomas are a rare entity. We report a case of a 35-year-old female presenting with a lump in the right lumbar region. She had loss of sensations over the L3-L4 dermatomes. Computerized tomography of the abdomen and pelvis revealed a mass of size 7.1 cm 7.1 cm 8.3 cm posterior to the right psoas muscle extending superiorly to the lower pole of the right kidney with its anterior displacement. There was narrowing of the right L3-L4 neural foramina. The mass was completely excised. It was diagnosed as benign schwannoma on histopathology examination. Post-operatively, the patient had shown recovery. In a 1-year follow-up post resection, the patient has not shown any evidence of recurrence. Most of the schwannomas are benign and hence follow-up is necessary to detect and prevent recurrence.

  14. Gorlin syndrome - an incidental radiographic detection

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    Shishir Ram Shetty

    2011-02-01

    Full Text Available Gorlin-Goltz syndrome (also known as nevoid basal cell carcinoma syndrome was first reported in 1894, but described by Gorlin and Goltz in 1960 as a distinct entity consisting of ectodermal and mesodermal abnormalities. It is an hereditary autosomal dominant disease with a prevalence estimated in various studies to be between 1/57 000 and 1/256 000, and a male:female ratio of 1:1. We describe in brief the important radiological features of an accidentally detected case of Gorlin syndrome in the form of a pictorial interlude.

  15. Incidental Detection of Late Subsequent Intracranial Neoplasms with Magnetic Resonance Imaging Among Adult Survivors of Childhood Cancer

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    Sabin, Noah D.; Santucci, Aimee K.; Klimo, Paul; Hudson, Melissa M.; Srivastava, Deokumar; Zhang, Nan; Kun, Larry E.; Krasin, Matthew J.; Pui, Ching-Hon; Patay, Zoltan; Reddick, Wilburn E.; Ogg, Robert J.; Hillenbrand, Claudia M.; Robison, Leslie L.; Krull, Kevin R.; Armstrong, Gregory T.

    2014-01-01

    Purpose Survivors of childhood cancer are at increased risk of developing subsequent neoplasms. In long term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. 164 of the survivors had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT), and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results Nineteen of the 219 survivors (8.7%) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-46 years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4% (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial

  16. Computed Tomography Features of Incidentally Detected Diffuse Thyroid Disease

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    Myung Ho Rho

    2014-01-01

    Full Text Available Objective. This study aimed to evaluate the CT features of incidentally detected DTD in the patients who underwent thyroidectomy and to assess the diagnostic accuracy of CT diagnosis. Methods. We enrolled 209 consecutive patients who received preoperative neck CT and subsequent thyroid surgery. Neck CT in each case was retrospectively investigated by a single radiologist. We evaluated the diagnostic accuracy of individual CT features and the cut-off CT criteria for detecting DTD by comparing the CT features with histopathological results. Results. Histopathological examination of the 209 cases revealed normal thyroid (n=157, Hashimoto thyroiditis (n=17, non-Hashimoto lymphocytic thyroiditis (n=34, and diffuse hyperplasia (n=1. The CT features suggestive of DTD included low attenuation, inhomogeneous attenuation, increased glandular size, lobulated margin, and inhomogeneous enhancement. ROC curve analysis revealed that CT diagnosis of DTD based on the CT classification of “3 or more” abnormal CT features was superior. When the “3 or more” CT classification was selected, the sensitivity, specificity, positive and negative predictive values, and accuracy of CT diagnosis for DTD were 55.8%, 95.5%, 80.6%, 86.7%, and 85.6%, respectively. Conclusion. Neck CT may be helpful for the detection of incidental DTD.

  17. High Resolution Three-Dimensional Delayed Contrast MRI Detects Endolymphatic Hydrops in Patients With Vertigo and Vestibular Schwannoma.

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    Moayer, Roxana; Ishiyama, Gail P; Karnezis, Stellios; Sepahdari, Ali R; Ishiyama, Akira

    2018-01-01

    Advances in high resolution magnetic resonance imaging (MRI) have enabled the detection of endolymphatic hydrops (EH), a pathological ballooning of the endolymphatic fluid system, known to be associated with Menière's disease. When a patient has a known diagnosis of vestibular schwannoma and develops recurrent episodic vertigo spells, many surgeons recommend surgical intervention, attributing the vestibular symptoms to the vestibular schwannoma. The aim of this study is to evaluate the clinical outcome in patients with vestibular schwannoma and EH, treated medically, for recurrent spells of vertigo. Two patients with EH and vestibular schwannoma who presented with recurrent spells of vertigo are included. Both had characteristic low frequency hearing loss ipsilateral to the schwannoma. MRI sequences with 3T scanner (Skyra, Siemens Healthcare, Erlangen, Germany) using high resolution three-dimensional delayed postcontrast protocol included "cisternographic" T2 and delayed intravenous-enhanced three-dimensional fluid-attenuation inversion recovery (DIVE-3D-FLAIR) sequences, performed with 2350 ms (bright perilymph) and 2050 ms (bright endolymph) inversion times and with subtracted images. MRI FLAIR evaluation of EH and presence or absence of vestibular symptoms. Both patients had resolution of the disabling vertigo spells with a diuretic, and Patient 1 had unchanged EH, while Patient 2 had partial resolution of the EH and the FLAIR hyperintensity. When EH coexists with vestibular schwannoma in a patient presenting with recurrent vertigo spells, medical treatments for EH may alleviate the vestibular symptoms. We recommend that patients with small vestibular schwannomas who present with vertigo spells undergo high resolution MRI to evaluate for EH and undergo a trial of medical treatment with diuretics.

  18. Positron emission tomography of incidentally detected small pulmonary nodules

    DEFF Research Database (Denmark)

    Fischer, B M; Mortensen, J; Dirksen, A

    2004-01-01

    from an ongoing 4-year placebo controlled intervention study of the effect of inhaled steroids in 300 smokers with moderate to severe chronic obstructive pulmonary disease. The participants received yearly CT scans of the chest. Patients with a negative chest radiograph at the time of inclusion......The aim of this study was to assess the value of fluorodeoxyglucose positron emission tomography (FDG PET) imaging of small pulmonary nodules incidentally detected by spiral computed tomography (CT) in a high-risk population. Ten patients (five females, five males, aged 54-72 years) were recruited......, but with pulmonary nodules indeterminate for malignancy detected by conventional spiral CT on a subsequent scan, were referred for FDG PET. Histological diagnoses were sought for all nodules with FDG uptake or where CT showed that they had grown. Ten patients had pulmonary nodules indeterminate for malignancy...

  19. Direct detection of incidental asymptomatic aneurysm by computed tomography

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    Asari, S.; Sakurai, M.; Yamamoto, Y.; Suzuki, K. (Matsuyama Shimin Hospital, Ehime (Japan)); Sadamoto, K.

    1981-02-01

    Incidental asymptomatic aneurysms were found in 9 of 52 patients with intracranial aneurysms from February, 1978 to March, 1980. They had only mild initial symptoms, namely, headache, dysarthria, aphasis, light hemiparesis and others. No patients had severe neurological deficits. In eight of 9 patients with asymptomatic aneurysm, except one case of hypertensive intracerebral hematoma, 9 aneurysms (8 patients) were directly detected by high resolution CT (GE CT/T 8800) and confirmed by angiography. Location of these aneurysms as follows: three at the middle cerebral artery trifurcation, two at the internal carotisposterior communicans junction, one at anterior communication artery, one at the basilar top, one at the basilaris artery-superior cerebelli artery junction and one at the posterior cerebral artery. The smallest aneurysm detected by CT as 5 x 4 x 4 mm in size on angiography. The aneurysm may be suggested by small round or oval defect in the Sylvian fissure or suprasellar cistern, defect of the edge of the so called ''pentagon'' in the plain CT and then if its density is highly and homogeneously increased after contrast-enhanced (CE) scan. As the circle of Willis and other major cerebral arteries can often be demonstrated on CE.CT images, the aneurysm is frequently seen on these cerebral arteries. Limiting factors to direct CT detection of intracranial aneurysms are seemed to be size and location of aneurysm, anatomic location of circle of Willis and motion of patients etc. It may be considered, in our experiences, that the CT is useful in diagnosis of asymptomatic aneurysm and the higher direct CT detection rate to aneurysms, small or medium sized as well as giant aneurysms, will be obtained by devising scanning method, namely, multiprojection scans, multiple overlapping method and improvement of enhanced method.

  20. Schwannoma of the nasal septum

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    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.

  1. Incidentally detected lung nodules: clinical predictors of adherence to fleischner society surveillance guidelines.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2014-02-28

    The objective of this study was to determine adherence to incidentally detected lung nodule computed tomographic (CT) surveillance recommendations and identify demographic and clinical factors that increase the likelihood of CT surveillance.

  2. Detection of synchronous gastric schwannoma on FDG PET/CT aided by discordant metabolic response.

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    Yap, June; Huang, Yi-Tung Tom; Lin, Michael

    2015-05-01

    This is a case of an unsuspected synchronous gastric schwannoma demonstrating increased F-FDG accumulation on PET/CT in a 65-year-old female patient diagnosed with non-Hodgkin lymphoma on the basis of different metabolic activity to other sites of disease at staging and discordant metabolic response to therapy. The gastric schwannoma was confirmed by histopathology and immunohistochemistry after surgical resection. This case adds to the limited literature on FDG-avid gastric schwannoma and highlights the importance of investigating differential metabolic activity and response on serial PET/CT imaging.

  3. Persistent L5 lumbosacral radiculopathy caused by lumbosacral trunk schwannoma

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    Sharifi, Guive; Jahanbakhshi, Amin

    2017-01-01

    Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI). In pre-operative studies a large pelvic mass was detected in the right pre-sacral area with solid and cystic components consistent with schwannoma. The patient underwent a low midline laparotomy to evacuate the retroperitoneal mass. Uniquely, we found the tumor to be arisen from lumbosacral trunk not from a root or peripheral nerve. Most cases with intra-pelvic schwannoma present so late with vague abdominal and pelvic discomfort or pain, low back pain, urinary and bowel symptoms because of compressive effect of the tumor, or incidentally following gynecologic work-ups; So, these patients are mostly referred to gynecologists and urologists. A neurosurgeon should have a high degree of suspicion to diagnose such an entity among his or her patients presented with pains typical for discopathy. PMID:28413533

  4. H. Pylori in a gastric schwannoma: a case report

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    Lavy, Daniel S.; Paulin, Ethan T.; Parker, Mitchell I.; Zhang, Bin; Parker, Glenn S.; Schwartz, Mark R.

    2016-01-01

    Schwannomas are benign, often asymptomatic, slow-growing tumors that originate from Schwann cells of the neural sheath. Although H. Pylori has been associated with gastric adenocarcinoma, there has never been a recorded association with schwannoma formation. We present a 64-year-old woman who underwent a laparoscopic partial wedge gastrectomy for an incidentally discovered gastric mass. Histologic examination was consistent with schwannoma; however, chronic inflammation with microorganisms mo...

  5. H. Pylori in a gastric schwannoma: a case report.

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    Lavy, Daniel S; Paulin, Ethan T; Parker, Mitchell I; Zhang, Bin; Parker, Glenn S; Schwartz, Mark R

    2016-04-01

    Schwannomas are benign, often asymptomatic, slow-growing tumors that originate from Schwann cells of the neural sheath. Although H. Pylori has been associated with gastric adenocarcinoma, there has never been a recorded association with schwannoma formation. We present a 64-year-old woman who underwent a laparoscopic partial wedge gastrectomy for an incidentally discovered gastric mass. Histologic examination was consistent with schwannoma; however, chronic inflammation with microorganisms morphologically consistent with H. Pylori was also present. This case suggests the first recorded case of H. Pylori in an immunohistochemically confirmed gastric schwannoma.

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

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    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.

  7. Utility of Noncontrast Magnetic Resonance Imaging for Detection of Recurrent Vestibular Schwannoma.

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    Williams, Jamie C; Carr, Carrie M; Eckel, Laurence J; Kotsenas, Amy L; Hunt, Christopher H; Carlson, Matthew L; Lane, John I

    2018-01-16

    Gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) (T1WI) is the conventional imaging technique of choice to detect vestibular schwannoma (VS) recurrence or regrowth, despite suboptimal specificity secondary to enhancing postoperative changes. Furthermore, recent concerns regarding the accumulation of gadolinium in body tissues have led for a call to reduce the number of contrast-enhanced examinations. The objective of the current study is to evaluate the diagnostic accuracy of high-resolution noncontrast (three-dimensional [3D] T2) MRI relative to gadolinium-enhanced T1WI in the detection of VS recurrence after resection. Following Institutional Review Board approval, 13 consecutive postoperative patients with VS recurrence or regrowth were identified from a prospectively maintained clinical database in which recurrence was determined by progression on serial postoperative MRI examination. Three blinded neuroradiologists retrospectively evaluated a total of 41 postoperative MRI examinations from these patients using only gadolinium-enhanced T1WI and 3D T2 MRI for recurrence or regrowth. Interobserver agreement, differences in detection between the two sequences, and the sensitivity and specificity of 3D T2 MRI were assessed. Fifteen of the 41 postoperative MRIs demonstrated progression, as determined by examiner consensus on the gadolinium-enhanced T1WI. Agreement, measured using Krippendorff's alpha, was 0.82 for the 3D T2 images and 0.83 for the contrast-enhanced T1WI. All the three examiners demonstrated no difference in the detection of progression between the two sequences (McNemar's test p values 0.69 for examiner 1, 0.63 for examiner 2, and 0.99 for examiner 3). The sensitivity of 3D T2 was 0.78 (CI 0.60-0.96), while the specificity was 0.94 (CI 0.86-1.00). Noncontrast high-resolution 3D T2 MRI seems sufficient to assess for recurrence or regrowth after VS resection. The results of this study have implications for reducing cost, time, and

  8. Cholestrol granuloma of the breast incidentally detected on dynamic abdominal CT: A case report

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    Jeong, Sun Hye; Lee, Eun Hye; Hong, Hyun Sook; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2016-01-15

    A breast cholesterol granuloma is an uncommon nodular breast lesion. We incidentally detected a persistently enhancing breast mass on the dynamic abdominal computed tomography (CT) of a 78-year-old woman. The mass decreased in diameter over 50 days following a core needle biopsy. This report is the first to describe the dynamic-enhanced CT features of a breast cholesterol granuloma.

  9. Comparative study of ultrasound and computed tomography for incidentally detecting diffuse thyroid disease.

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    Kim, Dong Wook; Jung, Soo Jin; Ha, Tae Kwun; Park, Ha Kyoung; Kang, Taewoo

    2014-08-01

    The aim of this study was to compare the diagnostic values of thyroid ultrasound (US) and neck computed tomography (CT) in incidentally detecting diffuse thyroid disease (DTD). A single radiologist made US and CT diagnoses of incidentally detected DTD in 130 consecutive patients before thyroidectomy for various malignancies. Histopathologic examinations confirmed normal thyroid (n = 80), Hashimoto thyroiditis (n = 20), non-Hashimoto lymphocytic thyroiditis (n = 28) and diffuse hyperplasia (n = 2). Receiver operating characteristic curves revealed that the best diagnostic indices of both imaging methods were achieved on the basis of two or more abnormal imaging findings. The sensitivity, specificity and accuracy of US and CT in incidentally detecting DTD by this classification were 72% and 72%, 87.5% and 91.3% and 81.5% and 83.8%, respectively. Thyroid US and neck CT have similar diagnostic values for differentiating incidental DTD from normal thyroid. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  10. Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma in situ.

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    Munro, Aime; Codde, Jim; Spilsbury, Katrina; Steel, Nerida; Stewart, Colin J R; Salfinger, Stuart G; Tan, Jason; Mohan, Ganendra R; Leung, Yee; Semmens, James B; O'Leary, Peter; Williams, Vincent; Cohen, Paul A

    2017-03-01

    Adenocarcinoma in situ of the uterine cervix is a precursor to cervical adenocarcinoma and may coexist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia 2 and 3). Up to 60% of adenocarcinoma in situ lesions are detected incidentally following excisional biopsies performed for the treatment of cervical intraepithelial neoplasia 2/3. To date there are no data regarding risk factors for persisting or progressive cervical neoplasia in these patients. We sought to investigate patient outcomes following incidentally detected cervical adenocarcinoma in situ after loop electrosurgical excision procedure or cold knife cone biopsy performed for the treatment of high-grade cervical intraepithelial neoplasia. We conducted a retrospective, population-based cohort study of Western Australian patients with an incidental diagnosis of adenocarcinoma in situ from 2001 through 2012. Primary outcomes were persistent or recurrent cervical intraepithelial neoplasia 2/3 and or adenocarcinoma in situ, and invasive adenocarcinoma during follow-up (neoplasia 2/3, 23 (7.7%) had adenocarcinoma in situ, and 3 (1.0%) had adenocarcinoma diagnosed during the follow-up and surveillance periods. Age >30 years, pure adenocarcinoma in situ lesions, and larger lesions (>8 mm) were associated with a greater risk of disease persistence or recurrence. Following the incidental detection of adenocarcinoma in situ, age >30 years, pure adenocarcinoma in situ lesions, and lesions >8 mm were significantly associated with disease persistence/recurrence. In younger women, incidentally detected adenocarcinoma in situ that coexists with cervical intraepithelial neoplasia 2/3 and is <8 mm extent with clear margins may not require reexcision. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Gastric schwannoma.

    Science.gov (United States)

    Lin, Chen-Sung; Hsu, Han-Shui; Tsai, Chien-Ho; Li, Wing-Yin; Huang, Min-Hsiung

    2004-11-01

    Gastrointestinal mesenchymal tumors are a group of tumors originated from the mesenchymal stem cells of the gastrointestinal tract, consisting of gastrointestinal stromal tumors (GIST), leiomyomas or leiomyosarcomas or schwannomas. Gastric schwannoma is a very rare gastrointestinal mesenchymal tumor, which represents only 0.2% of all gastric tumors and 4% of all benign gastric neoplasms. We report a 24-year-old girl who suffered from an episode of upper gastrointestinal bleeding. The endoscopic examination showed a round submucosal tumor with a central ulceration and bleeding over the high body of the stomach. Surgical resection of the tumor was performed. The pathological examination revealed a picture of spindle cell tumor that was strongly positive for S-100 protein stain, and non-reactive for CD34, CD117, actin, HHF-35, desmin, melan-A and HMB-45, consistent with gastric schwannoma. The literature is reviewed.

  12. Incidental Memory Encoding Assessed with Signal Detection Theory and Functional Magnetic Resonance Imaging (fMRI).

    Science.gov (United States)

    Clemens, Benjamin; Regenbogen, Christina; Koch, Kathrin; Backes, Volker; Romanczuk-Seiferth, Nina; Pauly, Katharina; Shah, N Jon; Schneider, Frank; Habel, Ute; Kellermann, Thilo

    2015-01-01

    In functional magnetic resonance imaging (fMRI) studies that apply a "subsequent memory" approach, successful encoding is indicated by increased fMRI activity during the encoding phase for hits vs. misses, in areas underlying memory encoding such as the hippocampal formation. Signal-detection theory (SDT) can be used to analyze memory-related fMRI activity as a function of the participant's memory trace strength (d(')). The goal of the present study was to use SDT to examine the relationship between fMRI activity during incidental encoding and participants' recognition performance. To implement a new approach, post-experimental group assignment into High- or Low Performers (HP or LP) was based on 29 healthy participants' recognition performance, assessed with SDT. The analyses focused on the interaction between the factors group (HP vs. LP) and recognition performance (hits vs. misses). A whole-brain analysis revealed increased activation for HP vs. LP during incidental encoding for remembered vs. forgotten items (hits > misses) in the insula/temporo-parietal junction (TPJ) and the fusiform gyrus (FFG). Parameter estimates in these regions exhibited a significant positive correlation with d('). As these brain regions are highly relevant for salience detection (insula), stimulus-driven attention (TPJ), and content-specific processing of mnemonic stimuli (FFG), we suggest that HPs' elevated memory performance was associated with enhanced attentional and content-specific sensory processing during the encoding phase. We provide first correlative evidence that encoding-related activity in content-specific sensory areas and content-independent attention and salience detection areas influences memory performance in a task with incidental encoding of facial stimuli. Based on our findings, we discuss whether the aforementioned group differences in brain activity during incidental encoding might constitute the basis of general differences in memory performance between HP and

  13. Incidental Detection of Interstitial Pregnancy on CT Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of)

    2010-02-15

    Ectopic pregnancy is a potentially life-threatening condition. Detection of ectopic pregnancy on CT images is rare. In this case, we describe the CT findings of interstitial pregnancy both before and after rupture. If CT images demonstrate the presence of a strong enhancing ring-like mass in the pelvis, ectopic pregnancy should be considered

  14. Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies.

    Science.gov (United States)

    Bianchi, Diana W; Chudova, Darya; Sehnert, Amy J; Bhatt, Sucheta; Murray, Kathryn; Prosen, Tracy L; Garber, Judy E; Wilkins-Haug, Louise; Vora, Neeta L; Warsof, Stephen; Goldberg, James; Ziainia, Tina; Halks-Miller, Meredith

    2015-07-14

    Understanding the relationship between aneuploidy detection on noninvasive prenatal testing (NIPT) and occult maternal malignancies may explain results that are discordant with the fetal karyotype and improve maternal clinical care. To evaluate massively parallel sequencing data for patterns of copy-number variations that might prospectively identify occult maternal malignancies. Case series identified from 125,426 samples submitted between February 15, 2012, and September 30, 2014, from asymptomatic pregnant women who underwent plasma cell-free DNA sequencing for clinical prenatal aneuploidy screening. Analyses were conducted in a clinical laboratory that performs DNA sequencing. Among the clinical samples, abnormal results were detected in 3757 (3%); these were reported to the ordering physician with recommendations for further evaluation. NIPT for fetal aneuploidy screening (chromosomes 13, 18, 21, X, and Y). Detailed genome-wide bioinformatics analysis was performed on available sequencing data from 8 of 10 women with known cancers. Genome-wide copy-number changes in the original NIPT samples and in subsequent serial samples from individual patients when available are reported. Copy-number changes detected in NIPT sequencing data in the known cancer cases were compared with the types of aneuploidies detected in the overall cohort. From a cohort of 125,426 NIPT results, 3757 (3%) were positive for 1 or more aneuploidies involving chromosomes 13, 18, 21, X, or Y. From this set of 3757 samples, 10 cases of maternal cancer were identified. Detailed clinical and sequencing data were obtained in 8. Maternal cancers most frequently occurred with the rare NIPT finding of more than 1 aneuploidy detected (7 known cancers among 39 cases of multiple aneuploidies by NIPT, 18% [95% CI, 7.5%-33.5%]). All 8 cases that underwent further bioinformatics analysis showed unique patterns of nonspecific copy-number gains and losses across multiple chromosomes. In 1 case, blood was

  15. Incidental Detection of Maternal Neoplasia in Noninvasive Prenatal Testing.

    Science.gov (United States)

    Dharajiya, Nilesh G; Grosu, Daniel S; Farkas, Daniel H; McCullough, Ron M; Almasri, Eyad; Sun, Youting; Kim, Sung K; Jensen, Taylor J; Saldivar, Juan-Sebastian; Topol, Eric J; van den Boom, Dirk; Ehrich, Mathias

    2018-02-01

    Noninvasive prenatal testing (NIPT) uses cell-free DNA (cfDNA) as an analyte to detect copy-number alterations in the fetal genome. Because maternal and fetal cfDNA contributions are comingled, changes in the maternal genome can manifest as abnormal NIPT results. Circulating tumor DNA (ctDNA) present in cases of maternal neoplasia has the potential to distort the NIPT readout to a degree that prevents interpretation, resulting in a nonreportable test result for fetal aneuploidy. NIPT cases that showed a distortion from normal euploid genomic representation were communicated to the caregiving physician as nonreportable for fetal aneuploidy. Follow-up information was subsequently collected for these cases. More than 450000 pregnant patients who submitted samples for clinical laboratory testing >3 years are summarized. Additionally, in-depth analysis was performed for >79000 research-consented samples. In total, 55 nonreportable NIPT cases with altered genomic profiles were cataloged. Of these, 43 had additional information available to enable follow-up. A maternal neoplasm was confirmed in 40 of these cases: 18 malignant, 20 benign uterine fibroids, and 2 with radiological confirmation but without pathological classification. In a population of pregnant women who submitted a blood sample for cfDNA testing, an abnormal genomic profile not consistent with fetal abnormalities was detected in about 10 out of 100000 cases. A subset of these observations (18 of 43; 41.9%) was attributed to maternal malignant neoplasms. These observational results suggest the need for a controlled trial to evaluate the potential of using cfDNA as an early biomarker of cancer. © 2017 American Association for Clinical Chemistry.

  16. Incidental orthographic learning during a color detection task.

    Science.gov (United States)

    Protopapas, Athanassios; Mitsi, Anna; Koustoumbardis, Miltiadis; Tsitsopoulou, Sofia M; Leventi, Marianna; Seitz, Aaron R

    2017-09-01

    Orthographic learning refers to the acquisition of knowledge about specific spelling patterns forming words and about general biases and constraints on letter sequences. It is thought to occur by strengthening simultaneously activated visual and phonological representations during reading. Here we demonstrate that a visual perceptual learning procedure that leaves no time for articulation can result in orthographic learning evidenced in improved reading and spelling performance. We employed task-irrelevant perceptual learning (TIPL), in which the stimuli to be learned are paired with an easy task target. Assorted line drawings and difficult-to-spell words were presented in red color among sequences of other black-colored words and images presented in rapid succession, constituting a fast-TIPL procedure with color detection being the explicit task. In five experiments, Greek children in Grades 4-5 showed increased recognition of words and images that had appeared in red, both during and after the training procedure, regardless of within-training testing, and also when targets appeared in blue instead of red. Significant transfer to reading and spelling emerged only after increased training intensity. In a sixth experiment, children in Grades 2-3 showed generalization to words not presented during training that carried the same derivational affixes as in the training set. We suggest that reinforcement signals related to detection of the target stimuli contribute to the strengthening of orthography-phonology connections beyond earlier levels of visually-based orthographic representation learning. These results highlight the potential of perceptual learning procedures for the reinforcement of higher-level orthographic representations. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Facial Schwannoma

    Directory of Open Access Journals (Sweden)

    Mohammadtaghi Khorsandi Ashtiani

    2005-06-01

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

  18. Incidentally detection of non-palpable testicular nodules at scrotal ultrasound: What is new?

    Directory of Open Access Journals (Sweden)

    Massimo Valentino

    2014-12-01

    Full Text Available The increased use of ultrasound in patients with urological and andrological symptoms has given an higher detection of intra-testicular nodules. Most of these lesions are hypoechoic and their interpretation is often equivocal. Recently, new ultrasound techniques have been developed alongside of B-mode and color-Doppler ultrasound. Although not completely standardized, contrast-enhanced ultrasound (CEUS and tissue elastography (TE, added to traditional ultrasonography, can provide useful information about the correct interpretation of incidentally detected non-palpable testicular nodules. The purpose of this review article is to illustrate these new techniques in the patient management.

  19. Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer

    Directory of Open Access Journals (Sweden)

    Kim Sung

    2009-08-01

    Full Text Available Abstract Background Incidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer. Methods FDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUVmax and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively. Results Two hundred eighty five patients (8.4% were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99 and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUVmax between the benign and malignant nodules (3.35 ± 1.69 vs. 6.64 ± 4.12; P max and the size of the cancer. Conclusion The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.

  20. Atypical presentations of retroperitoneal giant schwannomas

    Directory of Open Access Journals (Sweden)

    Cetin Dincel

    2011-04-01

    Full Text Available Schwannomas are usually benign rare tumors that originating from Schwann cells of peripheral nerve sheaths. Presentation is generally varied and changed in a non-specific range from abdominal mass, flank pain to incidental findings. Herein we report 2 cases of retroperitoneal giant schwannomas with different clinical presentations, of whom one presented with vague abdominal pain, palpable abdominal mass for 4 years, swelling and bilateral hydronephrosis that caused by giant abdominal mass; the other one presented with right flank pain, rectal hemorrhage and lower extremities edema. Two patients were treated by complete surgical excision of masses. The histological and immunohistochemical diagnosis was reported as benign schwannoma. Both of patients are doing well and had no recurrence in 9 years and 28 months follow-up, respectively.

  1. Incidental breast masses detected by computed tomography: are any imaging features predictive of malignancy?

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom)], E-mail: Gareth.Porter@phnt.swest.nhs.uk; Steel, J.; Paisley, K.; Watkins, R. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom); Holgate, C. [Department of Histopathology, Derriford Hospital, Plymouth (United Kingdom)

    2009-05-15

    Aim: To review the outcome of further assessment of breast abnormalities detected incidentally by multidetector computed tomography (MDCT) and to determine whether any MDCT imaging features were predictive of malignancy. Material and methods: The outcome of 34 patients referred to the Primrose Breast Care Unit with breast abnormalities detected incidentally using MDCT was prospectively recorded. Women with a known diagnosis of breast cancer were excluded. CT imaging features and histological diagnoses were recorded and the correlation assessed using Fisher's exact test. Results: Of the 34 referred patients a malignant diagnosis was noted in 11 (32%). There were 10 breast malignancies (seven invasive ductal carcinomas, one invasive lobular carcinoma, two metastatic lesions) and one axillary lymphoma. CT features suggestive of breast malignancy were spiculation [6/10 (60%) versus 0/24 (0%) p = 0.0002] and associated axillary lymphadenopathy [3/10 (33%) versus 0/20 (0%) p = 0.030]. Conversely, a well-defined mass was suggestive of benign disease [10/24 (42%) versus 0/10 (0%); p = 0.015]. Associated calcification, ill-definition, heterogeneity, size, and multiplicity of lesions were not useful discriminating CT features. There was a non-significant trend for lesions in involuted breasts to be more frequently malignant than in dense breasts [6/14 (43%) versus 4/20 (20%) p = 0.11]. Conclusion: In the present series there was a significant rate (32%) of malignancy in patients referred to the breast clinic with CT-detected incidental breast lesions. The CT features of spiculation or axillary lymphadenopathy are strongly suggestive of malignancy.

  2. Incidental detection of two adult gravid filarial worms in breast: a case report.

    Science.gov (United States)

    Tummidi, Santosh; Kothari, Kanchan; Patil, Roshni; Singhal, Shruti S; Keshan, Pooja

    2017-08-16

    Microfilaria is a major public health problem in tropical and subtropical countries and is an endemic problem in India. Wuchereria bancrofti is the commonest filarial infection. In some lesions, microfilariae and adult filarial worm have been incidentally detected in fine-needle aspirates. A 35 year old hindu female presented with lump in upper outer quadrant of left breast. Fine needle aspiration revealed two adult gravid female filarial worms. To our knowledge this is the first ever case report to demonstrate two live gravid female and embryoid forms in wet mount preparation.

  3. Incidental musculoskeletal lesions detected on abdomnopelvic CT scans: A pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Song, Eun Jee; Ryu, Kyung Nam; Park, Ji Seon [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Jin, Wook; Park, So Young [Dept. of Radiology, Kyung Hee University Hospital at Gangdong Hospital, Seoul (Korea, Republic of)

    2015-02-15

    Various musculoskeletal findings incidentally detected on abdominopelvic computed tomography (CT) images have risen with the increasing use of abdominopelvic CT; however, it is not uncommon for radiologists to overlook the musculoskeletal system when they examine abdominopelvic CT images. Some musculoskeletal lesions may have more clinical significance than abdominopelvic lesions, although most lesions are of little to no significance. Many osseous lesions can be diagnosed using the bone window setting and reconstructed images. The purpose of this article was to review the wide variety of musculoskeletal lesions depicted on abdominopelvic CT images and to emphasize the use of the bone window setting.

  4. [Lung cancer incidentally detected at the treatment of pneumothorax ; report of two cases].

    Science.gov (United States)

    Hokka, Daisuke; Yoshikawa, Koichi; Morimoto, Masato; Hashimoto, Shotaro; Kamimura, Ryosuke; Tai, Kentaro; Hoshida, Yoshihiko

    2012-03-01

    We report 2 cases of lung cancer incidentally detected following pneumothorax. Case 1:A 40-year-old man complaining of dyspnea was admitted with right pneumothorax. Chest computed tomography (CT) after chest drainage showed a cavitary nodule with pleural indentations in the right lower lobe. It was indicated at surgery that pneumothorax was caused by perforation of the tumor into the pleural cavity. Right lower lobectomy was performed because the pathological diagnosis of the nodule was a large cell carcinoma. The final histopathological diagnosis was stage II A (pT2aN1M0). The patient died of recurrence 14 months after surgery. Case 2:A 47-year-old man who admitted with right pneumothorax was found to have a nodule with pleural indentations closely a bulla at the apex of the right lung by chest CT after chest drainage. Pneumothorax was indicated to be caused by rupture of the bulla at surgery. Right upper lobectomy was performed because the pathological diagnosis of the nodule was a squamous carcinoma. The final histopathological diagnosis was stage I A (pT1bN0M0). The patient is alive at 2 years after the operation without recurrence. Lung cancer detected following pneumothorax which was caused by perforation of the tumor is generally considered to have poor prognosis. Whereas, prognosis of lung cancer incidentally detected following pneumothorax depends on its staging.

  5. Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.

    Science.gov (United States)

    Yang, Jia-Hua; Zhang, Min; Zhao, Zhi-Hua; Shu, Yu; Hong, Jun; Cao, Yi-Jun

    2015-02-21

    Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermittent, colicky abdominal pain, nausea, and vomiting for over 4 wk accompanied by a weight loss. A diagnosis of gastric intussusception was made by computed tomography. A Billroth II distal gastrectomy was then performed, and complete en bloc removal (R0 resection) was achieved. Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.

  6. Asymptomatic Right Coronary Artery-to-Pulmonary Artery Fistula Incidentally Detected by Transthoracic Echocardiography.

    Science.gov (United States)

    Lim, Woo-Hyun; Kang, Si-Hyuck; Jeon, Kihyun; Cho, Iksung; Kim, Kyung-Hee; Hwang, Sung-Wook; Kim, Hyung-Kwan; Sohn, Dae-Won

    2009-09-01

    In this case report, we describe a 71-year-old woman with right conal coronary artery-to-pulmonary trunk fistula. She visited the outpatient clinic of the nephrology department for long-term management of renal dysfunction. On transthoracic echocardiography (TTE) conducted as a part of cardiac evaluation, an abnormal Doppler color flow taking a course toward echocardiographic probe was incidentally detected outside the main pulmonary trunk, giving an impression of congenital coronary arteriovenous (AV) fistula. Computed tomography coronary angiography confirmed the presence of congenital coronary AV fistula from a conal branch of the right coronary artery to the main pulmonary trunk in the form of a ground cherry. Although the direction of Doppler color flow is not usual (i.e. toward, not away from, echocardiographic probe) in this case, congenital coronary AV fistula should be in the first priority among potential diagnoses when an abnormal Doppler color flow was found near the main pulmonary trunk on TTE.

  7. Natural course of asymptomatic abnormal prostate findings incidentally detected by CT after intravesical BCG therapy.

    Science.gov (United States)

    Matsushima, Masashi; Kikuchi, Eiji; Akita, Hirotaka; Miyajima, Akira; Oya, Mototsugu; Jinzaki, Masahiro

    2017-06-01

    Detailed information is not currently available on the incidence, natural course, and management of asymptomatic abnormal prostate findings incidentally detected by radiologic evaluations after BCG therapy for non-muscle-invasive bladder cancer patients. We identified 38 patients who were evaluated by contrast-enhanced CT scans before TUR-BT and after BCG therapy between 2006 and 2012. We evaluated the clinical courses of patients with abnormal radiologic findings of the prostate gland after BCG therapy. Abnormal findings on CT scans were found in the prostate glands of 11 of the 38 patients examined (28.9%), none of whom exhibited any sign or symptom associated with prostatitis. Abnormal findings included a low attenuation area (n = 6, 15.8%), contrast enhancement (n = 3, 7.9%), and a low attenuation area and contrast enhancement in the prostate gland (n = 2, 5.3%). During the follow-up, abnormal prostate findings disappeared spontaneously in most cases without any anti-bacterial or anti-tuberculous drug treatments. No significant differences were observed in patient clinical backgrounds, with the exception of post-BCG prostate volumes, between patients with and without abnormal CT findings. Furthermore, no significant differences were noted in the incidence of the adverse effects of BCG therapy, tumor recurrence rates, or progression rates between patients with and without abnormal CT findings of the prostate gland after BCG therapy. Asymptomatic abnormal prostate findings incidentally detected by CT after BCG therapy are not rare, and these disappear over time during the follow-up period without any treatment.

  8. Cardiac pathologies incidentally detected with non-gated chest CT; Inzidentelle Pathologien des Herzens im Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, Axel; Kroepil, P.; Lanzman, R.S.; Moedder, U. [Inst. fuer Radiologie, Universitaetsklinikum Duesseldorf, Heinrich-Heine-Univ. (Germany); Choy, G.; Abbara, S. [Cardiovascular Imaging Section, Massachusetts General Hospital, Harvard Medical School (United States)

    2009-12-15

    Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT. (orig.)

  9. Frequency and clinical significance of previously undetected incidental findings detected on computed tomography simulation scans for breast cancer patients.

    Science.gov (United States)

    Nakamura, Naoki; Tsunoda, Hiroko; Takahashi, Osamu; Kikuchi, Mari; Honda, Satoshi; Shikama, Naoto; Akahane, Keiko; Sekiguchi, Kenji

    2012-11-01

    To determine the frequency and clinical significance of previously undetected incidental findings found on computed tomography (CT) simulation images for breast cancer patients. All CT simulation images were first interpreted prospectively by radiation oncologists and then double-checked by diagnostic radiologists. The official reports of CT simulation images for 881 consecutive postoperative breast cancer patients from 2009 to 2010 were retrospectively reviewed. Potentially important incidental findings (PIIFs) were defined as any previously undetected benign or malignancy-related findings requiring further medical follow-up or investigation. For all patients in whom a PIIF was detected, we reviewed the clinical records to determine the clinical significance of the PIIF. If the findings from the additional studies prompted by a PIIF required a change in management, the PIIF was also recorded as a clinically important incidental finding (CIIF). There were a total of 57 (6%) PIIFs. The 57 patients in whom a PIIF was detected were followed for a median of 17 months (range, 3-26). Six cases of CIIFs (0.7% of total) were detected. Of the six CIIFs, three (50%) cases had not been noted by the radiation oncologist until the diagnostic radiologist detected the finding. On multivariate analysis, previous CT examination was an independent predictor for PIIF (p = 0.04). Patients who had not previously received chest CT examinations within 1 year had a statistically significantly higher risk of PIIF than those who had received CT examinations within 6 months (odds ratio, 3.54; 95% confidence interval, 1.32-9.50; p = 0.01). The rate of incidental findings prompting a change in management was low. However, radiation oncologists appear to have some difficulty in detecting incidental findings that require a change in management. Considering cost, it may be reasonable that routine interpretations are given to those who have not received previous chest CT examinations within 1 year

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

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

    2011-09-15

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

  11. Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers

    Energy Technology Data Exchange (ETDEWEB)

    Bazzocchi, Alberto [Orthopaedic Institute, Diagnostic and Interventional Radiology, Bologna (Italy); Bologna Univ. (Italy). Imaging Div.; Spinnato, Paolo; Garzillo, Giorgio; Ciccarese, Federica [Bologna Univ. (Italy). Imaging Div.; Albisinni, Ugo; Mignani, Stefano; Battista, Giuseppe [Orthopaedic Institute, Diagnostic and Interventional Radiology, Bologna (Italy); Rossi, Cristina [Parma Univ. (Italy). Imaging Div.

    2012-12-15

    Incidental diagnosis of vertebral fractures (VFs) may represent a key point in the assessment of bone health status. Our purpose was to retrospectively evaluate localisation sequences (MR-loc) of breast MRI as a potential tool to detect osteoporotic VFs. MR-loc sagittal images of 856 breast MRIs were reviewed by three expert musculoskeletal radiologists with a semiquantitative approach to detecting VFs. Anamnesis and data of patients were investigated. Official breast MRI and previous imaging reports were checked to understand if VFs or other relevant bone findings were known in patients' clinical history. A total of 780/856 female patients (91.1 %) undergoing MRI for oncological reasons and 76/856 (8.9 %) with non-oncological aims were recruited into the study (54.7 {+-} 12.2 years old, 21-89 years); 57/856 MR-loc images (6.7 %) were considered inadequate for diagnostic purposes and were excluded from the analysis. MR-loc detected VFs in 71/799 patients (8.9 %). VFs were neither reported nor previously known in the clinical history of 63/71 patients (88.7 %; P < 0.001). No mention of VFs was found in any breast MR reports. In four patients MR-loc identified vertebral metastases. A systematic evaluation of MR-loc may offer additional clinical information to prevent unrecognised VFs. MR-loc may screen for VFs in other imaging settings. (orig.)

  12. Benign Ancient Schwannoma of the abdominal wall: An unwanted birthday present

    Directory of Open Access Journals (Sweden)

    Ram Manisha

    2010-01-01

    Full Text Available Abstract Background There has been a recent growth in the use of whole body Computerised Tomography (CT scans in the private sector as a screening test for asymptomatic disease. This is despite scant evidence to show any positive effect on morbidity or mortality. There has been concern raised over the possible harms of the test in terms of radiation exposure as well as the risk and anxiety of further investigation and treatment for the large numbers of benign lesions identified. Case Presentation A healthy 64 year old lady received a privately funded whole body CT scan for her birthday which revealed an incidental mass in the right iliac fossa. This was investigated with further imaging and colonoscopy and as confident diagnosis could not be made, eventually excised. Histology demonstrated this to be a benign ancient schwannoma and we believe this to be the first reported case of an abdominal wall schwannoma in the English literature Conclusions Ancient schwannomas are rare tumours of the peripheral nerve sheaths more usually found in the head, neck and flexor surfaces of extremities. They are a subtype of classical schwannomas with a predominance of degenerative changes. Our case highlights the pitfalls of such screening tests in demonstrating benign disease and subjecting patients to what turns out to be unnecessary invasive investigation and treatment. It provides evidence as to the consequences of the large number of false positive results that are created by blind CT scanning of asymptomatic patients i.e. its tendency to detect pseudodiesease rather than affect survival rates. Should the number of scans increase there may be an unnecessary burden on NHS resources due to the large numbers of benign lesions picked up, that are then referred for further investigation.

  13. Incidental findings detected on abdomino-pelvic multidetector computed tomography performed in the acute setting.

    Science.gov (United States)

    Shuaib, Waqas; Waqas, Shuaib; Johnson, Jamlik-Omari; Salastekar, Ninad; Maddu, Kiran K; Khosa, Faisal

    2014-01-01

    The objective of the study is to determine the prevalence and significance of incidental findings in patients with a chief complaint of abdominal pain presenting to the emergency department (ED) who received abdomino-pelvic multidetector computed tomography. We conducted a retrospective review of data collected for 290 patients over a period of 5 months (April to September 2012) from 3 different university-affiliated EDs. Two board-certified radiologists reviewed the original images independently and recorded the incidental findings. These findings were classified as benign, indeterminate, and worrisome. Only those findings present in the original report were included in the study. If an indeterminate or worrisome incidental finding was identified, the patient's medical records were reviewed to determine if the incidental finding was previously known, whether recommendation was made for further evaluation, and whether this recommendation led to any change in management. We identified 283 incidental findings—144 benign (51%), 114 indeterminate (40%), and 25 worrisome (9%) findings. A statistically significant difference was observed in the percentage of patients who experienced a change in management among those who received recommendations as compared with those who did not, in both previously known (87% vs 22%, P=.001) and previously unknown (70% vs 2%, P=.001) indeterminate findings. Unlike benign incidental findings, indeterminate and worrisome findings frequently alter the course of management. Recommendation from radiologists appears to significantly contribute to the management of indeterminate incidental findings.

  14. 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

    We report a case of a 66-year-old man with a gastric schwannoma incidentally discovered during the treatment of a colon cancer. At the pre-operative computed tomography performed for the stadiation of the colonic tumor was incidentally noted the presence of a nodular tumor between the liver and the gastric wall. A wedge resection of this gastic tumor and the surgical resection of the left colon were performed all at once. The pathological examination of the gastric neoplasia revealed a picture consistent with gastric schwannoma. Gastrointestinal schwannomas are difficult but not impossible to diagnose preoperatively although they are often asymptomatic and radiologic findings are often nonspecific. Radiological features of Gastrointestinal schwannomas described in literature are reviewed. The treatment of choice is complete surgical excision with free margins because of diagnostic uncertainty, and the long-term outcome is excellent as these lesions are uniformly benign.

  15. Isolated eyelid Schwannoma: A rare differential diagnosis of lid tumor.

    Science.gov (United States)

    Morsi, Nabila H; AlMansouri, Osama Samir; AlMansour, Ebrahim Mohammed

    2017-01-01

    Primary Schwannomas of the eyelid are extremely uncommon. It accounts for one percent of orbital tumors. We present a case of isolated eyelid Schwannoma in the lateral canthus of the left eye with no systemic diseases associated. Surgical excisional biopsy was done. In two years follow up, no recurrence or malignant conversion was detected.

  16. Isolated eyelid Schwannoma: A rare differential diagnosis of lid tumor

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    Nabila H. Morsi

    2017-04-01

    Full Text Available Primary Schwannomas of the eyelid are extremely uncommon. It accounts for one percent of orbital tumors. We present a case of isolated eyelid Schwannoma in the lateral canthus of the left eye with no systemic diseases associated. Surgical excisional biopsy was done. In two years follow up, no recurrence or malignant conversion was detected.

  17. Gastric Schwannoma: A Case Report and Review of Literature.

    Science.gov (United States)

    Sreevathsa, M R; Pipara, Gotam

    2015-06-01

    Schwannomas are usually benign, slow growing tumors, that originate from any nerve that has a Schwann cell sheath. Here, we report the case of a 40 year-old female patient with an incidentally noted submucosal gastric tumor while being evaluated for cervical lymphadenopathy as a part of workup for lymphoma. She underwent sleeve resection of the stomach under suspicion of a gastrointestinal stromal tumor, but postoperative histopathological and immunohistochemical findings confirmed the diagnosis of shwannoma. Although schwannomas are mostly benign, they are often indistinguishable preoperatively from malignant tumors such as gastrointestinal stromal tumors. Therefore, resection is the treatment of choice for all such tumors.

  18. Natural language processing of radiology reports for the detection of thromboembolic diseases and clinically relevant incidental findings.

    Science.gov (United States)

    Pham, Anne-Dominique; Névéol, Aurélie; Lavergne, Thomas; Yasunaga, Daisuke; Clément, Olivier; Meyer, Guy; Morello, Rémy; Burgun, Anita

    2014-08-07

    Natural Language Processing (NLP) has been shown effective to analyze the content of radiology reports and identify diagnosis or patient characteristics. We evaluate the combination of NLP and machine learning to detect thromboembolic disease diagnosis and incidental clinically relevant findings from angiography and venography reports written in French. We model thromboembolic diagnosis and incidental findings as a set of concepts, modalities and relations between concepts that can be used as features by a supervised machine learning algorithm. A corpus of 573 radiology reports was de-identified and manually annotated with the support of NLP tools by a physician for relevant concepts, modalities and relations. A machine learning classifier was trained on the dataset interpreted by a physician for diagnosis of deep-vein thrombosis, pulmonary embolism and clinically relevant incidental findings. Decision models accounted for the imbalanced nature of the data and exploited the structure of the reports. The best model achieved an F measure of 0.98 for pulmonary embolism identification, 1.00 for deep vein thrombosis, and 0.80 for incidental clinically relevant findings. The use of concepts, modalities and relations improved performances in all cases. This study demonstrates the benefits of developing an automated method to identify medical concepts, modality and relations from radiology reports in French. An end-to-end automatic system for annotation and classification which could be applied to other radiology reports databases would be valuable for epidemiological surveillance, performance monitoring, and accreditation in French hospitals.

  19. Asymptomatic schwannoma of the heart

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    Kennedy Maria

    2007-01-01

    Full Text Available Abstract We present a case of an asymptomatic right atrial mass detected on a screening ECHO. Pre-operative imaging and intraoperative frozen section suggested an atrial myxoma, but the extracardiac nature of the mass and its adherence to the right superior pulmonary vein and interatrial septum were inconsistent with this. Detailed histological assessment confirmed the diagnosis of atrial schwannoma. Limited case reports have shown complete resection is curative.

  20. Incidentally detected Castleman disease in a patient with allergic rhinosinu sitis

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    Stojšić Jelena

    2008-01-01

    Full Text Available INTRODUCTION Castleman disease was for the first time described in 1956 as a mediastinal tumour mass. Etiology of this disease is still unknown. The disease can be solitary and multicentric or rarely of a mixed type. The former is often of hyaline vascular type, while the latter is of plasma cell type. CASE REPORT Castleman disease was diagnosed in a 26-year old male patient when a well defined shadow was incidentally detected in the middle lobe of the right lung. A year before, he was diagnosed with allergic rhinitis to Ambrosia. Two years after surgery the patient was feeling well, and was without any recurrence, however, allergic rhinitis still persisted. CONCLUSION Castleman disease can occur in any organ containing lymph tissues. Most frequently the disease is described as mediastinal, rarely as an intrapulmonary tumorous mass, and it is most frequently seen in younger persons. The solitary type of Castleman disease is surgical treatable with a prospect of good prognosis, while the multicentric and mixed types recur despite treatment with cortisone, irradiation and cytostatics. As the association between Castleman disease and allergic diseases has not been confirmed up-tonow, it could be concluded that this patient suffered from two separated diseases.

  1. Atypical presentation of a retrorectal ancient schwannoma: a case report and review of the literature.

    Science.gov (United States)

    Santiago, Camilo; Lucha, Paul A

    2008-08-01

    Retrorectal tumors are rare and frequently present either incidentally or with vague symptoms. Schwannomas of the presacral region are one variant described as benign tumors of neurogenic origin. The "ancient degenerative variant" is uncommonly reported. We present the case of a 37-year-old man presenting with symptoms of left renal colic, impotence, and left trochanteric pain. Computed tomography and magnetic resonance imaging of the pelvis showed a presacral mass with cystic changes and calcifications consistent with a schwannoma. The patient underwent an exploratory laparotomy with resection of the tumor, which subsequent analysis showed to be a schwannoma with ancient degenerative changes.

  2. A COMPARATIVE STUDY OF REAL-TIME AND STATIC ULTRASONOGRAPHY DIAGNOSES FOR THE INCIDENTAL DETECTION OF DIFFUSE THYROID DISEASE.

    Science.gov (United States)

    Kim, Dong Wook

    2015-08-01

    The aim of this study was to compare the diagnostic accuracy of real-time and static ultrasonography (US) for the incidental detection of diffuse thyroid disease (DTD). In 118 consecutive patients, a single radiologist performed real-time US before thyroidectomy. For static US, the same radiologist retrospectively investigated the sonographic findings on a picture-archiving and communication system after 3 months. The diagnostic categories of both real-time and static US diagnoses were determined based on the number of abnormal findings, and the diagnostic indices were calculated by a receiver operating characteristic (ROC) curve analysis using the histopathologic results as the reference standard. Histopathologic results included normal thyroid (n = 77), Hashimoto thyroiditis (n = 11), non-Hashimoto lymphocytic thyroiditis (n = 29), and diffuse hyperplasia (n = 1). Normal thyroid and DTD showed significant differences in echogenicity, echotexture, glandular margin, and vascularity on both real-time and static US. There was a positive correlation between US categories and histopathologic results in both real-time and static US. The highest diagnostic indices were obtained when the cutoff criteria of real-time and static US diagnoses were chosen as indeterminate and suspicious for DTD, respectively. The ROC curve analysis showed that real-time US was superior to static US in diagnostic accuracy. Both real-time and static US may be helpful for the detection of incidental DTD, but real-time US is superior to static US for detecting incidental DTD.

  3. Schwannoma of stomach.

    Science.gov (United States)

    Enshaei, Ali; Hajipour, Babak; Abbasi, Fariba; Doost, Pantea Rohani; Rezaei, Seyfolah

    2015-06-01

    Gastrointestinal mesenchymal tumours are a group of tumours originating from the mesenchymal stem cells of the gastrointestinal (GI) tract. Digestive tract Schwannomas are rare mesenchymal tumours occurring most frequently in the stomach. We report the case of a 40-year-old woman with gastric Schwannoma located at the posterior wall of the antrum.

  4. Intraosseous schwannoma in schwannomatosis

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

    2013-12-15

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

  5. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen

    2014-01-01

    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

  6. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour – a case series

    Science.gov (United States)

    Williamson, JML

    2012-01-01

    INTRODUCTION Gastric schwannomas are rare mesenchymal tumours that arise from the nerve plexus of the gut wall. They present with non-specific symptoms and are often detected incidentally. Pre-operative investigation is not pathognomonic and many are therefore diagnosed as gastrointestinal stromal tumours (GISTs). Operative resection is usually curative as they are almost always benign, underpinning the importance of differentiating them from GISTs. METHODS Three cases of gastric schwannomas were identified over a seven-year period. The clinical details and management were reviewed retrospectively. RESULTS There were two women and one man with a mean age of 62 years (range: 51–69 years). Two patients presented with bleeding and one with abdominal pain. The mean tumour size was 5.2cm (range: 2–10cm) and the tumours were resected completely following total or wedge gastrectomies. Histology in all cases showed spindle cells with a cuff of lymphoid tissue. Immunohistochemistry confirmed positive S100 staining and negative CD117 and DOG-1 staining in all cases. CONCLUSIONS We report our experience with these unusual primary stromal tumours of the gut and their presentations, preoperative investigations, operative findings and pathological findings are discussed. Operative resection in all cases has been considered curative, which is supported by previous series confirming the excellent prognosis of gastric schwannomas. PMID:22613302

  7. Gastric schwannoma: a benign tumour often mistaken clinically, radiologically and histopathologically for a gastrointestinal stromal tumour--a case series.

    Science.gov (United States)

    Williamson, J M L; Wadley, M S; Shepherd, N A; Dwerryhouse, S

    2012-05-01

    Gastric schwannomas are rare mesenchymal tumours that arise from the nerve plexus of the gut wall. They present with non-specific symptoms and are often detected incidentally. Pre-operative investigation is not pathognomonic and many are therefore diagnosed as gastrointestinal stromal tumours (GISTs). Operative resection is usually curative as they are almost always benign, underpinning the importance of differentiating them from GISTs. Three cases of gastric schwannomas were identified over a seven-year period. The clinical details and management were reviewed retrospectively. There were two women and one man with a mean age of 62 years (range: 51-69 years). Two patients presented with bleeding and one with abdominal pain. The mean tumour size was 5.2 cm (range: 2-10 cm) and the tumours were resected completely following total or wedge gastrectomies. Histology in all cases showed spindle cells with a cuff of lymphoid tissue. Immunohistochemistry confirmed positive S100 staining and negative CD117 and DOG-1 staining in all cases. We report our experience with these unusual primary stromal tumours of the gut and their presentations, pre-operative investigations, operative findings and pathological findings are discussed. Operative resection in all cases has been considered curative, which is supported by previous series confirming the excellent prognosis of gastric schwannomas.

  8. Incidental detection of colorectal lesions by FDG PET/CT scans in melanoma patients.

    Science.gov (United States)

    Young, Christopher J; Zahid, Assad; Choy, Ian; Thompson, John F; Saw, Robyn P M

    2017-11-01

    Increased use of PET/CT scans in oncology patients has raised detection of Colorectal incidentalomas (CIs). The frequency and diagnostic outcomes of identifying these lesions in melanoma patients have not previously been studied. This studies primary objective was to determine the prevalence of CIs found on PET/CT scans in melanoma patients. The secondary objectives were to correlate the PET/CT findings with the pathology found at colonoscopy, and identify which patients were referred for colonoscopy. A retrospective analysis of patients identified from the prospectively collected research database of Melanoma Institute Australia. 2509 patients with melanoma underwent PET/CT scans between 2001 and 2013. The prevalence of CIs, the correlation of lesions, and the survival of patients who underwent colonoscopy versus patients who did not were analyzed. The prevalence of CIs in melanoma patients who had PET/CT scans was 3.2%. Forty-five of the 81 (56%) patients with CIs underwent colonoscopy. Of these, premalignant or malignant disease was found in 58%. Patients with previous metastatic melanoma were significantly less likely to be referred for colonoscopy. Patients undergoing colonoscopy had significantly better survival, as did those without previous distant metastases before the CIs were found, and those without any metastases at the time the CIs were found. These factors were not significant on multivariate analysis. The prevalence of incidental colorectal lesions identified on PET/CT scans in melanoma patients was found to be equivalent to that in the general cancer population. Patients undergoing colonoscopy had better survival than those who did not. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  9. Longitudinal followup of incidentally detected pseudotumors in patients with metal on metal implants: A retrospective study

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    Khushboo Pilania

    2017-01-01

    Full Text Available Background: This study describes the significance and temporal evolution of incidentally detected, presumed, metal-induced reactive periprosthetic masses in patients with metal on metal (MoM hip arthroplasty and its management. The literature concerning the temporal evolution of these lesions is meagre and so it is still unclear, whether asymptomatic patients with periprosthetic collections should undergo revision. Materials and Methods: Patients with MoM hip replacements fitted with a recalled implant (ASR, DuPuy often undergo magnetic resonance imaging with metal artifact reduction sequences to look for complications. From a cohort of 136 asymptomatic patients, with 181 MoM hips, hips with a mention of periprosthetic masses in their reports at first presentation, and a repeat scan within 6 months to 3 years were selected for this retrospective study. Patients with complications such as loosening, osteomyelitis, and muscle/tendon tears were excluded from the study, and the final study cohort consisted of 55 MoM hips and 61 periprosthetic masses. Ethics committee approval is not required in our institution for retrospective studies. The followup scans of each patient were compared, and the periprosthetic masses were described to have progressed, regressed, or remained unchanged. Results: Comparison revealed that 29 of the 61 reactive masses remained unchanged, 20 regressed, while only 12 showed progression. The study, therefore, has maximum power as the outcome of interest, i.e., regression or unchanged status of the pseudotumors, was seen in approximately 80% (more than half of the study group. The P value of the study was < 0.005. Conclusion: Periprosthetic soft tissue masses are not uncommon in patients with MoM hips. The majority of them in asymptomatic individuals remain stable or regress in the short to medium term, and close followup or decisions on revision surgery may not be warranted in asymptomatic patients.

  10. Solitary eyelid schwannoma

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    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.

  11. 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...

  12. Incidental detection of adult polycystic kidney disease on routine bone scan

    Energy Technology Data Exchange (ETDEWEB)

    Axelrod, M.S.; Maayan, M.L.

    1989-04-01

    A routine bone scan performed on a 36-y old male incidentally demonstrated enlarged kidneys with multifocal areas of radionuclide concentration suggestive of polycystic kidneys. Further evaluation using ultrasonography, CT scan, and a /sup 99m/Tc-GHA renal scan confirmed the initial impression. The routine evaluation of the kidneys on a bone scan is emphasized as a simple method of identifying previously unsuspected renal structural abnormalities. (orig.).

  13. [Clinical analysis of 53 cases of retroperitoneal schwannoma].

    Science.gov (United States)

    Zhou, Haitao; Zhou, Zhixiang; Liang, Jianwei; Wang, Zheng; Zhang, Xingmao; Hu, Junjie; Zhao, Hong; Fang, Yi; Huang, Zhen; Wang, Jian; Zeng, Weigen

    2014-11-01

    To explore the clinical characteristics, diagnosis and treatment regimens for retroperitoneal schwannoma. Clinicopathological data of 53 retroperitoneal schwannoma patients treated from January 1999 to April 2013 in our hospital were collected and analyzed using SPSS 13.0 statistical software. Symptoms of the retroperitoneal schwannoma were vague and nonspecific. 12 patients had interrupted abdominal pain, 9 patients had abdominal discomfort, and only 6 patients presented with abdominal mass while 24 patients were detected by health checkup. There were some characteristics but not specific findings in imaging examination such as CT, ultrasonography and MRI, so preoperative diagnosis rate was low with only 9 patients diagnosed as retroperitoneal schwannoma and 21 patients diagnosed as neurogenic tumor. S-100 immunohistochemisty was very important in pathological diagnosis, and the patients with benign retroperitoneal schwannoma got 100% tumor specific 5-year survival after complete excision while the 5-year survival of malignant retroperitoneal schwannoma was only 50.0%. Retroperitoneal schwannoma is a rare disease. Most of them are benign tumors, and complete surgical excision is the effective treatment.

  14. Pneumomediastinum and subcutaneous emphysema after dental extraction detected incidentally by regular medical checkup: a case report.

    Science.gov (United States)

    Arai, Ikuko; Aoki, Takayuki; Yamazaki, Hiroshi; Ota, Yoshihide; Kaneko, Akihiro

    2009-04-01

    Most cases of pneumomediastinum are caused by iatrogenic injury during surgery on the cervical region and chest or by tracheostomy. It is also well known that emphysema may occur secondary to dental treatment using an air turbine drill, but there have been few cases of emphysema extending to involve the mediastinum. Presented is a rare case in which subcutaneous emphysema and pneumomediastinum developed asymptomatically, probably due to extraction of a mandibular third molar, and were found incidentally on the day after the dental procedure. To avoid subcutaneous emphysema and pneumomediastinum associated with dental treatment and surgical intraoral procedures such as tooth extraction, air turbine drills should be used only when it is essential.

  15. Sandstorm appearance of pulmonary alveolar microlithiasis incidentally detected in a young, asymptomatic male

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    Ching, Li Shyan; Bux, Shaik Ismail; Liam, Chong Kin; Rahman, Nazarina Abdul; Ho, Choon Yan [Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur (Malaysia)

    2013-10-15

    Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical 'sandstorm' appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM.

  16. Laparoscopic resection of a gastric schwannoma: A case report.

    Science.gov (United States)

    Vargas Flores, Edgar; Bevia Pérez, Francisco; Ramirez Mendoza, Pablo; Velázquez García, José Arturo; Ortega Román, Oscar Alejandro

    2016-01-01

    Mesenchymal tumors of the gastrointestinal tract are a group spindle cell tumors which include gastrointestinal stromal tumors, leiomyomas, leiomyosarcomas and schwannomas (Nishida and Hirota, 2000). Schwannomas generally present as a slow and asymptomatic growing mass in the gastrointestinal tract typically arising in the gastric submucosa accounting for up to 0.2% of gastric tumors (Melvin and Wilkinson, 1993; Sarlomo-Rikala M, Miettinen, 1995). with negative surgical margin resection (as approached in this case) is considered the standard treatment. A 60-year-old woman was referred to our general surgery service for dyspepsia. During her evaluation a gastric mass was incidentally found on upper GI endoscopy which showed a submucosal exophytic neoplasm at the gastric antrum. The patient was discharged following an uneventful recovery from a successful surgical laparoscopic tumor resection. Schwannomas are benign neurogenic tumors that originate from Schwann cells. They commonly occur in the head and neck but are rare in the GI tract (Menno et al., 2010). The differential diagnosis between gastric schwannomas and GISTs can be difficult in the preoperative assessment. With the advent of immunohistochemical staining techniques it is now possible to make a differential diagnosis based on their distinctive immunophenotypes. Gastric schwannomas are consistently positive for S-100 protein and negative for c-kit; conversely, 95% of GISTs are positive for c-kit and negative for S-100 protein in up to 98 to 99% of the cases. Gastric schwannomas should be included in the differential diagnosis of any gastric submucosal mass. Negative margin resection as seen with this patient is the standard surgical treatment as there is low malignant transformation potential. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. Incidental detection of hyperfunctioning thyroid cancer metastases in patients presenting with thyrotoxicosis

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    Nishikant A Damle

    2012-01-01

    Full Text Available Thyrotoxicosis due to functioning metastases from thyroid cancer is rare. It also presents a therapeutic challenge, as both the metastatic cancer and thyrotoxicosis need to be treated. We present here two cases of thyrotoxicosis which on a routine 99m Tc-pertechnetate thyroid scan showed extrathyroidal foci of uptake. Two patients who initially presented with thyrotoxicosis underwent a routine thyroid scan. Abnormal uptake in the shoulder was incidentally noted, which prompted us to do a whole body pertechnetate scan in the same sitting, which revealed extensive hyperfunctioning metastases in the lungs and bones. We also discuss the ′Flip Flop′ phenomenon in thyroid cancer, which was seen in our case. This report emphasizes the importance of evaluating the abnormal foci of uptake seen on a routine thyroid scan.

  18. Predictive factors for malignancy in incidental pulmonary nodules detected in breast cancer patients at baseline CT

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    Hammer, Mark M.; Mortani Barbosa, Eduardo J. [University of Pennsylvania, Division of Cardiothoracic Imaging, Department of Radiology, Perelman School of Medicine, Philadelphia, PA (United States)

    2017-07-15

    Pulmonary nodules are commonly encountered at staging CTs in patients with extrathoracic malignancies, but their significance on a per-patient basis remains uncertain. We undertook a retrospective analysis of pulmonary nodules identified in patients with a diagnosis of breast cancer from 2010 - 2015, evaluating nodules present at a baseline CT (i.e. prevalent nodules). We reviewed 211 patients with 248 individual nodules. The rate of malignancy in prevalent nodules is low, approximately 13 %. Variables associated with metastasis include pleural studding, hilar lymphadenopathy and the presence of extrapulmonary metastasis, as well as number of nodules, nodule size and nodule shape. Using a combination of these factors, we have developed an evidence-based multivariate decision tree to predict which nodules are malignant in these patients, which is 91 % accurate and 100 % sensitive for metastasis. We propose a simplified clinical prediction algorithm to guide radiologists and oncologists in managing patients with breast cancer and incidental pulmonary nodules. (orig.)

  19. Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Joong Keun Kim

    2014-12-01

    Full Text Available Malignant pheochromocytoma (PCC is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE. A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

  20. Interventions to increase osteoporosis treatment in patients with 'incidentally' detected vertebral fractures.

    Science.gov (United States)

    Majumdar, Sumit R; McAlister, Finlay A; Johnson, Jeffrey A; Bellerose, Debbie; Siminoski, Kerry; Hanley, David A; Qazi, Ibrahim; Lier, Douglas A; Lambert, Robert G; Russell, Anthony S; Rowe, Brian H

    2012-09-01

    Most vertebral compression fractures are not recognized or treated. We conducted a controlled trial in older patients with vertebral fractures incidentally reported on chest radiographs, comparing usual care with osteoporosis interventions directed at physicians (opinion-leader-endorsed evidence summaries and reminders) or physicians+patients (adding activation with leaflets and telephone counseling). Patients aged >60 years who were discharged home from emergency departments and who had vertebral fractures reported but were not treated for osteoporosis were allocated to usual care (control) or physician intervention using alternate-week time series. After 3 months, untreated controls were re-allocated to physician+patient intervention. Allocation was concealed, outcomes ascertainment blinded, and analyses intent-to-treat. Primary outcome was starting osteoporosis treatment within 3 months. There were 1315 consecutive patients screened, and 240 allocated to control (n=123) or physician intervention (n=117). Groups were similar at baseline (average age 74 years, 45% female, 58% previous fractures). Compared with controls, physician interventions significantly (all P vs 2 [2%]), bone mineral density testing (51 [44%] vs 5 [4%]), and bone mineral density testing or treatment (57 [49%] vs 7 [6%]). Three months after controls were re-allocated to physician+patient interventions, 22% had started treatment and 65% had bone mineral density testing or treatment (P vs controls). Physician+patient interventions increased bone mineral density testing or treatment an additional 16% compared with physician interventions (P=.01). An opinion-leader-based intervention targeting physicians substantially improved rates of bone mineral density testing and osteoporosis treatment in patients with incidental vertebral fractures, compared with usual care. Even better osteoporosis management was achieved by adding patient activation to physician interventions [NCT00388908]. Copyright

  1. 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....

  2. Incidental auditory category learning.

    Science.gov (United States)

    Gabay, Yafit; Dick, Frederic K; Zevin, Jason D; Holt, Lori L

    2015-08-01

    Very little is known about how auditory categories are learned incidentally, without instructions to search for category-diagnostic dimensions, overt category decisions, or experimenter-provided feedback. This is an important gap because learning in the natural environment does not arise from explicit feedback and there is evidence that the learning systems engaged by traditional tasks are distinct from those recruited by incidental category learning. We examined incidental auditory category learning with a novel paradigm, the Systematic Multimodal Associations Reaction Time (SMART) task, in which participants rapidly detect and report the appearance of a visual target in 1 of 4 possible screen locations. Although the overt task is rapid visual detection, a brief sequence of sounds precedes each visual target. These sounds are drawn from 1 of 4 distinct sound categories that predict the location of the upcoming visual target. These many-to-one auditory-to-visuomotor correspondences support incidental auditory category learning. Participants incidentally learn categories of complex acoustic exemplars and generalize this learning to novel exemplars and tasks. Further, learning is facilitated when category exemplar variability is more tightly coupled to the visuomotor associations than when the same stimulus variability is experienced across trials. We relate these findings to phonetic category learning. (c) 2015 APA, all rights reserved).

  3. Ethical framework for the detection, management and communication of incidental findings in imaging studies, building on an interview study of researchers’ practices and perspectives

    NARCIS (Netherlands)

    E.M. Bunnik (Eline); L. Van Bodegom (Lisa); W. Pinxten (Wim); I.D. de Beaufort (Inez); M.W. Vernooij (Meike)

    2017-01-01

    textabstractBackground: As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with

  4. Incidentally Detected Primary Giant Renal Cystic Enchinococcosis in a Young Patient: An Underestimated Entity?

    Directory of Open Access Journals (Sweden)

    Emre Urer

    2015-01-01

    Full Text Available Echinococcosis is a parasitic infestation caused by Echinococcus granulosus and is an endemic disease in many parts of world. The symptoms and signs depend on the location and size of the cyst. Renal cystic echinococcosis or hydatid cyst (HC disease of the kidney is extremely rare and constitutes only 2-4% of all cases of hydatid disease (HD. We present a 39-year-old male patient who was referred to our outpatient clinic with cystic right kidney mass that was incidentally diagnosed during hepatobiliary ultrasound for chronic hepatitis B evaluation. Routine blood tests were normal without eosinophilia. Indirect haemagglutination test was negative. Abdominal kidneys, ureters, and bladder X-ray showed an 83×95 mm sized curvilinear calcification in the right upper abdominal quadrant. Abdominal computed tomography scan and magnetic resonance imaging demonstrated a 10x9x10 cm sized cystic mass arising from the middle pole of the right kidney, destructing the whole upper pole and extending into the liver. Daughter vesicles were present in the cystic lesion suggesting renal HD. Right retroperitoneal exploration with flank approach and right radical nephrectomy was performed without any complications. Pathology confirmed HC lesion. Following surgery, albendazole 400 mg per os twice daily for 4 weeks was suggested.

  5. Hypervascular vestibular Schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  6. 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....

  7. True incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  8. Prognostic value of incidental hypervascular micronodules detected on cone-beam computed tomography angiography of patients with liver metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Odisio, Bruno C.; Mahvash, Armeen; Gupta, Sanjay; Tam, Alda L.; Murthy, Ravi [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology, Division of Diagnostic Imaging, Houston, TX (United States); Cox, Veronica L.; Faria, Silvana C. [The University of Texas MD Anderson Cancer Center, Diagnostic Radiology, Houston, TX (United States); Yamashita, Suguru; Vauthey, Jean-Nicolas [The University of Texas MD Anderson Cancer Center, Surgical Oncology, Houston, TX (United States); Shi, Xiao [Baylor College of Medicine, Department of Diagnostic Radiology, Houston, TX (United States); Ensor, Joe [Biostatistics of the Houston Methodist Cancer Center, Houston, TX (United States); Jones, Aaron K. [The University of Texas MD Anderson Cancer Center, Imaging Physics, Houston, TX (United States)

    2017-11-15

    To determine the clinical relevance of incidentally-found hypervascular micronodules (IHM) on cone-beam computed tomography angiography (CBCTA) in patients with liver metastasis undergoing transarterial (chemo)embolization (TACE/TAE). This was a HIPAA-compliant institutional review board-approved single-institution retrospective review of 95 non-cirrhotic patients (52 men; mean age, 60 years) who underwent CBCTA prior to (chemo)embolic delivery. IHM were defined by the presence of innumerable subcentimetre hepatic parenchymal hypevascular foci not detected on pre-TACE/TAE contrast-enhanced cross-sectional imaging. Multivariate analysis was performed to compare time to tumour progression (TTP) between patients with and without IHM. IHM were present in 21 (22%) patients. Patients with IHM had a significantly shorter intrahepatic TTP determined by a higher frequency of developing new liver metastasis (hazard ratio [HR]: 1.99; 95% confidence interval [CI] 1.08-3.67, P= 0.02). Patients with IHM trended towards a shorter TTP of the tumour(s) treated with TACE/TAE (HR: 1.72; 95% CI: 0.98-3.01, P= 0.056). Extrahepatic TTP was not significantly different between the two cohorts (P= 0.27). Patients with IHM on CBCTA have worse prognosis due to a significantly higher risk of developing new hepatic tumours. Further work is needed to elucidate its underlying mechanisms of pathogenesis. (orig.)

  9. The Rate and Clinical Significance of Incidental Thyroid Uptake as Detected by Gallium-68 DOTATATE Positron Emission Tomography/Computed Tomography

    OpenAIRE

    Nockel, Pavel; Millo, Corina; Keutgen, Xavier; Klubo-Gwiezdzinska, Joanna; Shell, Jasmine; Patel, Dhaval; Nilubol, Naris; Herscovitch, Peter; Sadowski, Samira M.; Kebebew, Electron

    2016-01-01

    Background: Gallium-68 (Ga-68) DOTATATE is a radiolabeled peptide���imaging modality that targets the somatostatin receptor (SSTR), especially subtype 2 (SSTR2). Benign and malignant thyroid tumors have been observed to express SSTR. The aim of this study was to evaluate the frequency and clinical significance of incidental atypical thyroid uptake as detected by Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT).

  10. Parathyroid Adenoma, Gastric Adenocarcinoma, and Intraabdominal Schwannoma in One Patient

    Directory of Open Access Journals (Sweden)

    Gülşah Elbüken

    2016-09-01

    Full Text Available Intraabdominal schwannomas, which occur quite rarely, are usually benign tumors. They are often discovered coincidentally when abdominal scans are performed for other reasons. We also coincidentally detected an intraabdominal schwannoma in addition to primary hyperparathyroidism related to a parathyroid adenoma and a gastric adenoma which caused partial pyloric obstruction in a 69-year-old female patient who was admitted to our emergency room with vomiting while we were further investigating hypercalcemia that was found during laboratory workup. It is rare to diagnose multiple tumors concurrently in a single patient which are components of certain neuroendocrine syndromes themselves. It is more interesting to see a rare tumor such as intraabdominal schwannoma coexisting with a parathyroid adenoma that can be a component of multiple endocrine neoplasia syndromes. In the literature, there are few case reports of the coexistence of intraabdominal schwannomas with adenocarcinoma of the gastrointestinal tract. Here, we present an unusual case of intraabdominal schwannoma coexisting with parathyroid adenoma and gastic adenocarcinoma, all diagnosed in a single patient. To our best knowledge, this is the first case report of such a rare coexistence which makes it rather interesting.

  11. [A Case of Pelvic Schwannoma, Mimicking Metastasis of Rectal Carcinoma].

    Science.gov (United States)

    Watanabe, Yuichiro; Baba, Hiroyuki; Matsuzawa, Takeaki; Fukuchi, Minoru; Kumagai, Youichi; Ishibashi, Keiichiro; Mochiki, Erito; Ishida, Hideyuki

    2015-11-01

    Schwannoma in the lateral lymph node region is extremely rare; however, this tumor has been reported to have relatively high SUV on PET-CT, suggestive of malignancy. A 67-year-old man with advanced lower rectal cancer had a small nodule with FDG accumulation (SUVmax 2.6) near the left internal iliac artery. His preoperative diagnosis was rectal cancer with lateral lymph node metastasis. He underwent super-low anterior resection with lateral lymph node dissection. Histopathological examination was conclusive for pT3 (A), with an Rt263D lymph node metastasis. Interestingly, a schwannoma was detected among the harvested lymph nodes. Although rectal cancer is known to involve pelvic lymph nodes, the role of preoperative diagnosis with FDG-PET is unclear. We should consider that schwannoma is associated with slight elevation of SUVmax and it may mimic lymph node metastasis.

  12. 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...

  13. 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.)

  14. Clinicopathologic Features of Gastric Schwannoma

    OpenAIRE

    Tao, Kaixiong; Chang, Weilong; Zhao, Ende; Deng, Rui; Gao, Jinbo; Cai, Kailin; Wang, Guobin; Zhang, Peng

    2015-01-01

    Abstract To explore the clinicopathologic characteristics, diagnosis, treatment, and prognosis of gastric schwannoma in the imatinib era. The clinicopathologic characteristics and postoperative outcomes of patients diagnosed with gastric schwannoma at our institution between January 2007 and February 2015 were retrospectively collected and analyzed. The main patient complaint was epigastric pain or discomfort. Tumor sizes ranged from 15 to 80?mm (mean, 57.1?mm). In 17 patients, the tumors wer...

  15. Thyroid lesions incidentally detected by 18F-FDG PET-CT ― a two centre retrospective study

    Directory of Open Access Journals (Sweden)

    Jamsek Jan

    2015-06-01

    Full Text Available Background. Incidental 18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.

  16. Intramedullary schwannoma of conus medullaris with syringomyelia

    Directory of Open Access Journals (Sweden)

    Mete Karatay

    2017-05-01

    Full Text Available Intramedullary schwannomas of the spinal cord are rare tumors. They are most commonly observed in the cervical region; however, few have been described in the conus medullaris. The association of intramedullary schwannomas with syringomyelia is also rare. In this report, we present a case of intramedullary schwannoma of the conus medullaris with syringomyelia, which was treated surgically.

  17. Intramedullary schwannoma of conus medullaris with syringomyelia.

    Science.gov (United States)

    Karatay, Mete; Koktekir, Ender; Erdem, Yavuz; Celik, Haydar; Sertbas, Idris; Bayar, Mehmet Akif

    2017-05-01

    Intramedullary schwannomas of the spinal cord are rare tumors. They are most commonly observed in the cervical region; however, few have been described in the conus medullaris. The association of intramedullary schwannomas with syringomyelia is also rare. In this report, we present a case of intramedullary schwannoma of the conus medullaris with syringomyelia, which was treated surgically. Copyright © 2017. Published by Elsevier Taiwan.

  18. Frequency of New Pulmonary Neoplasm Incidentally Detected by Computed Tomography Angiography in Acute Stroke Patients—A Single-Center Study

    DEFF Research Database (Denmark)

    Bentsen, Line; Christensen, Anders; Havsteen, Inger

    2015-01-01

    . The aim of the present study was to report the frequency of suspect lung opacities on routine acute stroke imaging. METHODS: Seven hundred and fifty-seven consecutive stroke patients evaluated for intravenous thrombolysis treatment within 4.5 hours of symptom debut, from June 2009 to December 2011, were......BACKGROUND: Incidental findings of suspect lung opacities are common in computed tomography (CT)-based thorax examinations, especially in high-risk patients, such as stroke patients. Screening with CT of the thorax has detected lung cancer in approximately .31%-1.20% of high-risk populations...... not support full CT of the thorax as routine on stroke patients....

  19. Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity

    Energy Technology Data Exchange (ETDEWEB)

    Arponen, Otso; Masarwah, Amro; Taina, Mikko [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sutela, Anna; Koenoenen, Mervi; Hakumaeki, Juhana; Sudah, Mazen [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sironen, Reijo [Kuopio University Hospital, Kuopio University Hospital, Department of Pathology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Clinical Pathology and Forensic Medicine, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland); Vanninen, Ritva [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland)

    2016-12-15

    To evaluate the value of adding T2- and diffusion-weighted imaging (DWI) to the BI-RADS registered classification in MRI-detected lesions. This retrospective study included 112 consecutive patients who underwent 3.0T structural breast MRI with T2- and DWI on the basis of EUSOMA recommendations. Morphological and kinetic features, T2 signal intensity (T2 SI) and apparent diffusion coefficient (ADC) findings were assessed. Thirty-three (29.5 %) patients (mean age 57.0 ± 12.7 years) had 36 primarily MRI-detected incidental lesions of which 16 (44.4 %) proved to be malignant. No single morphological or kinetic feature was associated with malignancy. Both low T2 SI (P = 0.009) and low ADC values (≤0.87 x 10{sup -3} mm{sup 2}s{sup -1}, P < 0.001) yielded high specificity (80.0 %/80.0 %). The BI-RADS classification supplemented with information from DWI and T2-WI improved the diagnostic performance of the BI-RADS classification as sensitivity remained 100 % and specificity improved from 30 % to 65.0 %. The numbers of false positive lesions declined from 39 % (N = 14) to 19 % (N = 7). MRI-detected incidental lesions may be challenging to characterize as they have few specific malignancy indicating features. The specificity of MRI can be improved by incorporating T2 SI and ADC values into the BI-RADS assessment. (orig.)

  20. Clinicopathologic Features of Gastric Schwannoma

    Science.gov (United States)

    Tao, Kaixiong; Chang, Weilong; Zhao, Ende; Deng, Rui; Gao, Jinbo; Cai, Kailin; Wang, Guobin; Zhang, Peng

    2015-01-01

    Abstract To explore the clinicopathologic characteristics, diagnosis, treatment, and prognosis of gastric schwannoma in the imatinib era. The clinicopathologic characteristics and postoperative outcomes of patients diagnosed with gastric schwannoma at our institution between January 2007 and February 2015 were retrospectively collected and analyzed. The main patient complaint was epigastric pain or discomfort. Tumor sizes ranged from 15 to 80 mm (mean, 57.1 mm). In 17 patients, the tumors were located in the body of the stomach. A total of 20 patients were preoperatively misdiagnosed with a gastrointestinal stromal tumor. The rate of correct preoperative diagnosis was only 3.3%. All patients underwent surgical resection and showed strong S-100 protein positivity. Laparoscopic surgery for gastric schwannoma was associated with less blood loss and a shorter postoperative hospital stay than open surgery (P Gastric schwannoma is often preoperatively misdiagnosed as gastric gastrointestinal stromal tumor. Laparoscopic resection of gastric schwannoma is considered safe and effective, and it may be the preferred surgery for most small- and moderate-sized tumors. The long-term outcome is excellent, as this type of neoplasm is uniformly benign. PMID:26559271

  1. Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Chae, Eun Young; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Kim, Hyun Ji; Oh, Ha Yeun [Dept. of Radiology, Research Inst. of Radiology, Asan Medical Center, Coll. of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)], e-mail: jhcha@amc.seoul.kr; Koh, Young Hwan [Center for Liver Cancer, National Cancer Center, Seoul (Korea, Republic of); Moon, Dae Hyuk [Dept. of Nuclear Medicine, Asan Medical Center, Coll. of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2012-06-15

    Background: With the widespread use of PET/CT, incidental hypermetabolic foci unrelated to the known malignancy have been described with increasing frequency. Purpose: To determine the frequency and clinical significance of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT, and to explore factors differentiating benign and malignant breast uptake. Material and Methods: From January 2005 to June 2010, a total of 51971 whole-body FDG PET/CT examinations were performed in our clinic. After excluding 7254 sets of PET/CT data from patients known to have breast cancer, we retrospectively identified patients showing incidental focal hypermetabolic activity in the breast. Of 44717 PET/CT examinations conducted on 32988 patients, we identified 131 patients with no previous known or suspected benign and malignant breast disease. The etiology, mean SUVmax, and diameter of breast lesions were assessed. We also compared the presentation of the lesions on CT, mammography, and ultrasonography. Results: Of the 131 patients, 60 were histologically diagnosed with breast lesions, including 32 with malignant and 28 with benign lesions. An additional 11 patients were followed-up for more than 2 years and were clinically considered to have benign lesions. The remaining 60 patients who had neither histologic confirmation nor followed-up for more than 2 years were excluded. Therefore, 71 patients were finally included. The mean SUVmax of 39 benign lesions and 32 malignant lesions were 2.02{+-}1.52 and 3.71{+-}3.83, respectively (P 0.0001). At a cut-off value of 2.3, the rate of malignancy and specificity of the mean SUVmax for differentiating benign and malignant breast lesions were 61.3%, 76.3, respectively. The CT data from PET/CT revealed that the mean diameters of benign and malignant lesions were 1.19{+-}0.97 cm and 2.26{+-}1.96 cm, respectively (P = 0.0009). Conclusion: Incidental focal 18F-FDG uptake in the breast as detected by PET/CT was

  2. Incidental detection of haemoglobin (Hb) variants during high performance liquid chromatography (HPLC) analysis of HbA1c: is it time for a standardised approach to reporting?

    Science.gov (United States)

    Reeve, J; Blake, L; Griffin, D; O'Shea, P

    2015-06-01

    Haemoglobin (Hb) variants are genetic variations in the globin genes that code for an abnormal globin protein structure. The prevalence of Hb variants has increased in Ireland due to the number of emigrants from Africa and Southeast Asia. The rate of incidentally detected Hb variants, in laboratories employing HPLC to measure HbA1c, has increased in parallel. The presence of a Hb variant can compromise HbA1c measurement and interpretation. In such cases, HbA1c cannot be used to diagnose diabetes or to assess concordance with glycaemic targets. To establish the number of incidentally identified Hb variants during 10 months of routine HbA1c analysis, and the percentage of HbA1c reports alerting the requesting clinician to the presence of a Hb variant. The laboratory database was interrogated to extract all records of HbA1c requests and incidentally identified Hb variants from March to December 2012. A total of 32,636 HbA1c analyses were performed during the evaluation period. Seventy-three Hb variants were identified in a total of 46 patients. In 32.6% (15 of 46) the haemoglobinopathy status was known prior to testing and 97% of HbA1c reports communicated the presence of the Hb variant to the requesting clinician. Hb variants may invalidate the results of HbA1c analysis and could result in a missed diagnosis or a misdiagnosis of diabetes or mismanagement of a patient with diabetes mellitus. It is, therefore, imperative that a comment alerting the requesting clinician to the presence of the Hb variant is appended to the HbA1c result.

  3. Segmental neurofibromatosis with deep schwannoma.

    Science.gov (United States)

    Smith, Wallace A; Buhalog, Brittany A; Fiala, Katherine H

    2016-01-01

    An elderly patient presented with two clusters of asymptomatic fleshy and pedunculated papules. Biopsy of the papules was consistent with neurofibromas. Decades prior she had undergone a surgery for the excision of a large schwannoma. Given her lack of other neurofibromatosis findings, the patient was diagnosed with multisegmental neurofibromatosis (multi-SN) with deep schwannoma, a possible new phenotype of SN. Because this entity may be associated with internal malignancy, it is important to screen and educate these patients as well as to provide regular follow-up.

  4. Segmental neurofibromatosis with deep schwannoma

    Directory of Open Access Journals (Sweden)

    Wallace A Smith

    2016-01-01

    Full Text Available An elderly patient presented with two clusters of asymptomatic fleshy and pedunculated papules. Biopsy of the papules was consistent with neurofibromas. Decades prior she had undergone a surgery for the excision of a large schwannoma. Given her lack of other neurofibromatosis findings, the patient was diagnosed with multisegmental neurofibromatosis (multi-SN with deep schwannoma, a possible new phenotype of SN. Because this entity may be associated with internal malignancy, it is important to screen and educate these patients as well as to provide regular follow-up.

  5. Gastric Schwannoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kye Ho; Jee, Keum Nahn [Dankook University Cellege of Medicine, Seoul (Korea, Republic of)

    2006-03-15

    Gastric Schwannoma is a rare benign intramural tumor arising from the stomach, and it accounts for only 0.1% of all the different kinds of gastric neoplasms, and it's less than 4% of all the benign gastric tumors. This tumor is very difficult to differentiate from the other mesenchymal tumors by the clinical, endoscopic and radiologic findings. In this study, we demonstrate the appearance of this tumor on endoscopic ultrasound and contrast-enhanced abdomen CT. We also show the histopathologic findings of a surgically confirmed gastric Schwannoma that was located in the proper muscle layer.

  6. [Difficult and unusual diagnostic and therapeutic gastric Schwannoma case].

    Science.gov (United States)

    Frejlich, Ewelina; Rudno-Rudzińska, Julia; Hałoń, Agnieszka; Kielan, Wojciech; Grzebianiak, Zygmunt

    2013-01-01

    Schwannoma is a rare, usually benign, generally slow growing, asymptomatic mesenchymal neoplasm derived from nerve cells. In the gastrointestinal tract the most common localization is stomach and the gastric schwannomas represent about 0.2% of all gastric neoplasms. We present a case of 44-years-old male admitted to 2nd Department of General Surgery and Oncological Surgery Medical University for treatment of a submucosal gastric tumor detected in upper gastrointestinal endoscopy, endoscopic ultrasonography and computed tomography (CT). Patient presented with no gastrointestinal disorders and the random endoscopy revealed a gastric tumor, but the biopsy of the lesion showed no carcinomas' cells and the suspicion of GIST. CT confirms the presence of the 5 cm large gastric tumor and intraabdominal lymphadenopathy. The patient was directed to surgery because of the malignant risk. The subtotal gastrectomy with BII anastomosis was performed and no perioperative complications were observed. The postoperative histopathological examination revealed a typical morphology and immunophenotype of tumor. The neoplastic cells were immunoreactive with S-100 protein, but lacked immunoreactivity with CD 117, CD 34 and smooth-muscle actin (SMA). The histopathologic features and immunohistochemical staining pattern were consistent with a gastric schwannoma. The lymph nodes resected, during the operation revealed reactive inflammatory changes without evidence of neoplastic cells and any malignancy. 10-month after the surgery patient has no complains but the follow up will be continued. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass.

  7. Schwannoma de párpado Eyelid schwannoma

    Directory of Open Access Journals (Sweden)

    E. Moretti

    2012-09-01

    Full Text Available El schwannoma es un tumor benigno de las células de Schwann de los nervios periféricos. Cuando se origina en ramas del V par craneal puede representar el 0,7 % de los tumores palpebrales. Aunque rara vez maligniza, la cirugía es el tratamiento de elección. Hasta donde conocemos, existen 11 casos de schwannoma palpebral publicados en la literatura. Nuestro objetivo es presentar un caso clínico de esta estirpe tumoral en una paciente de 51 años de edad, con antecedentes de extirpación transconjuntival previa de chalazión.Schwannoma is a benign tumour of Schwann cells of the peripheral nerves. When originated from branches of the V cranial nerve can represent 0.7 % of eyelid tumours. Although rarely malignant, surgery is the treatment of choice. Until we can know, there are 11 cases reported in the literature. Our goal is to present a case of eyelid schwannoma in a 51 years old patient with a history of previous transconjunctival excision of chalazion.

  8. Sporadic NF2 Mosaic: Multiple spinal schwannomas presenting with severe, intractable pain following pregnancy

    Directory of Open Access Journals (Sweden)

    Jeffrey H. Zimering

    2017-12-01

    Full Text Available The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus. There were two small punctate lesions in the cauda equina suggestive of myxopapillary ependymoma with ‘drop metastases.’ The patient underwent surgical resection of two cystic compressive conus masses. Her low back pain improved after surgery. The masses were consistent with cystic/cellular schwannomas. An incidental finding was of a small, low-grade spinal ependymoma which lacked the characteristic histologic features of myxopapillary ependymoma. Multiple, large cystic schwannomas are not uncommon in schwannomatosis, however, the co-occurrence of low-grade ependymoma strongly suggests a clinical diagnosis of new, sporadic neurofibromatosis type 2. Although cranial nerve schwannomas (orbital, auditory have been reported to enlarge during pregnancy, to our knowledge, this is the first report of multiple cystic/cellular schwannomas causing severe pain (due to conus compression during and immediately after pregnancy.

  9. 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)

  10. Special problems encountering surgical management of large retroperitoneal schwannomas

    Science.gov (United States)

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

    2008-01-01

    Background Retroperitoneal schwannomas are rare, usually benign tumors that originate in the neural sheath and account for only a small percentage of retroperitoneal tumors. The aim of this clinical study is to present our experience in managing retroperitoneal schwannomas with a review of the current literature and to point out the surgical technical difficulties we faced, due to the tumor's strange behavior that eroded the vertebra in two cases without causing malignant invasion. Methods We reviewed the medical files of 69 patients treated in our department for retroperitoneal tumors from January 1991 until December 2006. Five patients had retroperitoneal schwannomas according to pathology report. Results There were two male and three female patients, with a mean age of 56 years (range 44–67 years). All patients were asymptomatic and none suffered from von Recklinghausen disease. Imaging workup included ultrasonography, computed tomography and magnetic resonance imaging. One patient, after having a non-diagnostic computed tomography fine needle aspiration (CT-FNA), underwent exploratory laparotomy and incisional biopsy that established the diagnosis of schwannoma. After complete excision of the tumors, postoperative course was uneventful in all patients. Tumors' maximum diameter was 12.7 cm (range 7–20 cm). No recurrences were detected during the follow up period (6–75 months). Conclusion Preoperative establishment of diagnosis is difficult in case of retroperitoneal schwannomas, however close relationship of retroperitoneal tumors with adjacent neural structures in imaging studies should raise a suspicion. Complete surgical resection is the treatment of choice. Histology and Immunohistochemistry confirms the diagnosis. PMID:18834531

  11. AN INTERESTING CASE OF ANCIENT SCHWANNOMA

    Directory of Open Access Journals (Sweden)

    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

  12. The Rate and Clinical Significance of Incidental Thyroid Uptake as Detected by Gallium-68 DOTATATE Positron Emission Tomography/Computed Tomography.

    Science.gov (United States)

    Nockel, Pavel; Millo, Corina; Keutgen, Xavier; Klubo-Gwiezdzinska, Joanna; Shell, Jasmine; Patel, Dhaval; Nilubol, Naris; Herscovitch, Peter; Sadowski, Samira M; Kebebew, Electron

    2016-06-01

    Gallium-68 (Ga-68) DOTATATE is a radiolabeled peptide-imaging modality that targets the somatostatin receptor (SSTR), especially subtype 2 (SSTR2). Benign and malignant thyroid tumors have been observed to express SSTR. The aim of this study was to evaluate the frequency and clinical significance of incidental atypical thyroid uptake as detected by Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT). A retrospective analysis was conducted of a prospective study in which 237 patients underwent Ga-68 DOTATATE PET/CT as part of a work-up for metastatic and unknown primary neuroendocrine tumors. The types of uptake in the thyroid gland (focal/diffuse) and maximum standardized uptake value (SUVmax) levels were evaluated and compared with the background uptake in the liver and salivary glands. Of 237 patients, 26 (11%) had atypical thyroid uptake as detected by Ga-68 DOTATATE PET/CT. There were no significant clinical or biochemical variables associated with atypical thyroid uptake. Fourteen (54%) patients had positive focal uptake, and 12 (46%) patients had diffuse uptake. Of the 14 patients with atypical focal uptake, 10 (71%) had thyroid nodules on the corresponding side, as detected by anatomic imaging. Three of 10 patients (21%) were found to have papillary thyroid cancer, and seven (70%) had adenomatoid nodules. Of the 12 patients with diffuse increased uptake, six (50%) had a history of hypothyroidism, five (42%) had chronic lymphocytic thyroiditis, and one (8%) had nontoxic multinodular goiter. Patients with an incidental focal abnormal thyroid uptake on Ga-68 DOTATATE PET/CT scan should have further clinical evaluation to exclude a diagnosis of thyroid cancer.

  13. 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.

  14. 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.

  15. 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....

  16. Solitary gastric melanotic schwannoma: sonographic findings.

    Science.gov (United States)

    Chen, Yang-Yuan; Yen, Hsu-Heng; Soon, Maw-Soan

    2007-01-01

    Solitary gastric schwannoma is rare, and solitary melanotic schwannoma is even rarer, posing a dilemma in diagnosis and treatment. We report the case of a 69-year-old woman with gastric melanotic schwannoma who presented with nausea, vomiting, and abdominal pain. Abdominal sonographic examination revealed a 5-cm hypoechoic mass in the epigastric area that was confirmed to be a gastric submucosal tumor on endoscopic examination. The diagnosis of melanotic schwannoma was confirmed via sonographically guided percutaneous core biopsy. The tumor was resected, and no recurrence has occurred in a 3-year follow-up.

  17. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature.

    Science.gov (United States)

    Voltaggio, Lysandra; Murray, Rebecca; Lasota, Jerzy; Miettinen, Markku

    2012-05-01

    Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT, DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor-specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein-positive gastrointestinal clear cell sarcoma and metastatic

  18. GASTRIC SCHWANNOMA – A CLINICOPATHOLOGIC STUDY OF 51 CASES AND CRITICAL REVIEW OF THE LITERATURE

    Science.gov (United States)

    Voltaggio, Lysandra; Murray, Rebecca; Lasota, Jerzy; Miettinen, Markku

    2011-01-01

    Schwannoma is a rare gastrointestinal mesenchymal tumor as the vast majority of gastric mesenchymal tumors are GISTs. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men, median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely by gastric outlet obstruction, and many were incidental findings during other medical procedures. The tumors ranged from 1–10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization and dilatation, were absent or infrequent. Median mitotic count was 2/50 HPFs, with the highest count being 13/50 HPFs. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT, DOG1/Ano 1, SMA, desmin, and synaptophysin. None of the 9 tumors studied contained GIST-specific KIT or PDGFRA mutations. FISH studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from GIST and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein-positive gastrointestinal clear cell sarcoma and metastatic melanoma. PMID:22137423

  19. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  20. 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.

  1. Cellular schwannoma arising from sigmoid mesocolon presenting ...

    African Journals Online (AJOL)

    We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation. Keywords: Pelvis, Retroperitoneum, Schwannoma, Sigmoid mesocolon, Torsion, Tumor ...

  2. Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting ...

    African Journals Online (AJOL)

    We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation. Keywords: Pelvis, Retroperitoneum, Schwannoma, Sigmoid mesocolon, Torsion, Tumor.

  3. 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.

  4. 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.

  5. Gastric Schwannoma: A Case Report.

    Science.gov (United States)

    Romdhane, Hayfa; Cheikh, Myriam; Mzoughi, Zeineb; Slama, Sana Ben; Ennaifer, Rym; Belhadj, Najet

    2016-10-24

    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.

  6. Incidental detection of a small solid pseudopapillary neoplasm of the pancreas after a traffic accident in a 12-year-old girl: a case report

    Directory of Open Access Journals (Sweden)

    Kim Y

    2015-10-01

    Full Text Available Younglim Kim, Suk-Bae MoonDepartment of Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South KoreaAbstract: Solid pseudopapillary neoplasm (SPN is a rare tumor of the pancreas that tends to grow silently in patients at a young age, to a large size and mass. We report here a case of a small-sized SPN detected incidentally in a 12-year-old girl following a traffic accident. The tumor was 3.5 cm in maximal diameter and was found to have hemorrhagic necrosis without a solid component. Laparoscopic spleen-preserving distal pancreatectomy was performed which cured the patient. SPN is generally accepted to be a low grade malignant tumor, but its clinical behavior is sometimes unpredictable. Tumor size and the proportion of solid portion of the tumor have both recently been identified as predictors of malignancy. Although the initial presentation in this case was that of the traffic accident, the subsequent detection of a small, totally cystic SPN, and then the complete eradication of the lesion, led to a favorable outcome for the patient. Long-term monitoring should prevent any chance of recurrence.Keywords: pancreatic neoplasm, children, distal pancreatectomy

  7. Schwannoma of the stomach: a case report.

    Science.gov (United States)

    Singh, Aminder; Mittal, Ankur; Garg, Bhavna; Sood, Neena

    2016-01-15

    Schwannomas, also known as neurilemmomas, are benign slow-growing neoplasms originating from a Schwann cell sheath. These neoplasms are rare among the mesenchymal tumors of the gastrointestinal tract. In the stomach, Schwannomas only represent 0.2 % of all gastric tumors; this makes the presentation of a schwannoma in the stomach of a man in his seventh decade unusual. This case report highlights the rarity of a schwannoma at the greater curvature of the stomach because only a few cases have been reported in the literature. This case describes the importance of including gastric schwannomas in the differential diagnosis when preoperative assessment reveals a submucosal gastric mass with gastrointestinal stromal tumor as a leading differential diagnosis because of its common occurrence at this site. A 72-year-old man of Indian origin presented with a painless abdominal mass with nonspecific gastrointestinal upset. An endoscopy showed a submucosal lesion in his stomach measuring 4 × 3 × 2 cm. Histology revealed a benign spindle cell tumor. Immunohistochemistry confirmed the diagnosis of gastric schwannoma. He is on regular follow-up and doing well. It should be remembered that a schwannoma can present as a mass lesion in the stomach and mimic gastrointestinal stromal tumor. Patients should undergo an endoscopy and a biopsy of the lesion should be done. Many patients do not undergo endoscopy which can delay diagnosis and management. As these tumors have an excellent prognosis, surgical removal is sufficient treatment. Surgeons, radiologists, pathologists and gastroenterologists must be aware of this entity.

  8. 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.

  9. Gastric Schwannoma: A Case Report

    Directory of Open Access Journals (Sweden)

    S. Shariat-Torbaghan

    2008-02-01

    Full Text Available Gastrointestinal mesenchymal tumors are a group of tumors originating from the mesenchymal stem cells of the GI tract. Digestive tract Schwannomas are rare mesenchymal tumors which occur most frequently in the stomach.We report a 56-yearold woman who was examined endoscopically for dyspepsia which she had suffered from since 3 years ago.Around gastric antral mass was seen.Surgical resection was recommended.The pathological examination revealed a spindle cell tumor that was strongly positive for S-100 protein stain and non-reactive for other markers.The literature is reviewed. 

  10. 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.

  11. Proximal tibial epiphyseal intraosseous schwannoma: a rare entity.

    Science.gov (United States)

    Meyer, Alain; Sailhan, Frédéric; Coulomb, Aurore; Thevenin-Lemoine, Camille; Mary, Pierre; Ducou-Lepointe, Hubert; Damsin, Jean-Paul

    2008-01-01

    Schwannoma is a benign nerve sheath tumor most commonly located in the soft tissue. Occasionally, schwannomas involve osseous structures. The rarity of osseous involvement leads to omission of schwannoma from the initial differential diagnosis in the majority of cases. Intraosseous schwannomas arising in children have not been reported. We present the case of a schwannoma affecting the proximal tibial epiphysis in a growing child. Intraosseous schwannomas should be included in the differential diagnosis of lytic epiphyseal benign-appearing bone lesions in children. Its radiographic characteristics mimic those of benign chondroblastoma.

  12. Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis.

    Directory of Open Access Journals (Sweden)

    Yu-Pang Lin

    Full Text Available To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs. A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI to measure the HU within the most suspicious part of the lesion.

  13. Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis.

    Science.gov (United States)

    Lin, Yu-Pang; Hsu, Hsian-He; Ko, Kai-Hsiung; Chu, Chi-Ming; Chou, Yu-Ching; Chang, Wei-Chou; Chang, Tsun-Hou

    2016-01-01

    To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units) to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs). A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU) analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU) to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI) to measure the HU within the most suspicious part of the lesion.

  14. 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.

  15. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    Science.gov (United States)

    ... vestibular schwannoma is key to preventing its serious consequences. There are three options for managing a vestibular ... Disorders Balance Problems and Disorders - National Institute on Aging Enlarged Vestibular Aqueducts and Childhood Hearing Loss Genetics ...

  16. Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting ...

    African Journals Online (AJOL)

    leiomyosarcoma, fibrosarcoma, gastrointestinal stromal tumor, metastatic melanoma, Kaposi's sarcoma, solitary fibrous tumor, inflammatory fibroid polyps, and inflammatory myofibroblastic tumors.[5] For differentiation of cellular schwannomas from these tumors, immunohistochemical staining for various markers such as ...

  17. 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.

  18. Gastric schwannoma: CT findings and clinicopathologic correlation.

    Science.gov (United States)

    Ji, Jian-song; Lu, Chen-ying; Mao, Wei-bo; Wang, Zu-fei; Xu, Min

    2015-06-01

    The purpose of this study was to evaluate the computed tomography (CT) imaging characteristics of gastric schwannoma. Eight cases of gastric schwannomas confirmed by surgery and pathology were retrospectively analyzed by CT. We reviewed the CT findings of gastric schwannomas for the following characteristics: tumor location, size, contour, margin, growth pattern, enhancement pattern, the presence or absence of necrosis, and perigastric lymph nodes. The tumors were located in the lesser curvature of gastric body (n = 5) and greater curvature of the gastric antrum (n = 3) with a median size of 4.8 cm (range 1.7-11.4 cm). Gastric schwannomas appeared as submucosal tumors with CT features of ovoid (7/8 patients), well-defined (8/8) and exophytic (4/8) or mixed (3/8) growth patterns. On dynamic CT examination, the tumors displayed homogeneous enhancement in seven cases and heterogeneous enhancement in one case. Solid parts of eight tumors demonstrated mild enhancement during the arterial phase and strengthened progressive enhancement during the venous and delayed phases. Two cases had perigastric lymph nodes. Gastric schwannomas typically manifested as ovoid, well-defined, exophytic, or mixed growth pattern masses on CT. Homogeneous progressive enhancement on dynamic CT is a characteristic finding of gastric schwannoma.

  19. The effects of incidentally learned temporal and spatial predictability on response times and visual fixations during target detection and discrimination.

    Directory of Open Access Journals (Sweden)

    Melissa R Beck

    Full Text Available Responses are quicker to predictable stimuli than if the time and place of appearance is uncertain. Studies that manipulate target predictability often involve overt cues to speed up response times. However, less is known about whether individuals will exhibit faster response times when target predictability is embedded within the inter-trial relationships. The current research examined the combined effects of spatial and temporal target predictability on reaction time (RT and allocation of overt attention in a sustained attention task. Participants responded as quickly as possible to stimuli while their RT and eye movements were measured. Target temporal and spatial predictability were manipulated by altering the number of: 1 different time intervals between a response and the next target; and 2 possible spatial locations of the target. The effects of target predictability on target detection (Experiment 1 and target discrimination (Experiment 2 were tested. For both experiments, shorter RTs as target predictability increased across both space and time were found. In addition, the influences of spatial and temporal target predictability on RT and the overt allocation of attention were task dependent; suggesting that effective orienting of attention relies on both spatial and temporal predictability. These results indicate that stimulus predictability can be increased without overt cues and detected purely through inter-trial relationships over the course of repeated stimulus presentations.

  20. [Subcutaneous plexiform schwannoma of the forearm. A case report].

    Science.gov (United States)

    Daoudi, A; Znati, K; Elibrahimi, A; Loudiyi, W D; Elmrini, A; Amarti, A R; Chakour, K; Boutayeb, F

    2009-02-01

    Plexiform schwannoma is an exceptional schwannoma subtype. It's a benign nerve sheath tumor. Mainly, it's solitary, asymptomatic and slowly growing nodule that occurs in the subcutis or dermis. Histology gives the diagnosis. The authors report a case of solitary superficial plexiform schwannoma of the right forearm of a patient aged 22. A review of literature is done.

  1. MR findings in primary retroperitoneal schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Hayasaka, K. [Tuebingen Univ. (Germany). Dept. of Diagnostic Radiology]|[Nihon Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology; Tanaka, Y.; Soeda, S. [Nihon Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology; Huppert, P.; Claussen, C.D. [Tuebingen Univ. (Germany). Dept. of Diagnostic Radiology

    1999-01-01

    Objective: To evaluate the MR findings in primary retroperitoneal schwannoma. Material and Methods: Seven cases of primary retroperitoneal schwannoma, in whom the diagnosis was confirmed histopathologically, were analyzed retrospectively. The following items were reviewed at MR imaging: tumor diameter, margin, homogeneity, signal intensity as compared to normal renal parenchyma, presence/absence of infiltration into adjacent organs, and, in 1 and 4 cases, the enhancement on Gd-dynamic images and post-contrast T1-weighted images, respectively. Results: Tumor diameter was 5.5{+-}3.1 cm, ranging from 2.5 to 10 cm in the 6 benign schwannomas, and 12 cm in 1 malignant. The tumor margin was regular in all of the benign cases and irregular in the malignant one. The malignant case showed infiltration into the liver and duodenum. Four of the benign schwannomas showed a homogeneous, and 2 presented a heterogeneous pattern, while the malignant schwannoma was heterogeneous. On T1-weighted images, the benign schwannomas were hypointense in 4 cases, isointense in 1 and mixed in 1, while on T2-weighted images, they were hyperintense in 5 and mixed in 1. The malignant case showed mixed intensity on both T1- and T2-weighted images. On enhanced T1-weighted images, capsular, septal enhancement was noted in 2 cases, overall enhancement in 2, and on Gd-dynamic images, late enhancement was shown. Conclusion: On MR imaging, primary retroperitoneal schwannomas show different signal intensity characteristics, including cystic degeneration. There are, however, no specific characteristics of these tumors. (orig.)

  2. Crane. Incidental Classroom Instruction 20295

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, Richard Jennings [Los Alamos National Laboratory

    2016-04-01

    The purpose of this course is to introduce safe hoisting and rigging practices to personnel who are attempting to become LANL incidental crane operators and to review and refresh safe hoisting and rigging practices with existing incidental crane operators.

  3. Diagnosis and management of retroperitoneal ancient schwannomas

    Directory of Open Access Journals (Sweden)

    Gusani Niraj J

    2009-02-01

    Full Text Available Abstract Background Ancient schwannomas are degenerate peripheral nerve sheath tumors that very rarely occur in the retroperitoneum. They generally reach large proportions before producing symptoms due to mass effect. We describe three cases of retroperitoneal ancient schwannomas and discuss the diagnosis and management of these tumors. Case presentations Three female patients with retroperitoneal ancient schwannomas were reviewed. One patient presented with several weeks of upper abdominal pain and lower chest discomfort, whereas back pain and leg pain with associated weakness were predominant symptoms in the remaining two. Abdominal imaging findings demonstrated heterogeneous masses in the retroperitoneum with demarcated margins, concerning for malignancy. The patients successfully had radical excision of their tumors. Histological examination showed encapsulated tumors that displayed alternating areas of dense cellularity and areas of myxoid matrix consistent with a diagnosis of ancient schwannoma. Conclusion A diagnosis of ancient schwannoma should be entertained for any heterogeneous, well encapsulated mass in the retroperitoneum. In these cases less radical surgical resection should be considered as malignant transformation of these tumors is extremely rare and recurrence is uncommon following excision.

  4. The phosphorylation status of merlin in sporadic vestibular Schwannomas.

    Science.gov (United States)

    Wang, Zhaoyan; Lu, Yanjun; Tang, Juanjuan; Wang, Haojie; Wu, Hao

    2009-04-01

    The events leading to Schwannomas development are still largely unknown. Some studies have demonstrated that merlin acts as a tumor suppressor by blocking Ras-mediated signaling. In this study, we analyze the clinical and biological behaviors of seven randomly selected sporadic vestibular Schwannomas removed from the patients. We find that merlin was commonly lost in these Schwannomas, due to loss of merlin expression or phosphorylation status of merlin expression. Heightened CDKs/cyclins signal transduction concomitant with loss of p27 was well correlated with loss of functional merlin in Schwannomas. More, we show that phosphorylated merlin Schwannomas exhibited increased Ras/Rac/PAK signal transduction. That was in agreement with the severe clinical behaviors, i.e., phosphorylation status of merlin increased tumor size in sporadic vestibular Schwannomas. These results led us to suggest that phosphorylated merlin, a kind of type of mutation merlin, is involved in tumorigenesis of sporadic vestibular Schwannomas.

  5. Breast cancer only detected at US. Incidental finding or clinical evidence?; Le neoplasie mammarie visualizzabili solo con esame ecografico. Reperti incidentali o realta' clinica?

    Energy Technology Data Exchange (ETDEWEB)

    Nori, J.; Masi, A.; Boeri, C.; Vivian, A.; Nori Bufalini, F. [Azienda Ospedaliera Careggi, Florence (Italy). Unita' Operativa di Radiodiagnostica 2; Cariti, G. [Florence Univ., Florence (Italy). Dipt. di Ginecologia e Ostetricia

    2000-06-01

    Mammography is the only technique of proven efficacy in the early diagnosis of breast cancer, even though its sensitivity is much lower in breasts that are dense or with a high parenchymal-stroma component. In the past malignant breast nodules detected at US in patients with negative mammographic and physical findings were considered incidental findings, but more recent papers report increasing numbers of breast cancers detected only at US. It was investigated the yield of US performed as a diagnostic complement in asymptomatic women with mammographic findings that were either negative or poorly readable because of dense breast. 13 women were examined: 37 to 55 years old (mean 47): 9 of them were asymptomatic and 4 had poorly specific physical findings. The patients underwent physical examination, mammography, US, micro histologic biopsy with 14G needles under US guidance and surgery. Fourteen breast lesions 7.0-15 mm in diameter were detected only by US. Mammography (2 or 3 standard views) was negative in all cases. The lesions detected only by US (10% of all carcinomas) were typified with US-guided needle biopsy and finally confirmed surgically. Though obtained in a small series, the results seem to suggest that US should be included in the diagnostic work-up, especially of women with dense breast. Also, any hypoechoic lesion detected at breast US in clinically asymptomatic women with negative mammographic findings should be further investigated with US, needle aspiration or core biopsy to make the final diagnosis. [Italian] Si intende con questo lavoro valutare l'utilita' dell'esame ecografico, eseguito come completamento diagnostico in donne clinicamente negative e con mammografia negativa o comunque scarsamente leggibile in relazione alla elevata densita' del parenchima mammario (mammelle dense). Tredici donne con eta' compresa tra 37 e 55 anni (eta' media 47 anni) asintomatiche o con quadri clinici vaghi o comunque non

  6. Schwannoma

    Science.gov (United States)

    ... of Tumors Astrocytoma Atypical Teratoid Rhaboid Tumor (ATRT) Chondrosarcoma Choroid Plexus Craniopharyngioma Cysts Ependymoma Germ Cell Tumor ... of Tumors Astrocytoma Atypical Teratoid Rhaboid Tumor (ATRT) Chondrosarcoma Choroid Plexus Craniopharyngioma Cysts Ependymoma Germ Cell Tumor ...

  7. EXTRACRANIAL HEAD AND NECK SCHWANNOMA: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ashok

    2015-03-01

    Full Text Available Schwannoma is a benign nerve sheath tumour composed of Schwan cells which normally produce the insulating myelin sheath covering peripheral nerves. Schwannoma is a homogenous tumour, consisting only of schwan cells. The tumour cells stay outside the nerve, but the tumour itself may either push the nerve aside or up against a bony structure there by producing nerve damage. They arise from peripheral, cranial and autonomic nerves and usually present as solitary well demarcated lesions. Extracranial Head and Neck schwannomas are rare tumours. They may produce secondary symptoms like nasal obstruction, dysphagia, and hoarseness of voice depending upon the location of the tumour. FNAC, Ultra sound, CT, MRI may be of limited help in the diagnosis. Complete surgical excision is the treatment of choice. Post operative histopa thological examination establishes the final diagnosis

  8. [Clinical and pathologic features of gastric schwannoma].

    Science.gov (United States)

    Wang, Zhan-bo; Shi, Huai-yin; Yuan, Jing; Chen, Wei; Wei, Li-xin

    2012-02-01

    To study the clinical and pathologic features of gastric schwannomas. The macroscopic and microscopic features of 9 cases of gastric schwannoma were analyzed. Immunohistochemical study for S-100 protein, CD117, CD34, neurofilament, desmin, nestin, glial fibrillary acidic protein, platelet derived growth factor-alpha (PDGFR-α) and vimentin was carried out. Mutation analysis of c-kit gene (exon 9, 11, 13 and 17) and PDGFR-α gene (exon 12 and 18) in 1 case was examined by PCR amplification and direct sequencing. The patients included 5 males and 4 females. The age of patients ranged from 42 to 81 years (median = 56.5 years). The size of the tumors ranged from 2 to 9 cm in greatest diameter. Follow-up data in 8 cases (from 1 month to 65 months) showed no evidence of recurrence or metastasis. Gross examination showed that gastric schwannomas were homogeneous, firm, yellow-white and bore no true fibrous capsule. Histologically, all cases were composed of fascicles of spindle cells associated with nuclear palisading, Verocay body formation and peripheral cuff of reactive lymphoid aggregates. Some of them showed degenerative changes including cyst formation, calcification, hemorrhage, necrosis and hyalinization. Immunohistochemical study showed that the tumor cells were strongly positive for S-100 protein and vimentin. There was various degree of staining for nestin (8/9) and glial fibrillary acidic protein (6/9). They were negative for CD117, CD34, neurofilament, desmin and smooth muscle actin. One case showed focal positivity for PDGFR-α (1/9), with no mutations found. Gastric schwannomas share similar histologic features with conventional soft tissue schwannomas, in addition to the presence a reactive lymphoid cuff. The clinical, macroscopic, histologic and immunohistochemical features of gastric schwannomas were different from those of gastrointestinal stromal tumors and leiomyomas.

  9. Incidental gallbladder carcinoma: our experience.

    Science.gov (United States)

    Panebianco, A; Volpi, A; Lozito, C; Prestera, A; Ialongo, P; Palasciano, N

    2013-01-01

    Aim. Gallbladder carcinoma is an uncommon cancer with a poor prognosis. In the era of laparoscopic cholecistectomy for treatment of benign diseases incidental gallbladder carcinoma has dramatically increased and now constitutes the major way patients present with gallbladder cancer and allows to detect cancer at early stages with a better prognosis. In this single-center study we report our experience with gallbladder carcinoma incidentally diagnosed during or after laparoscopic colecistectomy performed for cholelithiasis. Methods. From January 2003 to December 2011 a total of 1193 patients underwent cholecistectomy at General Surgical Unit III of University of Bari. The patients were 458 males and 735 females, mean age was 52 years (range 19-91). In 6 of 1188 patients adenocarcinoma was present in the pathologic specimens (0,5%). Results. Of 1188 patients in whom laparoscopic cholecistectomy was attempted adenocarcinoma was diagnosed histopathologically in 6 cases (0,5%). There was no suspicion of malignancy to any of them. Intraoperatively, gallbladder wall appeared abnormal in one patients and frozen section analysis revealed adenocarcinoma. In the remaining 5 cases routine histopathological studies revealed the diagnosis of gallbladder carcinoma. One patient had T1 tumor, two had T2 and three had T3 tumor. Conclusions. In the present study the rate of incidental gallbladder carcinoma was 0,5%, according to the published English language literature. The risk factors widely related to the gallbladder cancer are advanced age and gallstones disease. The therapeutic approach to gallbladder cancer was applied according to the stage of tumor, but in our study this was possible only in two patients with T2 and T3 tumor since high risk and important comorbidities were the main causes for the refusal of 3 patient out of 5. Only the T1 patient underwent simple cholecystectomy. Similar to other reports in this single-center study the diagnosis of incidental gallbladder

  10. Vestibular schwannoma presenting with sudden facial paralysis.

    Science.gov (United States)

    Wexler, D B; Fetter, T W; Gantz, B J

    1990-04-01

    Facial paralysis is an unusual manifestation of vestibular schwannoma, and generally signifies an advanced stage of tumor growth. We describe a case of eighth-nerve schwannoma that presented initially with rapid-onset complete unilateral facial paralysis. At the time of operation the nerve was found to be electrically intact despite marked compression by tumor. The facial nerve was preserved and facial motion has partially recovered postoperatively. All unexplained persistent facial paralysis should be evaluated by magnetic resonance imaging with paramagnetic contrast enhancement.

  11. THREE YEARS STUDY OF SCHWANNOMAS OF PERIPHERAL NERVES

    Directory of Open Access Journals (Sweden)

    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

  12. Primary Schwannoma of the Thyroid Gland: A Case Report

    Directory of Open Access Journals (Sweden)

    İsa Özbay

    2014-09-01

    Full Text Available A 59-year-old female patient was referred to our Ear, Nose and Throat Department at Haseki Training and Research Hospital complaining of neck swelling for the past three months. Physical examination revealed a palpable anterior neck mass measuring 1.5x1 cm in the thyroid gland. The mass was moving with swallowing. Laboratory tests, such as fT3, fT4, TSH and calcium were normal. Ultrasonography showed four-five nodules with the biggest one measuring 12x8 mm. Fine needle aspiration biopsy was done and a few thyrocyte clusters were detected. Thyroidectomy was done with the pre-diagnosis of multinodular goiter. On post-operative examination, the vocal cords were mobile and native bilaterally. Calcium values were normal and the patient was discharged with necessary recommendations. Six-month follow-up was uneventful. Schwannoma can be misdiagnosed as thyroid nodule. Although schwannoma is frequently seen in the head and neck region, it is rarely observed in the thyroid gland. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 205-7

  13. Complications of Microsurgery of Vestibular Schwannoma

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    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. [Intracranial facial nerve schwannomas. Seven cases reviewed].

    Science.gov (United States)

    Fichten, A; Bourgeois, P; Desaulty, A; Louis, E; Lejeune, J-P

    2006-02-01

    Intracranial facial nerve schwannomas are rare neoplasms. Preoperative diagnosis is difficult because of non-specific clinical presentations (deafness, facial paralysis sudden or progressive) and radiological differential diagnosis (petrous bone tumor, vestibular schwannoma). Treatment depends on localization and has to be discussed for each case. Seven cases (four men and three women) of intracranial facial nerve schwannomas were retrospectively studied. Before treatment, we found deafness in six cases (two sudden and four progressive), a facial palsy in five cases (three sudden and two progressive). Five patients had deafness and facial palsy. One patient had only headache. Three schwannomas were supra and intra-petrous, two in the cerebello-pontine angle, and two were plurifocal (petrous bone, internal auditive canal and cerebellopontine angle). Six patients were operated on with an oto-neurosurgical procedure. After treatment, facial palsy always worsened (requesting secondary hypoglosso-facial anastomosis in cinq cases). Only one case of transmission deafness improved after ossiculoplasty. One patient is still under clinical and radiological observation. Diagnosis is difficult and made operatively in half of patients. A large tumor requires surgery, but surveillance can be a good option for a small one, considering the risk of postoperative facial palsy.

  15. Stereotactic radiation therapy for large vestibular schwannomas

    NARCIS (Netherlands)

    Mandl, Ellen S.; Meijer, Otto W. M.; Slotman, Ben J.; Vandertop, W. Peter; Peerdeman, Saskia M.

    2010-01-01

    Background and purpose: To evaluate the morbidity and tumor-control rate in the treatment of large vestibular schwannomas (VS) after stereotactic radiation therapy in our institution. Material and methods: Twenty-five consecutive patients (17 men, 8 women) with large VS (diameter 3.0 cm or larger),

  16. Schwannoma on palmar surface of the hand: A rare case report

    Directory of Open Access Journals (Sweden)

    Selim Turkkan

    2015-12-01

    Full Text Available Schwannomas, also known as neurilemmomas, are benign, intracapsular peripheral nerve sheath tumors. They are the most common type of peripheral nerve sheath tumors and can be seen between the third and sixth decades of life, but are nevertheless rare. The goal of this report is to raise awareness in the medical community for this type of tumor. A 21-year-old male patient presented with a mass in the right palm. He reported that he had noticed the mass two years before and that the numbness started three months before. We detected a mobile, soft, palpable mass, 3X1 cm in size, in zone three of the palm. Tinel's test was positive. There was no history of neither neurofibromatosis nor any other hereditary diseases. USG showed a lobulated, encapsulated, highly vascularized and high resistant arterial flow solid mass with 11.5X28mm in size. Total excision was planned. Under general anesthesia the patient was placed in supine position. A 3 cm mid-palmar incision was made on the volar side of the right hand. Digital nerves and arteries were explored. The mass, which was found to be 30X15X10mm in size, emerged from the common digital nerve in zone three and was excised with microsurgical instruments via blunt dissection. The patient healed uneventfully. Histopathological examination of the mass revealed Vimentin S-100 positive schwannoma. Schwannomas are rare, benign tumors. To the best of our knowledge, a similar large mass was reported in an infant and no case has been reported in adults. Hand surgeons should keep the schwannomas' diagnosis in mind if upper extremity masses are isolated that are palpable and slow growing with positive Tinel's sign. The presented study showed how big schwannomas can be in size and that the cure is achieved by total excision. [Hand Microsurg 2015; 4(3.000: 71-74

  17. Real-time MRI navigated US: Role in diagnosis and guided biopsy of incidental breast lesions and axillary lymph nodes detected on breast MRI but not on second look US

    Energy Technology Data Exchange (ETDEWEB)

    Pons, Elena Pastor, E-mail: elenapastorpons@gmail.com; Azcón, Francisco Miras, E-mail: frmiaz00@gmail.com; Casas, María Culiañez, E-mail: mariacc1980@gmail.com; Meca, Salvador Martínez, E-mail: isalvaa@hotmail.com; Espona, José Luis García, E-mail: gespona@hotmail.com

    2014-06-15

    Objectives: To prospectively evaluate the accuracy of real-time ultrasound combined with supine-MRI using volume navigation technique (RtMR-US) in diagnosis and biopsy of incidental breast lesions (ILSM) and axillary lymph nodes (LNSM) suspicious of malignancy on contrast enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Five hundred and seventy-seven women were examined using breast CE-MRI. Those with incidental breast lesions not identified after second-look ultrasound (US) were recruited for RtMR-US. Biopsy was performed in ILSM. Breast lesions were categorized with BI-RADS system and Fisher’ exact test. Axillary lymph nodes morphology was described. To assess efficacy of RtMR-US, diagnostic accuracy, sensitivity, specificity, detection rate and Kappa index of conventional-US and RtMR-US were calculated. Results: Forty-three lesions were detected on CE-MRI before navigation. Eighteen were carcinomas and 25 ILSM. Of these, 21 underwent a RtMR-US. Detection rate on RtMR-US (90.7%) was higher than on conventional-US (43%) (p < 0.001). Agreement between both techniques was low (k = 0.138). Twenty ILSM and 2 LNSM were biopsied. Sixty-five percent were benign (100% of BI-RADS3 and 56% of BI-RADS4-5). Diagnostic performance of RtMR-US identifying malignant nodules for overall lesions and for the subgroup of ILSM was respectively: sensitivity 96.3% and 100%, specificity 18.8% and 30.7%, positive predictive value 66.7% and 43.7%, negative predictive value 75% and 100%. In addition RtMR-US enabled biopsy of 2 metastatic lymph nodes. Conclusions: Real time-US with supine-MRI using a volume navigation technique increases the detection of ILSM. RtMR-US may be used to detect occult breast carcinomas and to assess cancer extension, preventing unnecessary MRI-guided biopsies and sentinel lymph node biopsies. Incidental lesions BI-RADS 3 non-detected on conventional-US are probably benign.

  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. SCHWANNOMA ORIGINATING FROM LOWER CRANIAL NERVES: REPORT OF 4 CASES

    OpenAIRE

    OYAMA, HIROFUMI; KITO, AKIRA; MAKI, HIDEKI; HATTORI, KENICHI; NODA, TOMOYUKI; WADA, KENTARO

    2012-01-01

    ABSTRACT Four cases of schwannoma originating from the lower cranial nerves are presented. Case 1 is a schwannoma of the vagus nerve in the parapharyngeal space. The operation was performed by the transcervical approach. Although the tumor capsule was not dissected from the vagus nerve, hoarseness and dysphagia happened transiently after the operation. Case 2 is a schwannoma in the jugular foramen. The operation was performed by the infralabyrinthine approach. Although only the intracapsular ...

  20. Gastric schwannoma: a case report and literature review.

    Science.gov (United States)

    Atmatzidis, S; Chatzimavroudis, G; Dragoumis, D; Tsiaousis, P; Patsas, A; Atmatzidis, K

    2012-07-01

    Schwannomas are generally benign, slow growing tumors, which can originate from any nerve that has a Schwann cell sheath. Digestive tract schwannomas are rare and are usually asymptomatic. We present the case of a 48-year-old woman with a symptomatic submucosal tumour of the gastric antrum. The patient underwent partial gastrectomy and the histological and immunohistochemical findings of the resected specimen established the diagnosis of schwannoma.

  1. 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.

  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. Clinicopathological and Immunohistochemical Characterisation of Gastric Schwannomas in 29 Cases

    Directory of Open Access Journals (Sweden)

    Lijun Zheng

    2014-01-01

    Full Text Available Schwannomas are tumors arising from the nervous system that also occur infrequently in the gastrointestinal tract, most commonly in the stomach. This report characterizes 29 patients with benign or malignant gastric schwannomas. Surgical data and clinical follow-up information were available for 28 cases with a median postoperative duration of 57 months. Clinicopathological and immunohistochemical characteristics of benign and malignant schwannomas were analysed. Four cases (13.7% were histologically diagnosed with malignant schwannoma. All tumors were positive for S-100 and CD56 proteins, displaying a diffuse staining pattern. Vimentin was expressed in 100% cases and all schwannomas were negative for smooth muscle actin, c-kit, and HMB-45. A significant difference was observed between the group of benign and malignant schwannomas as regards recurrences and metastasis after complete resection (P=0.015. The survival time of patients with benign schwannomas was longer than the malignant group (P=0.013, so gastric malignant schwannomas have a potential for recurrence and metastasis, with subsequently short survival. Complete resection with an attempt to remove all tumor tissue with negative margins is of paramount importance in the management of gastric schwannomas, particularly when they turn out to be malignant.

  4. 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.

  5. 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.

  6. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Imaging in the Diagnosis and Management of Patients With Vestibular Schwannomas.

    Science.gov (United States)

    Dunn, Ian F; Bi, Wenya Linda; Mukundan, Srinivasan; Delman, Bradley N; Parish, John; Atkins, Tyler; Asher, Anthony L; Olson, Jeffrey J

    2017-12-20

    What sequences should be obtained on magnetic resonance imaging (MRI) to evaluate vestibular schwannomas before and after surgery? Adults with vestibular schwannomas. Initial Preoperative Evaluation Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. Level 3: Standard T1, T2, fluid attenuated inversion recovery, and diffusion weighted imaging MR sequences obtained in axial, coronal, and sagittal plane may be used for detection of vestibular schwannomas. Preoperative Surveillance Level 3: Preoperative surveillance for growth of a vestibular schwannoma should be followed with either contrast-enhanced 3-dimensional (3-D) T1 magnetization prepared rapid acquisition gradient echo (MPRAGE) or high-resolution T2 (including constructive interference in steady state [CISS] or fast imaging employing steady-state acquisition [FIESTA] sequences) MRI. Postoperative Evaluation Level 2: Postoperative evaluation should be performed with postcontrast 3-D T1 MPRAGE, with nodular enhancement considered suspicious for recurrence. Is there a role for advanced imaging for facial nerve detection preoperatively (eg, CISS/FIESTA or diffusion tensor imaging)? Adults with proven or suspected vestibular schwannomas by imaging. Level 3: T2-weighted MRI may be used to augment visualization of the facial nerve course as part of preoperative evaluation. What is the expected growth rate of vestibular schwannomas on MRI, and how often should they be imaged if a "watch and wait" philosophy is pursued? Adults with suspected vestibular schwannomas by imaging. Level 3: MRIs should be obtained annually for 5 yr, with interval lengthening thereafter with tumor stability. Do cystic vestibular schwannomas behave differently than their solid counterparts? Adults with vestibular schwannomas with cystic components. Level 3: Adults with cystic vestibular schwannomas should be counseled that their tumors may more often be

  7. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

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

    2015-01-01

    that this may be caused by both cochlear and retrocochlear mechanisms. Multiple mechanisms may also be at play in the case of dizziness, which may broaden perspectives of therapeutic approach. This study presents a systematic and detailed assessment of vestibular histopathology in temporal bones from patients...... with VS. METHODS: Retrospective analysis of vestibular system histopathology in temporal bones from 17 patients with unilateral VS. The material was obtained from The Copenhagen Temporal Bone Collection. RESULTS: Vestibular schwannomas were associated with atrophy of the vestibular ganglion, loss of fiber...... 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...

  8. 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

  9. A Case Report of Schwannoma Presenting as Sciatica

    Directory of Open Access Journals (Sweden)

    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.

  10. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  11. Malignant Transformation of Vagal Nerve Schwannoma in to ...

    African Journals Online (AJOL)

    Vagal schwannomas are benign, rare peripheral nerve sheath tumors in the head and neck region. Some physicians opt to closely observe cases of schwannoma of the neck on an outpatient basis rather than to perform radical surgery. However, there is a possibility, albeit rare, of malignant transformation of a.

  12. Emergency embolization after resection of a laryngeal Schwannoma

    Directory of Open Access Journals (Sweden)

    Fabio Augusto Cypreste Oliveira

    2013-12-01

    Full Text Available Schwannoma is a rare cause of benign tumors of the larynx. The first-choice treatment is surgical resection. The objective of this paper is to report on a rare case of a young female patient who suffered severe intraoperative hemorrhaging during surgical resection of a laryngeal Schwannoma and needed emergency embolization.

  13. Vestibular schwannoma: an unusual post radiotherapy response.

    Science.gov (United States)

    Uddin, Najam; Iqbal, Muhammad; Memon, Muhammad Ali; Farrukh, Salman

    2014-11-01

    Vestibular schwannoma is a relatively uncommon tumor. Although, it is benign but locally expansile and spreads to damage the adjacent structures. Treatment strategy includes surgery, Stereotactic Radiosurgery (SRS) either by standard or hypofractionated protocols. Due to its benign nature, radiation therapy cannot remove the tumor completely, instead radiation therapy halts the growth of vestibular schwannoma and inactivates this benign tumor. Response of radiation in the form of tumor shrinkage is seen 2 - 2.5 years after the radiations. We report a case of vestibular Schwannoma in which residual tumor of 3.1 cm size following subtotal resection was irradiated of the dose of 54 Gy in 30 equal fractions on 3-Dimensional Conformal Radiation Therapy (3-DCRT). A follow-up CT scan brain after 2 months of radiotherapy showed complete disappearance of the disease categorized as complete response. This is an unusual phenomenon and is likely due to the very rarely seen malignant transformation or presence of malignant component in this benign tumor.

  14. 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.

  15. 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.

  16. Molecular studies of vestibular schwannomas: a review.

    Science.gov (United States)

    Welling, D Bradley; Packer, Mark D; Chang, Long-Sheng

    2007-10-01

    To summarize advances in understanding the molecular biology of vestibular schwannomas over the past year. The role of the neurofibromatosis type 2 protein, denoted as merlin or schwannomin, in embryonic development, cellular adherence, and in cell proliferation has become better elucidated in the past year. Likewise, the role of merlin in Schwann cell-axon interaction has been studied. Additionally, two comprehensive analyses of the spectrum of human neurofibromatosis type 2 mutations have been compiled which make up a valuable resource in understanding critical regions of the neurofibromatosis type 2 gene. Neurofibromatosis type 2 screening guidelines for young patients with solitary vestibular schwannomas have been published. The role of electromagnetic radiation via cellular and portable telephones as a predisposing factor to vestibular schwannoma formation has also been the topic of several studies. Based on increased knowledge of the pathways in which merlin functions and the available transgenic and xenograft mouse models, preliminary data regarding directed pharmacotherapy are also summarized. With increased knowledge of the pathologic mechanisms and interacting proteins associated with merlin, the research community is poised to begin trials of targeted interventions in vitro and in the current mouse models.

  17. Gastric schwannoma exhibiting increased fluorodeoxyglucose uptake.

    Science.gov (United States)

    Komatsu, Daisuke; Koide, Naohiko; Hiraga, Risako; Furuya, Naoyuki; Akamatsu, Taiji; Uehara, Takeshi; Miyagawa, Shinichi

    2009-01-01

    This is the first case of gastric schwannoma that exhibited increased accumulation of [(18)F] fluorodeoxyglucose (FDG) on positron emission tomography (PET) imaging. The patient was a 60-year-old woman in whom esophagogastroduodenoscopy showed a submucosal tumor, about 25 mm in size, in the upper body of the stomach, with ulceration at the top of the tumor. Endoscopic ultrasonography revealed a well-defined hypoechoic mass located in the proper muscle layer of the stomach. The specimen taken from the tumor showed only inflammatory degenerative tissue. Abdominal computed tomography revealed a tumor in the upper body of the stomach. FDG-PET showed FDG uptake (standardized uptake value [SUV] max 5.8) coincident with the tumor. Hence, the tumor was diagnosed initially as a gastrointestinal stromal tumor of the stomach. Laparoscopic partial gastrectomy was performed. Pathological examination showed that the tumor consisted of spindle cells with large nuclei, and mitosis was absent. The Ki-67 labeling index of the tumor cells was 4%. Immunohistochemically, the tumor cells showed a positive reaction for S-100 protein, whereas they were negative for KIT, CD 34, and alpha-smooth muscle actin protein. The tumor was diagnosed as a benign gastric schwannoma. Gastric schwannoma should be included in the differential diagnosis of submucosal tumors of the stomach with FDG uptake.

  18. Vestibular schwannoma: negative growth and audiovestibular features.

    Science.gov (United States)

    Stipkovits, E M; Graamans, K; Van Dijk, J E

    2001-11-01

    At the University Medical Center Utrecht, non-operative management was used for 44 patients with a unilateral vestibular schwannoma between 1990 and 1997. During that period, consecutive tumor sizes were determined by magnetic resonance imaging. Three of the 44 patients showed an average decrease in tumor size of 16.7% according to American Academy of Otolaryngology-Head and Neck Surgery standards. This study describes the initial vestibular status and audiometric changes measured over up to 10 years in these three patients. Vestibular function was determined once, by means of the bithermal caloric test, the torsion test, the saccade test, the smooth pursuit test, and the registration of spontaneous nystagmus. The three patients had severe vestibular paresis on the affected side. Pure-tone and speech audiometry were performed at regular intervals. Although the size of their tumors decreased, their hearing gradually deteriorated, just as it does in the majority of patients with a growing or stable vestibular schwannoma. The observations presented here suggest that the development of symptoms in a vestibular schwannoma does not differentiate between patients with a stable, growing or shrinking tumor. The development of symptoms may be the result of the same pathogenetic mechanism.

  19. Synchronous triple occurrence of MALT lymphoma, schwannoma, and adenocarcinoma of the stomach.

    Science.gov (United States)

    Choi, Kyeong W; Joo, Mee; Kim, Han S; Lee, Woo Y

    2017-06-14

    We present a case of a 56-year-old man with 3 synchronous gastric tumors. The patient presented with melena, and 3 gastric abnormalities were detected on gastroduodenoscopic examination, including a small ulcerative lesion in the gastric antrum, a submucosal mass in the gastric body, and severe erosion in the fundus. Histological examination of biopsy samples yielded respective diagnoses of gastric adenocarcinoma, gastritis, and mucosa-associated lymphoid tissue (MALT) lymphoma. The patient first received medication to eradicate any underlying Helicobacter pylori infection, which might have been a cause of the MALT lymphoma. Four weeks later, after examination of repeat biopsy samples revealed that the MALT lymphoma had resolved, the patient underwent subtotal gastrectomy. Further histological examination of resected tissue confirmed the antrum lesion as adenocarcinoma and the body lesion as schwannoma. To our knowledge, this is the first reported case of synchronous triple primary gastric adenocarcinoma, MALT lymphoma, and schwannoma.

  20. Cytologic findings of gastric schwannoma: a case report.

    Science.gov (United States)

    Rodriguez, Erika; Tellschow, Steven; Steinberg, David M; Montgomery, Elizabeth

    2014-02-01

    Spindle cell lesions of the stomach are rare. They usually affect the submucosa or muscularis propria and therefore can be sampled by endoscopic fine needle aspiration. The most common tumor in this category is gastrointestinal stromal tumor (GIST), followed by leiomyoma and gastric schwannoma. Gastric schwannoma is a benign tumor of neuroectodermal origin that has overlapping morphologic/cytologic features with GIST and leiomyoma. Gastric schwannomas differ from peripheral schwannomas by lacking a capsule, Verocay bodies, Antoni B areas, and thick-walled vessels. They are characterized morphologically by poorly defined borders, cuffs of lymphoid tissue and a haphazard spindle cell proliferation. We present here the cytologic and histopathologic features of a gastric schwannoma. The tumor was composed of spindle cells with delicate eosinophilic cytoplasm and wavy nuclei, with an associated conspicuous lymphoid backdrop. The latter feature raised the possibility of a lymphoid lesion, a problem cytopathologists should be aware of. Copyright © 2012 Wiley Periodicals, Inc.

  1. The molecular biology and novel treatments of vestibular schwannomas.

    Science.gov (United States)

    Fong, Brendan; Barkhoudarian, Garni; Pezeshkian, Patrick; Parsa, Andrew T; Gopen, Quinton; Yang, Isaac

    2011-11-01

    Vestibular schwannomas are histopathologically benign tumors arising from the Schwann cell sheath surrounding the vestibular branch of cranial nerve VIII and are related to the NF2 gene and its product merlin. Merlin acts as a tumor suppressor and as a mediator of contact inhibition. Thus, deficiencies in both NF2 genes lead to vestibular schwannoma development. Recently, there have been major advances in our knowledge of the molecular biology of vestibular schwannomas as well as the development of novel therapies for its treatment. In this article the authors comprehensively review the recent advances in the molecular biology and characterization of vestibular schwannomas as well as the development of modern treatments for vestibular schwannoma. For instance, merlin is involved with a number of receptors including the CD44 receptor, EGFR, and signaling pathways, such as the Ras/raf pathway and the canonical Wnt pathway. Recently, merlin was also shown to interact in the nucleus with E3 ubiquitin ligase CRL4(DCAF1). A greater understanding of the molecular mechanisms behind vestibular schwannoma tumorigenesis has begun to yield novel therapies. Some authors have shown that Avastin induces regression of progressive schwannomas by over 40% and improves hearing. An inhibitor of VEGF synthesis, PTC299, is currently in Phase II trials as a potential agent to treat vestibular schwannoma. Furthermore, in vitro studies have shown that trastuzumab (an ERBB2 inhibitor) reduces vestibular schwannoma cell proliferation. With further research it may be possible to significantly reduce morbidity and mortality rates by decreasing tumor burden, tumor volume, hearing loss, and cranial nerve deficits seen in vestibular schwannomas.

  2. PET/CT detection of incidental colorectal foci of F.D.G. uptake: Correlation with colonoscopy results;Decouverte fortuite de fixations colorectales focales du FDG en TEP/TDM: correlation aux donnees de la coloscopie

    Energy Technology Data Exchange (ETDEWEB)

    Nouira, M.; Evangelista, E.; Meignan, M.; Itti, E. [Universite Paris-12, Service de medecine nucleaire, hopital Henri-Mondor, AP-HP, 94 - Creteil (France); Sobhani, I. [Universite Paris-12, Service de gastroenterologie, hopital Henri-Mondor, AP-HP, 94 - Creteil (France); Hagege, H. [centre hospitalier intercommunal, Service de gastroenterologie, 94 - Creteil (France); Meignan, M.; Itti, E. [EAC CNRS 7054, 94 - Creteil (France)

    2010-04-15

    Purpose: F.D.G.-PET is an established tool for the diagnosis of recurrent or metastatic colorectal carcinoma. Several case series suggest that F.D.G.-PET often detects incidental adenomatous polyps or colorectal adenocarcinomas. The aim of this study was to correlate unexpected colorectal foci of F.D.G. uptake to pathology findings after systematic colonoscopy. Patients and methods: We reviewed the records of 3541 patients who underwent F.D.G. PET/CT in our institution over a 30-month period for the assessment of a known or suspected malignancy. In 85 of them, incidental, nodular shaped and well-circumscribed foci of abnormal uptake were identified in the area of the colon or rectum. Patients with segmental or diffuse abnormal colorectal uptake were excluded, as well as patients with known benign or malignant colorectal disease. Colonoscopy and complete pathology report was available in 29 patients. Maximal standardized uptake value (SUV{sub max}) was measured in all lesions. Results: Unexpected colorectal foci of F.D.G. uptake were associated with colonoscopic abnormalities in 23 patients (true positive rate: 79 %). Adenocarcinomas were found in six patients (SUV{sub max} = 7.3 +- 2.6), tubular adenomas in four patients (SUV{sub max} = 7.3 +- 4.9) and tubulovillous adenomas in 12 patients (SUV{sub max} = 4.2 +- 1.1). Hyperplasic polyps with no sign of dysplasia were found in the last patient (SUV{sub max} 3.3). Concomitant CT abnormalities were found on PET/CT fusion in eight patients and consisted of wall thickening (n = 5) or nodular mass (n = 3). Conversely, PET was falsely positive in six patients (21 %), with no concomitant CT abnormalities and no abnormal findings at endoscopy (SUV{sub max} 6.2 +- 2.8, no significant difference with true positive lesions). Conclusion: Our findings emphasize the need to perform a colonoscopy in front of incidental nodular colorectal foci of F.D.G. uptake because malignant or pre-malignant neoplasms, which are not clinically

  3. Vibration-induced nystagmus in patients with vestibular schwannoma: Characteristics and clinical implications.

    Science.gov (United States)

    Lee, Jeon Mi; Kim, Mi Joo; Kim, Jin Won; Shim, Dae Bo; Kim, Jinna; Kim, Sung Huhn

    2017-07-01

    To investigate the clinical significance of vibration-induced nystagmus (VIN) in unilateral vestibular asymmetry and vestibular schwannoma. Thirteen patients with vestibular schwannoma underwent the VIN test, in which stimulation was applied to the mastoid processes and sternocleidomastoid (SCM) muscles on the ipsilateral and contralateral sides of lesions. Preoperative VIN was measured, and changes in VIN were followed up for 6months after tumor removal. Significance of VIN was determined by evaluation of its sensitivity, correlation with vestibular function tests and tumor volume, and postoperative changes. The overall pre and postoperative sensitivities of VIN were 92.3% and 100%, respectively, considering stimulation at all four sites. Maximum slow-phase velocity (MSPV) of VIN was linearly correlated with caloric weakness and tumor volume, especially when stimulation was applied to the SCM muscle. Postoperative MSPV of VIN exhibited stronger linear correlation with postoperative changes in canal paresis value and inverse correlation with tumor size upon stimulation of the ipsilateral SCM muscle than upon stimulation of other sites. During the 6-month follow-up period, persistence of VIN without changes in MSPV was observed even after vestibular compensation. Evoking VIN by stimulation of the mastoid processes and SCM muscles is effective for detecting vestibular asymmetry. It could also help determine the degree of vestibular asymmetry and volume of vestibular schwannoma if stimulation is applied to the SCM muscle. The results of this study could provide clues for the basic application of VIN in patients with vestibular loss and vestibular schwannoma. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  4. Incidental Take Statement (ITS) Tracking

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Incidental Take Statement (ITS) Tracking Spreadsheet was created in 2012 and is updated annually by the NMFS GARFO Protected Resources Division. It is used to...

  5. INCIDENTAL VOCABULARY LEARNING THROUGH READING

    OpenAIRE

    Holly Warzecha, M.A. TESOL

    2017-01-01

    The purpose of the following paper is to take a closer look at the benefits of incidental learning through reading, with a specific focus on vocabulary acquisition. The teaching of vocabulary has traditionally been an explicit process where the target vocabulary is taken out of context and taught separately. However, this kind of explicit teaching and learning may only take into account a form-meaning connection. Therefore, this paper explores research on incidental learning and specifically ...

  6. Natural history of hearing deterioration in intracanalicular vestibular schwannoma

    NARCIS (Netherlands)

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

    2011-01-01

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

  7. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. 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.

  9. CT, MRI, and PET findings of gastric schwannoma.

    Science.gov (United States)

    Takeda, Minako; Amano, Yasuo; Machida, Tadashi; Kato, Shunji; Naito, Zenya; Kumita, Shinichiro

    2012-08-01

    Gastric schwannoma is a rare tumor that accounts for only 0.2 % of all gastric tumors. We report a case of gastric schwannoma that underwent computed tomography (CT), magnetic resonance imaging (MRI), and [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET), and its histological confirmation was acquired. Gastric schwannoma showed high intensity on T2-weighted and diffusion-weighted MRI and high maximum standardized uptake on [(18)F]-FDG-PET. Lymphadenopathy close to the tumor was also found. Although diffusion-weighted MRI, [(18)F]-FDG-PET, and the presence of lymphadenopathy could suggest malignant tumors, the detail interpretation of the other CT and MRI findings may give a clue for the diagnosis of gastric schwannoma.

  10. Laparoscopic resection of a gastric schwannoma: A case report

    Directory of Open Access Journals (Sweden)

    Edgar Vargas Flores

    2016-01-01

    Conclusion: Gastric schwannomas should be included in the differential diagnosis of any gastric submucosal mass. Negative margin resection as seen with this patient is the standard surgical treatment as there is low malignant transformation potential.

  11. CT and MR features of the intracranial Schwannomas

    Energy Technology Data Exchange (ETDEWEB)

    Jung, So Lyung; Ro, Hee Jeong; Lee, Hong Jae; Jung, Seung Eun; Byun, Jae Young; Yang, Il Kwon; Lee, Han Jin; Choi, Kyu Ho; Kim, Jong Woo; Shinn, Kyung Sub [Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-04-01

    To evaluate CT and MR findings of the intracranial schwannomas arising from variable cranial nerves. The authors retrospectively analyzed CT (n=21) and MR (n=15) findings of 24 cases in 23 patients (M : 7, F : 16) who had suffered from surgically-proven intracranial schwannomas over the previous five years. Schwannomas arose from the acoustic nerve(n=18), the trigeminal nerve(n=2), the glossopha-ryngeal-vagal-accessory nerve complex (n=2), and the olfactory nerve(n=1). Intracranial schwannomas were well defined, ,lobulated and inhomogeneously or homogeneously enhancing masses on CT and MR, and were located along the course of the specific cranial nerve. Acoustic schwannomas involved both the internal auditory canal(IAC) and the cerebellopontive angle(CPA) in 14 case, the IAC in three, and the SPA in two. Two trigeminal schwannomas involved both middle and posterior cranial fossa and were in the shape of a dumbbell. One of the two schwannomas that invelved lower cranial nerve complex(9-11th) was located in the medullary cistern and jugular foramen ; the other was located in the central posterior cranial fossa. A case of olfactory schwannoma was located in the right cribriform plate. The precontrast CT scan showed low density in 13 cases (62%), isodensity in seven(33%) and high density in one(5%). on postcontrast CT scan, enhancement was seen in 20 cases(95%). Of the 15 cases with MR, 2 had low signal intensity on T1 weighted image and 14 had high signal intensity on T2 weighted image. MR imaging after Gd-DTPA infusion showed enhancement in 14 cases. Enhancement was inhomogeneous in 14 cases on CT and in 13 on MR. Of 24 cases, intratumoral necrosis was seen in 19, ring enhancement in five and severe cystic change in one. Other findings were in tratumoral calcification (21%), hemorrhage(8%), pressure bony erosion(70.8%), midline shift(58%), peritumoral edema(29%) and hydrocephalus(33%). On MR, there was in all 15 cases a peritumoral low signal intensity rim on T1-and

  12. 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.

  13. A rare case of concurrent penile and spinal schwannomas

    Science.gov (United States)

    Wang, Luke; Arachchi, Asiri; Makris, Antonios

    2016-01-01

    Schwannoma of the penis is extremely rare. This is the case of a young male who presented with pain on sexual intercourse, multiple lumps on the dorsal shaft of his penis, as well as a temporal headache. He was subsequently diagnosed with schwannoma affecting both his penile region and cauda equina. This clinical finding has not been previously described in the literature. Hence, its presentation is unique to our specialty. PMID:27141200

  14. A rare case of concurrent penile and spinal schwannomas

    Directory of Open Access Journals (Sweden)

    Luke Wang

    2016-01-01

    Full Text Available Schwannoma of the penis is extremely rare. This is the case of a young male who presented with pain on sexual intercourse, multiple lumps on the dorsal shaft of his penis, as well as a temporal headache. He was subsequently diagnosed with schwannoma affecting both his penile region and cauda equina. This clinical finding has not been previously described in the literature. Hence, its presentation is unique to our specialty.

  15. Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  16. [Gastric Schwannoma: a case report and literature review].

    Science.gov (United States)

    Huesca-Jiménez, K; Medina-Franco, H

    2009-01-01

    We report a 49-year old male with diagnosis of gastric schwannoma who underwent subtotal gastrectomy. We describe clinicopathological and immunohistochemical characteristics of these tumors and performed an extensive literature review. Gastric schwannomas are very rare tumors but they should be taken into account in the differential diagnosis of more common mesenchimal neoplasms like gastrointestinal stromal tumors (GIST). The treatment of choice is surgical resection and their prognosis is very favourable.

  17. Schwannoma originating from lower cranial nerves: report of 4 cases.

    Science.gov (United States)

    Oyama, Hirofumi; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Noda, Tomoyuki; Wada, Kentaro

    2012-02-01

    Four cases of schwannoma originating from the lower cranial nerves are presented. Case 1 is a schwannoma of the vagus nerve in the parapharyngeal space. The operation was performed by the transcervical approach. Although the tumor capsule was not dissected from the vagus nerve, hoarseness and dysphagia happened transiently after the operation. Case 2 is a schwannoma in the jugular foramen. The operation was performed by the infralabyrinthine approach. Although only the intracapsular tumor was enucleated, facial palsy, hoarseness, dysphagia and paresis of the deltoid muscle occurred transiently after the operation. The patient's hearing had also slightly deteriorated. Case 3 is a dumbbell-typed schwannoma originating from the hypoglossal nerve. The hypoglossal canal was markedly enlarged by the tumor. As the hypoglossal nerves were embedded in the tumor, the tumor around the hypoglossal nerves was not resected. The tumor was significantly enlarged for a while after stereotactic irradiation. Case 4 is an intracranial cystic schwannoma originating from the IXth or Xth cranial nerves. The tumor was resected through the cerebello-medullary fissure. The tumor capsule attached to the brain stem was not removed. Hoarseness and dysphagia happened transiently after the operation. Cranial nerve palsy readily occurs after the removal of the schwannoma originating from the lower cranial nerves. Mechanical injury caused by retraction, extension and compression of the nerve and heat injury during the drilling of the petrous bone should be cautiously avoided.

  18. Endosonographic Features of Gastric Schwannoma: A Single Center Experience.

    Science.gov (United States)

    Yoon, Jong Min; Kim, Gwang Ha; Park, Do Youn; Shin, Na Ri; Ahn, Sangjeong; Park, Chul Hong; Lee, Jin Sung; Lee, Key Jo; Lee, Bong Eun; Song, Geun Am

    2016-11-01

    Gastric schwannomas are rare benign mesenchymal tumors that are difficult to differentiate from other mesenchymal tumors with malignant potential, such as gastrointestinal stromal tumors. This study aimed to evaluate the characteristic findings of gastric schwannomas via endoscopic ultrasonography (EUS). We retrospectively reviewed the EUS findings of 27 gastric schwannoma cases that underwent surgical excision at Pusan National University Hospital during 2007 to 2014. Gastric schwannomas were mainly located in the middle third of the stomach with a mean tumor size of 32 mm. All lesions exhibited hypoechoic echogenicity, and 24 lesions (88.9%) exhibited heterogeneous echogenicity. Seventeen lesions (63.0%) exhibited decreased echogenicity compared to the normal proper muscle layer. Distinct borders were observed in 24 lesions (88.9%), lobulated margins were observed in six lesions (22.2%), and marginal haloes were observed in 24 lesions (88.9%). Hyperechogenic spots were observed in 21 lesions (77.8%), calcifications were observed in one lesion (3.7%), and cystic changes were observed in two lesions (7.4%). During EUS, gastric schwannomas appear as heterogeneously hypoechoic lesions with decreased echogenicity compared to the normal proper muscle layer. These features may be helpful for differentiating gastric schwannomas from other mesenchymal tumors.

  19. Improved discrimination of melanotic schwannoma from melanocytic lesions by combined morphological and GNAQ mutational analysis

    NARCIS (Netherlands)

    Kusters-Vandevelde, Heidi V. N.; van Engen-van Grunsven, Ilse A. C. H.; Kusters, Benno; van Dijk, Marcory R. C. F.; Groenen, Patricia J. T. A.; Wesseling, Pieter; Blokx, Willeke A. M.

    2010-01-01

    The histological differential diagnosis between melanotic schwannoma, primary leptomeningeal melanocytic lesions and cellular blue nevus can be challenging. Correct diagnosis of melanotic schwannoma is important to select patients who need clinical evaluation for possible association with Carney

  20. Incidental Adrenal Nodules and Masses: The Imaging Approach

    OpenAIRE

    Willatt, J.; Chong, S.; Ruma, J. A.; Kuriakose, J.

    2015-01-01

    Adrenal nodules are detected with increasing frequency. The National Institute of Health (NIH), American College of Radiology (ACR), and the American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons (AACE/AAES) have produced guidelines for the management of incidental adrenal nodules. This review provides a summary of the consensus radiologic approach to these nodules.

  1. Incidental Adrenal Nodules and Masses: The Imaging Approach

    Directory of Open Access Journals (Sweden)

    J. Willatt

    2015-01-01

    Full Text Available Adrenal nodules are detected with increasing frequency. The National Institute of Health (NIH, American College of Radiology (ACR, and the American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons (AACE/AAES have produced guidelines for the management of incidental adrenal nodules. This review provides a summary of the consensus radiologic approach to these nodules.

  2. Adult attachment and incidental memory for emotional words

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    Nanxin Li

    2011-06-01

    Full Text Available A dual task of attachment priming and memory recognition was proposed to explore the effect of adult attachment styles on the incidental memory for emotional words. Subjects completed an attachment priming task which intends to activate internal working model of attachment by describing attachment-related scenes, and then an incidental memory recognition test of words which differ in emotional meaning and relevance of attachment styles. Signal detection theory was used to compare the discriminability index and decision criterion of emotional words in subjects of different attachment style. Results showed that subjects with secure attachment styles performed better than insecure-attached subjects in the memory recognition test, in terms of higher hit rate, lower false alarm rate, and higher discriminability index. We extended the influence of attachment styles on cognition to lower level of incidental memory, not just on higher cognitive level with emotional arousal as suggested by previous research.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  4. 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.

  5. Exacerbation of Symptoms of Lumbar Disc Herniation Complicated by a Schwannoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Sen-Yung Liu

    2007-09-01

    Full Text Available Herniation of the lumbar disc is a common cause of low back pain. Conservative management with physiotherapy, such as lumbar spine traction, is usually effective. Although a schwannoma of the lumbar spine is relatively uncommon, the clinical manifestations are similar to those of lumbar disc herniation, making the diagnosis difficult. This case report describes a 51-year-old male who had suffered from low back pain for 3 years and who was diagnosed with L2/L3 lumbar disc herniation. The low back pain was well-controlled by conservative treatment and the symptoms improved progressively. Two months prior to our evaluation, however, the symptoms worsened acutely, and were accompanied by the onset of symptoms of cauda equina syndrome. A small tumor at the site of the L2/L3 disc herniation, observed incidentally during magnetic resonance imaging, was responsible for the symptoms of spinal stenosis at the lumbar region. The patient underwent laminectomy, tumor resection, and discectomy with near-complete resolution of symptoms. In patients with lumbar disc herniation that improves with conservative treatment, the recurrence of symptoms should prompt a thorough review of the medical history, physical examination, and imaging studies to establish the diagnosis and prevent delay in treatment.

  6. Orbital Cystic Schwannoma Originating from the Frontal Nerve

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    Yasuhiko Hayashi

    2012-01-01

    Full Text Available Schwannomas of the orbit are very rare benign neoplasms. Intraorbital cystic schwannomas originating from the frontal nerve are even rarer, with only 1 case reported to date. This is most likely due to the fact that, in most cases, the origin of the orbital schwannoma cannot be identified intraoperatively. The nerve origin is usually speculated from histological examination of the specimen and the postoperative neurological deficits of the patient. Here, we present the case of a 65-year-old woman with a one-month history of exophthalmos, whose orbital cystic lesion was completely removed by microsurgical transcranial operation. Intraoperatively, the continuity between the tumor and frontal nerve was seen macroscopically, leading us to confirm the frontal nerve as an origin of the tumor, which was consistent with the postoperative neurological findings. The diagnosis of the tumor was established as schwannoma from the histological examination. As a differential diagnosis of the orbital cystic lesions, the possibility of schwannomas should be kept in mind.

  7. A Rare Causing of Difficulty in Defecation: Rectal Schwannoma

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    Ozgur Dandin

    2014-02-01

    Full Text Available Objective: Schwannomas are mainly benign, non-epithelial tumors originating in the Schwann cells, which form nerve sheaths. Schwannomas account for about 2-8% of all gastrointestinal mesenchymal tumors, encountered more frequently in the stomach and the small intestine. Schwannomas of the colon and rectum are extremely rare. Case Presentation: In this report, we present a thirty-nine-year-old woman admitted for complaints of rectal fullness and difficulty in defecation. At her rectal examination, a polypoid tumor 22x27x27mm in size was found filling the lumen of the rectum; it was well defined, with a homogeneous nature and benign appearance. Complete excision of the tumor was achieved by a transanal surgical approach. Histolopathological and immunohistochemical diagnosis of the tumor reported a rectal schwannoma. There has been no tumor recurrence at 18 months after surgical excision. Conclusion: A schwannoma of the rectum is rare; a benign tumor can usually be separated from GISTs with immunohistochemical staining, and it carries a good prognosis with local excision, which is the procedure of choice. [Arch Clin Exp Surg 2014; 3(1.000: 59-63

  8. 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.

  9. Regions of homozygosity identified by SNP microarray analysis aid in the diagnosis of autosomal recessive disease and incidentally detect parental blood relationships.

    Science.gov (United States)

    Sund, Kristen Lipscomb; Zimmerman, Sarah L; Thomas, Cameron; Mitchell, Anna L; Prada, Carlos E; Grote, Lauren; Bao, Liming; Martin, Lisa J; Smolarek, Teresa A

    2013-01-01

    The purpose of this study was to document the ability of single-nucleotide polymorphism microarray to identify copy-neutral regions of homozygosity, demonstrate clinical utility of regions of homozygosity, and discuss ethical/legal implications when regions of homozygosity are associated with a parental blood relationship. Study data were compiled from consecutive samples sent to our clinical laboratory over a 3-year period. A cytogenetics database identified patients with at least two regions of homozygosity >10 Mb on two separate chromosomes. A chart review was conducted on patients who met the criteria. Of 3,217 single-nucleotide polymorphism microarrays, 59 (1.8%) patients met inclusion criteria. The percentage of homozygosity ranged from 0.9 to 30.1%, indicating parental relationships from distant to first-degree relatives. First-degree kinship was suspected in the parents of at least 11 patients with regions of homozygosity covering >21.3% of their autosome. In four patients from two families, homozygosity mapping discovered a candidate gene that was sequenced to identify a clinically significant mutation. This study demonstrates clinical utility in the identification of regions of homozygosity, as these regions may aid in diagnosis of the patient. This study establishes the need for careful reporting, thorough pretest counseling, and careful electronic documentation, as microarray has the capability of detecting previously unknown/unreported relationships.

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

    Directory of Open Access Journals (Sweden)

    Mohammed T

    2010-01-01

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

  11. Intraventricular schwannoma in a child. Literature review and case illustration.

    Science.gov (United States)

    Abdolhosseinpour, Hesam; Vahedi, Payman; Saatian, Minoo; Entezari, AliReza; Narimani-Zamanabadi, Mahnaz; Tubbs, Richard Shane

    2016-06-01

    Intraventricular schwannoma remains a rare entity in the literature. Controversy exists on the possible pathogenesis of such a tumor within cerebral ventricles. Literature is sparse on tumor characteristics and differences between pediatric and adult patients. We present a case of intraventricular schwannoma in a 9-year-old patient presenting with headache, hemiparesis, and focal seizure. Brain CT scan and MRI revealed an intraventricular tumor within left atrium of lateral ventricle. The patient underwent total resection of the tumor via posterior parietal approach. Histopathological exam was in favor of schwannoma. Postoperative brain MRI and MRS showed no recurrence after 18 months. Our review of the literature indicates there are some significant differences between pediatric and adult cases in different aspects including gender predominance, intraventricular location, malignant transformation, tendency for recurrence, and surgical outcome. This needs to be taken into account in the literature.

  12. 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.

  13. Gastric Schwannoma or GIST: accuracy of preoperative diagnosis?

    Science.gov (United States)

    Guthrie, G; Mullen, R; Moses, A

    2011-11-01

    Mesenchymal cell tumours of the gastrointestinal tract are rare in western society. Gastrointestinal stromal tumour (GIST) is the most common of this group of tumours. Gastric schwannoma is rarer, accounting for only 0.2% of all gastric tumours and 4% of all benign gastric neoplasms. Indeed, schwannoma has only been recognized as a primary gastrointestinal tumour in the last 20 years through advances in pathological techniques. We report a rare case of gastric schwannoma, the endoscopic and radiological features of which were indistinguishable from a GIST. Due to the diagnostic uncertainty, surgical resection is the treatment of choice. Development of more reliable diagnostic methods, such as endoscopic core biopsy, may help the accuracy of preoperative diagnosis.

  14. Artesunate induces necrotic cell death in schwannoma cells.

    Science.gov (United States)

    Button, R W; Lin, F; Ercolano, E; Vincent, J H; Hu, B; Hanemann, C O; Luo, S

    2014-10-16

    Established as a potent anti-malaria medicine, artemisinin-based drugs have been suggested to have anti-tumour activity in some cancers. Although the mechanism is poorly understood, it has been suggested that artemisinin induces apoptotic cell death. Here, we show that the artemisinin analogue artesunate (ART) effectively induces cell death in RT4 schwannoma cells and human primary schwannoma cells. Interestingly, our data indicate for first time that the cell death induced by ART is largely dependent on necroptosis. ART appears to inhibit autophagy, which may also contribute to the cell death. Our data in human schwannoma cells show that ART can be combined with the autophagy inhibitor chloroquine (CQ) to potentiate the cell death. Thus, this study suggests that artemisinin-based drugs may be used in certain tumours where cells are necroptosis competent, and the drugs may act in synergy with apoptosis inducers or autophagy inhibitors to enhance their anti-tumour activity.

  15. Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

    Science.gov (United States)

    Fujiwara, Shinichi; Nakajima, Kiyokazu; Nishida, Toshirou; Takahashi, Tsuyoshi; Kurokawa, Yukinori; Yamasaki, Makoto; Miyata, Hiroshi; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

    2013-07-01

    Gastric schwannomas are not common but are clinically important in terms of differential diagnosis from other submucosal lesions. The precise preoperative diagnosis, however, has been challenging mainly owing to the lack of specific findings in conventional imaging studies. The aim of this study was to revisit the possibilities and limitations of modern preoperative diagnostic modalities for gastric schwannomas. Fourteen consecutive patients with a final pathological diagnosis of gastric schwannoma were retrospectively analyzed. Data included demographics, preoperative imaging studies/diagnosis, surgery, histopathology, and follow-up results. The series included 6 males and 8 females, with a median age of 49 years (range 26-68 years). No symptoms were presented, except for 1 patient with epigastric pain. The tumors were located in the upper (n = 5), middle (3), and lower stomach (6), with a median size of 41 mm (range 20-75 mm). Twelve schwannomas (86%) showed homogeneous enhancement on computed tomography. Ulceration was seen on endoscopy in 4 of 12 available cases (33%). Positron emission tomography was performed in the last 4 patients, showing fluorodeoxy-glucose uptake in all cases (100%). A preoperative diagnosis of schwannoma was not obtained in the majority of cases (13/14, 93%); only 1 case was correctly diagnosed, by endoscopic aspiration cytology. Laparoscopic partial gastrectomy was attempted and completed in 13 cases. The patients have been followed up for 4.7 years (range 2.1-20.3 years), with no recurrencesor metastases and acceptable gastrointestinal function. The precise preoperative diagnosis of gastric schwannomas remains difficult even with modern imaging studies. Surgery, therefore, should be positively considered for patients without a conclusive preoperative diagnosis.

  16. INCIDENTAL VOCABULARY LEARNING THROUGH READING

    Directory of Open Access Journals (Sweden)

    Holly Warzecha, M.A. TESOL

    2017-04-01

    Full Text Available The purpose of the following paper is to take a closer look at the benefits of incidental learning through reading, with a specific focus on vocabulary acquisition. The teaching of vocabulary has traditionally been an explicit process where the target vocabulary is taken out of context and taught separately. However, this kind of explicit teaching and learning may only take into account a form-meaning connection. Therefore, this paper explores research on incidental learning and specifically looks at what it takes to acquire new vocabulary incidentally through reading while considering the coverage rates of texts, how many words must be known already from the text, how many repetitions it takes to learn a word, types of texts that promote learning, and the effects of pairing students‘ reading with learner tasks. After reviewing many studies, it can be concluded that more reading is better. More specifically, extensive reading of chosen novels at an appropriate level and interest to the students showed important gains in vocabulary. In addition, readings that were supplemented with additional activities that focused on both form and meaning showed an even higher increase in word retention.

  17. Schwannoma of the stomach with elevated preoperative serum carbohydrate antigen 19-9: report of a case.

    Science.gov (United States)

    Fukuchi, Minoru; Naitoh, Hiroshi; Shoji, Hisanori; Yamagishi, Junko; Suzuki, Masaki; Yanoma, Toru; Kiriyama, Shinsuke; Kuwano, Hiroyuki

    2012-08-01

    We herein report a case of a gastric schwannoma with elevated preoperative serum carbohydrate antigen 19-9 (CA19-9) (155.2 U/ml, normal range 0-36.9 U/ml). A 59-year-old Japanese man was admitted to our hospital for treatment of a submucosal tumor of the stomach detected by barium meal, upper gastrointestinal endoscopy, and computed tomography. Endoscopic examination revealed a 3-cm diameter submucosal tumor in the antrum of the stomach, but biopsy of the lesion was unable to confirm the diagnosis. Positron emission tomography to evaluate the malignant potential showed a high uptake of (18)F-fluorodeoxyglucose in the tumor. Laparoscopy-assisted distal gastrectomy was therefore performed. The histopathological findings of the surgical specimen revealed a benign gastric schwannoma, positive for S-100 protein. The postoperative serum CA19-9 levels gradually decreased and normalized. To the best of our knowledge, this is the first report of a gastric schwannoma with elevated serum CA19-9.

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  19. Gastric Schwannoma: A Postoperative Surprise A Case Report.

    Directory of Open Access Journals (Sweden)

    Abdelmounaim Ait Ali

    2014-06-01

    Full Text Available Gastric Schwannoma is a rare, slow-growing, and clinically non-specific submucosal tumor, originating from Schwann cells with excellent prognosis after surgical resection.We report a clinical case of a patient presented with gastric schwannoma revealed by non-specific gastric signs and of which the definitive diagnosis is done through immunohistochemistry of the resected specimen, showing strong S100 protein positivity. The evolution is favorable after a partial gastrectomy with a decline of two years. Through this case, we are trying to trace the rarity, strong similarities with gastric stromal tumors and especially, the weak index of suspicion for this diagnosis.

  20. 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.

  1. Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

    Directory of Open Access Journals (Sweden)

    William Yoon

    2012-01-01

    Full Text Available Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

  2. Gastric schwannoma: a rare but important differential diagnosis of a gastric submucosal mass.

    Science.gov (United States)

    Yoon, William; Paulson, Kari; Mazzara, Paul; Nagori, Sweety; Barawi, Mohammed; Berri, Richard

    2012-01-01

    Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60-70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10-30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

  3. 78 FR 24731 - Taking Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to an...

    Science.gov (United States)

    2013-04-26

    ... National Oceanic and Atmospheric Administration RIN 0648-XC494 Taking Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to an Exploration Drilling Program in the Chukchi Sea... small numbers of marine mammals, by Level B harassment, incidental to conducting offshore exploration...

  4. Gamma knife radiosurgery for acoustic Schwannoma. Early effects and preservation of hearing

    Energy Technology Data Exchange (ETDEWEB)

    Hirato, Masafumi; Inoue, Hiroshi; Nakamura, Masaru; Ohye, Chihiro; Hirato, Junko [Gunma Univ., Maebashi (Japan). School of Medicine; Shibazaki, Tohru; Andou, Yoshitaka

    1995-10-01

    The effects of relatively low dose gamma knife irradiation on acoustic Schwannoma were evaluated. The signal intensity change and tumor shrinkage on magnetic resonance (MR) images, change in hearing, and complications in 28 patients (mean age 47.0{+-}13.6 yrs) were studied. Three patients had bilateral tumors. Six were already deaf when treated. The maximum tumor diameter was 35 mm. The mean dose delivered to the tumor was 12.1{+-}1.6 Gy at the periphery, and 25.2{+-}4.3 Gy at the center. The mean follow-up time was 16 months and the longest 24 months. Lowering of the MR signal intensity in the tumor center appeared after 3 months at earliest but generally after 6 months. Signs of tumor shrinkage appeared within 12 months on average. Cyst in the tumor enlarged rapidly after treatment in two patients. The percentage of hearing preservation was 85% (17/20) at 3 months, 80% (16/20) at 6 months, 72% (13/18) at 9 months, 75% (12/16) at 12 months, 67% (8/12) at 15 months, 60% (6/10) at 18 months, and 50% (2/4) at 24 months. Subtle changes in hearing were detected by speech tone audiometry. Temporary facial numbness and weakness was seen in one patient each. No patient had lower cranial nerve paresis. Relatively low dose gamma knife radiosurgery is effective in suppressing growth of acoustic Schwannoma with preservation of hearing. (author).

  5. [Impact of Microsurgical Exstirpation of Vestibular Schwannomas on the Sense of Taste].

    Science.gov (United States)

    Boeßert, P; Hempel, J M; van Ewijk, R; Mann, W J; Haxel, B R

    2016-05-01

    Patients with single sided vestibular schwannoma may report about a taste dysfunction apart from the well known cardinal symptoms. Very few data are published so far on that topic. The aim of this study was to investigate the influence of microsurgery for vestibular schwannomas on taste perception prospectively using a well validated taste test. 25 patients could be included in the study. No ageusia was claimed by the patients. In average a decrease of the taste score postoperatively could be detected on the tumor as well as on the non treated side. The differences were not statistically significant. But a subgroup of ¼ of the subjects revealed a new onset of side difference in the taste score that was not present before surgery. In all those cases the treated side showed a clinically significant reduced taste score of 6,2 in average. Within this subgroup the temporal access was overpresented in contrast to the whole group. This may indicate an influence of the choosen approach and that for the position of the tumor to the change of the taste score. The observations should be verified on a greater collective. © Georg Thieme Verlag KG Stuttgart · New York.

  6. The Incidental Thyroid Lesion in Parathyroid Disease Management

    Directory of Open Access Journals (Sweden)

    Uthman Alamoudi MD

    2017-03-01

    Full Text Available Objective The incidental thyroid lesion is a common finding during general imaging studies. Their management has been the subject of numerous studies and recommendations. Parathyroid disease workup necessitates imaging investigation of the adjacent thyroid gland and therefore provides a unique window to the perioperative management of thyroid incidentaloma. The specific prevalence of incidental thyroid lesions in the context of parathyroid disease is unknown. We seek to investigate its prevalence during parathyroid workup and surgery and to ascertain if there was a change in management of these patients. Study Design Five-year retrospective database review. Setting Tertiary care medical center. Subjects and Methods The source and indication for referral, preoperative investigation findings, and management of the incidental thyroid lesions were examined. The actual procedure performed and final pathology results were assessed. Results A total of 98 patients and 106 operations, including revision surgeries, were identified. There were 21 incidental thyroid lesions (21.4% detected, whereby 15 patients underwent fine-needle aspirations and 12 subsequently had diagnostic hemithyroidectomies. This decision was made preoperatively in 5 patients and intraoperatively in 7 patients at the time of parathyroid surgery. Along with other pathologies, there were 7 patients with micropapillary thyroid carcinoma identified. Conclusions In our series, the prevalence of incidental thyroid lesion and thyroid malignancy is comparable to the general population. The management of the initial parathyroid disease in our patients was altered by the imaging and cytological findings of these thyroid lesions. This has implications on perioperative counseling of the thyroid and parathyroid disease.

  7. Incidental findings in chest X-rays; Zufallsbefunde im Roentgenthorax

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Heidelberg (Germany); Weckbach, S. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany)

    2017-04-15

    Conventional projection radiography (chest x-ray) is one of the most frequently requested procedures in radiology. Even though chest x-ray imaging is frequently performed in asymptomatic patients for preoperative assessment, clinically relevant incidental findings are relatively scarce. This is due to the relatively low sensitivity of chest x-rays where few clinically relevant incidental findings are to be expected, as any detectable pathologies will as a rule already be clinically symptomatic. Recommendations from relevant societies for the management of incidental findings, apart from the clarification of incidental nodules, do not exist. This review article therefore describes the most frequent and typical incidental findings of lung parenchyma (apart from pulmonary nodules), mediastinal structures including the hilum of the lungs, pleura, chest wall and major vessels. Also described are those findings which can be diagnosed with sufficient certainty from chest x-rays so that further clarification is not necessary and those which must be further clarified by multislice imaging procedures or other techniques. (orig.) [German] Eine der haeufigsten Untersuchungen in der Radiologie ist die konventionelle Projektionsradiographie des Thorax (Roentgenthorax). Auch wenn projektionsradiographische Aufnahmen im Rahmen einer praeoperativen Abklaerung haeufig als orientierende Untersuchung angefertigt werden, sind - bedingt durch die relativ geringe Sensitivitaet des Roentgenthorax - wenig klinisch relevante Zufallsbefunde zu erwarten, da nachweisbare Pathologien in der Regel bereits auch klinisch apparent sind. Empfehlungen entsprechender Fachgesellschaften zu Zufallsbefunden im Roentgenthorax jenseits der Abklaerung von Rundherden liegen nicht vor. Die vorliegende Arbeit beleuchtet daher haeufige und typische Zufallsbefunde des Lungenparenchyms (ausser den Lungenrundherden), der mediastinalen Strukturen einschliesslich der Hili, der Pleura, der Thoraxwand sowie der

  8. Intrarenal Splenosis Diagnosed in an Incidentally Found Left Renal Mass

    Directory of Open Access Journals (Sweden)

    Eliza Lamin

    2015-09-01

    Full Text Available Intrarenal splenosis is very rare and its management is not well established. We present a patient in whom an enhancing left renal mass was incidentally detected on a Computerized tomographic (CT scan, concerning for renal cell carcinoma. However, the lesion was determined to represent intrarenal splenosis, confirmed by Technetium-99m (99mTc sulfur colloid scan and percutaneous biopsy, which revealed splenic tissue. This multimodal approach to diagnosis of an unusual condition spared the patient an invasive procedure.

  9. 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.

  10. 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...

  11. Retropharyngeal Schwannoma Excised Through a Transoral Approach: A Case Report

    Directory of Open Access Journals (Sweden)

    Chia-Ying Hsieh

    2006-09-01

    Full Text Available The contents of the retropharyngeal space are limited to fat and retropharyngeal nodes. Primary tumors originating from the retropharyngeal space are rare. More than 25% of schwannomas are found in the head and neck region, and they are rarely found in the retropharyngeal space. Here, we report the case of a 44-year-old woman with a schwannoma confined to the left retropharyngeal space, who presented with snoring and a mild lump in the throat sensation. Physical examination revealed anterior bulging of the left oropharyngeal wall, with intact mucosa. Magnetic resonance imaging showed a well-defined, encapsulated tumor in the left retropharyngeal space with bright signal intensity on T2-weighted images and low signal intensity on T1-weighted images, which was strongly enhanced after gadolinium administration. The tumor was removed through a transoral approach, resulting in a short postoperative recovery time without complications. The pathologic diagnosis was schwannoma. The patient has been well and free of tumor recurrence for 2 years. From anatomic and physiologic viewpoints, excision through a transoral approach is a good choice for a confined retropharyngeal schwannoma.

  12. 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...

  13. Gastric plexiform schwannoma in association with neurofibromatosis type 2.

    Science.gov (United States)

    Kudose, Satoru; Kyriakos, Michael; Awad, Michael Magdi

    2016-12-01

    Plexiform schwannoma (PS) is an uncommon variant of schwannoma characterized by a multinodular (plexiform) growth pattern. It comprises up to 5 % of all schwannomas. The association between PS and neurofibromatosis type 1 or type 2 (NF1/NF2) is only rarely reported. Most cases of PS occur in the skin and subcutaneous soft tissue, with only a few reports of digestive tract involvement. We describe an 18-year-old male with NF2 who had bilateral vestibular schwannomas and multiple cutaneous PSs, and a 3-year history of abdominal pain. The patient ultimately underwent a distal gastrectomy for a partially obstructing submucosal antral mass, associated with an overlying ulcer. Histopathologic examination showed the mass to be a PS. The patient is alive and well, without symptoms, 12 months postoperatively. A review of the English language medical literature yielded only ten examples of PS arising in the digestive tract. Our patient is the first to be reported to have a gastric PS, and only the second patient to be reported with a digestive tract PS to have NF2, and the only patient reported to have both digestive tract and cutaneous PSs. Despite its rare occurrence with NF2, the finding of PS at any site should stimulate an examination for other manifestations of this disorder. None.

  14. Schwannoma of the left brachial plexus mimicking a ...

    African Journals Online (AJOL)

    schwannomas ofthe vagus and phrenic nervcs appeafing as medi— astinal masses”. Bmchial plexus schwannomatas have been reported to mani— fest as causing nerve compression symptoms8 which our patient cxperienced or an abnormal mediastinal shadow on plain chest— xray due to intrathoracïc extension'.

  15. [Cystic mediastinal schwannoma appended to the vagus nerve].

    Science.gov (United States)

    Dahdah, J; Validire, P; Grigoroiu, M; Lenoir, S; Gossot, D; Stern, J-B

    2016-05-01

    Schwannomas are a form of rare tumor, arising from neural tissue and representing 2 % of mediastinal tumors. They are usually located in the posterior mediastinum, most often in the paravertebral gutters and typically appended to intercostal nerves. We report two cases of unusual mediastinal schwannomas, appended to the vagus nerve. The schwannoma was located in the subcarinal region in the first case and in the right para-tracheal region in the second case. The lesions were thought to be bronchogenic cysts preoperatively in both cases because of a cystic appearance on preoperative CT scan and endobronchial ultrasonography. A surgical approach was adopted to remove the tumors. Video-assisted thoracoscopy was used in one case and robotic-assisted surgery in the second case, without any complication, allowing for complete resection and to establish a certain pathological diagnosis. Despite this location and cystic presentation being unusual, schwannoma should be considered as a possible cause of cystic lesions in the mediastinum. Minimally invasive surgery allows for complete resection and definitive pathological diagnosis. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  16. Malignant Transformation of Vagal Nerve Schwannoma in to ...

    African Journals Online (AJOL)

    Here, we are reporting the first case from the Indian subcontinent which was transformed into the angiosarcoma from benign vagal schwannoma over a long period. A 47‑year‑old male patient complaining of left sided neck swelling since last 12 years, swelling was insidious in onset, gradually progressive very slowly. In last ...

  17. Global Proteome and Phospho-proteome Analysis of Merlin-deficient Meningioma and Schwannoma Identifies PDLIM2 as a Novel Therapeutic Target.

    Science.gov (United States)

    Bassiri, Kayleigh; Ferluga, Sara; Sharma, Vikram; Syed, Nelofer; Adams, Claire L; Lasonder, Edwin; Hanemann, C Oliver

    2017-02-01

    Loss or mutation of the tumour suppressor Merlin predisposes individuals to develop multiple nervous system tumours, including schwannomas and meningiomas, sporadically or as part of the autosomal dominant inherited condition Neurofibromatosis 2 (NF2). These tumours display largely low grade features but their presence can lead to significant morbidity. Surgery and radiotherapy remain the only treatment options despite years of research, therefore an effective therapeutic is required. Unbiased omics studies have become pivotal in the identification of differentially expressed genes and proteins that may act as drug targets or biomarkers. Here we analysed the proteome and phospho-proteome of these genetically defined tumours using primary human tumour cells to identify upregulated/activated proteins and/or pathways. We identified over 2000 proteins in comparative experiments between Merlin-deficient schwannoma and meningioma compared to human Schwann and meningeal cells respectively. Using functional enrichment analysis we highlighted several dysregulated pathways and Gene Ontology terms. We identified several proteins and phospho-proteins that are more highly expressed in tumours compared to controls. Among proteins jointly dysregulated in both tumours we focused in particular on PDZ and LIM domain protein 2 (PDLIM2) and validated its overexpression in several tumour samples, while not detecting it in normal cells. We showed that shRNA mediated knockdown of PDLIM2 in both primary meningioma and schwannoma leads to significant reductions in cellular proliferation. To our knowledge, this is the first comprehensive assessment of the NF2-related meningioma and schwannoma proteome and phospho-proteome. Taken together, our data highlight several commonly deregulated factors, and indicate that PDLIM2 may represent a novel, common target for meningioma and schwannoma. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  18. 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.

  19. Recrudescence of herpes virus infections following resection of schwannomas. An antiviral role of merlin?

    Science.gov (United States)

    Elmaci, İlhan; Altinoz, Meric A

    2017-05-01

    After schwannoma resection, reactivation of herpes infections were reported. Also, IgM antibody titers against Herpes viri increase among 30% of patients, who develop fascial palsy following schwannoma resection. Merlin interacts with p53 pathway and seems to function as a suppressor of viral propagation. Loss of merlin may increase viral particles in nerve fascicles, yet these may fail to cause infections due to immunostimulation by other aberrant antigens present in schwannoma cells. Removal of schwannomas may decrease the antigenic diversity and trigger viral recrudescence. Understanding the viral etiology - molecular merlin interactions in schwannoma tissues may also help to develop strategies against delayed fascial palsy seen following schwannoma resection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Giant schwannoma of the foot: a case report and literature review.

    Science.gov (United States)

    Muratori, Francesco; De Gori, Marco; Campo, Francesco Rosario; Bettini, Leonardo; D'Arienzo, Antonio; Scoccianti, Guido; Capanna, Rodolfo

    2017-01-01

    A schwannoma is a rare, benign tumor originating from Schwann cells of peripheral nerve sheath. It commonly occurs in subjects between 20 and 50 years of age, and its malignant transformation is exceptional. While schwannomas usually affect the head and neck region, localization in the lower extremity is exceptionally rare, and even fewer cases have described schwannomas occurring in the foot. We report a case of a giant schwannoma of the foot diagnosed in a 65-year-old woman. A giant schwannoma of the foot is an extremely rare soft tissue tumor. MRI may allow an earlier diagnosis and provide valuable information about the size and possible bone invasion. This case report noted that a complete excision of the schwannoma may prevent the risk of local recurrence, regardless of its size.

  1. Stereotactic Radiosurgery for Cystic Vestibular Schwannomas.

    Science.gov (United States)

    Frisch, Christopher D; Jacob, Jeffrey T; Carlson, Matthew L; Foote, Robert L; Driscoll, Colin L W; Neff, Brian A; Pollock, Bruce E; Link, Michael J

    2017-01-01

    The optimum treatment for cystic vestibular schwannoma (VS) remains controversial. Anecdotally, many treating physicians feel that cystic VSs do not respond to stereotactic radiosurgery (SRS) as well as noncystic tumors. To present outcomes after treatment of predominantly cystic VS with SRS. A prospectively maintained clinical database of patients undergoing Gamma Knife (Elekta Instruments, Stockholm, Sweden) radiosurgery (GKRS) for VS at a single tertiary academic referral center was retrospectively reviewed. Patients diagnosed with cystic VS who were treated with GKRS between 1997 and 2014 were analyzed. Size-matched solid tumors treated with GKRS during this period were selected as controls. Twenty patients (12 women; median age at treatment, 56 years; range, 36-85 years) with cystic VS met inclusion criteria. The median radiologic follow-up within the cystic group was 63 months (range, 17-201 months), and the median change in tumor size was -4.9 mm (range, -10.4 to 9.3 mm). Sixteen tumors (80%) shrank, 2 (10%) remained stable, and 2 (10%) enlarged, accounting for a tumor control rate of 90%. The median radiologic follow-up in the noncystic control group was 67 months (range, 6-141 months), and the median change in size was -2.0 mm (range, -10.4 to 2.5 mm). Tumor control in the solid group was 90%. Comparing only those tumors that decreased in size showed that there was a trend toward a greater reduction within the cystic group ( P = .05). The present study demonstrates that tumor control after SRS for cystic VS may not differ from that of noncystic VS in selected cases.

  2. Multisession stereotactic radiosurgery for large vestibular schwannomas.

    Science.gov (United States)

    Casentini, Leopoldo; Fornezza, Umberto; Perini, Zeno; Perissinotto, Egle; Colombo, Federico

    2015-04-01

    Microsurgery is not the only option for larger vestibular schwannomas (VSs); recent reviews have confirmed the feasibility and efficacy of radiosurgery for larger VSs. This study illustrates the outcomes of a series of large VSs after multisession stereotactic radiosurgery (SRS). A series of 33 VSs larger than 8 cm(3) (range 8-24 cm(3), mean 11 cm(3), median 9.4 cm(3)) were treated using the CyberKnife from 2003 to 2011 with the multisession SRS technique in 2-5 fractions (14-19.5 Gy). Five patients had undergone surgical removal and 5 had ventriculoperitoneal shunts. Nine patients were eligible for but refused surgery. Twelve patients were older than 70 years and 5 were younger than 40 years. Two female patients had neurofibromatosis. The follow-up period ranged from 12 to 111 months (median 48 months); radiological growth control was achieved in 94% of cases: 19 tumors (58%) displayed no size variation or reduction in tumor diameter; 12 (36%), after a transient enlargement, presented with arrested growth or shrinkage. Seven patients had a volume reduction of more than 50%. Two patients (6%) needed debulking and 2 were treated with ventriculoperitoneal shunts. Actuarial progressionfree survival rates at 1 year and 5 years were 97% and 83%, respectively. Hearing was retained in 7 of the 8 patients with serviceable baseline hearing. Adverse events were limited to 1 case each of vertigo, tongue paresthesia, and trigeminal neuralgia. The good control rate obtained with multisession SRS deepens the controversy of the radiobiology of VSs and may extend the indication of radiation therapy (fractionated or SRS) for large VSs to include patients without symptoms of mass effect. The limited number of cases and short follow-up period do not provide sufficient support for widespread application of multisession SRS in young patients. Further studies with multisession SRS are warranted.

  3. Autosomal Dominant Polycystic Kidney Disease, incidental finding ...

    African Journals Online (AJOL)

    Introduction: Pre-existing renal lesions predispose kidneys to effects of otherwise insignificant blunt trauma, and may uncommonly present as an incidental finding in the workup of a suspected renal injury. Observation: This is a case report of a 28-year-old male diagnosed incidentally with Autosomal Dominant Polycystic ...

  4. Animation, Incidental Learning, and Continuing Motivation.

    Science.gov (United States)

    Rieber, Lloyd P.

    1991-01-01

    Effects of animated graphics presentations on incidental learning and the degree to which various computer practice activities contain intrinsically motivating characteristics were studied with 70 fourth graders learning about Newton's laws of motion. Incidental learning occurred without sacrifice of intentional learning. Students were highly…

  5. Endoscopic resection for gastric schwannoma with long-term outcomes.

    Science.gov (United States)

    Cai, Ming-Yan; Xu, Jia-Xin; Zhou, Ping-Hong; Xu, Mei-Dong; Chen, Shi-Yao; Hou, Jun; Zhong, Yun-Shi; Zhang, Yi-Qun; Ma, Li-Li

    2016-09-01

    Gastric schwannoma is not so recognized by clinicians as its counterparts. The efficacy of endoscopic resection has not been described yet. Our aim was to assess the efficacy and safety of endoscopic resection in the management of gastric schwannoma. Retrospective data were reviewed from January 2008 to December 2013 in our center. Fourteen patients who had endoscopic resection with the final pathology result of gastric schwannoma were included in the study. Of the 14 patients, there were 12 females and two males. The median age was 59 years (range 32-83). Thirteen tumors (92.9 %) were from the muscularis propria and one located in the submucosa. Endoscopic en bloc resection was achieved in 12 patients (12/14, 85.7 %), including seven cases of endoscopic full-thickness resection (EFTR). The mean resected tumor size was 1.73 ± 1.10 cm (range 0.3-4.0 cm). In one case, endoscopic resection was suspended due to the limited experience of EFTR during the early period of the study. In another case, due to the difficult tumor location (gastric angle) and extraluminal growth pattern, the patient was referred to laparoscopic surgery. In the 12 successful endoscopic resection cases, during the median follow-up time of 4 years (range 17-77 months, one patient lost), no tumor residue, recurrence or metastasis was found. Endoscopic resection is safe and effective in treating gastric schwannoma with excellent long-term outcomes. However, it should be performed with caution because schwannoma is mainly located in the deep muscular layer, which leads to the full-thickness resection of gastric wall.

  6. 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.

  7. 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.

  8. Gastric Schwannoma Mimicking Malignant Gastrointestinal Stromal Tumor Exhibiting Increased Fluorodeoxyglucose Uptake

    OpenAIRE

    Sung Jin Oh; Byoung Jo Suh; Jong Kwon Park

    2016-01-01

    A schwannoma is a kind of neurogenic tumor that rarely occurs in the gastrointestinal tract. Gastric schwannomas make up 0.2% of all gastric neoplasms. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors and up to 60?70% of GIST occur in the stomach. Schwannoma and GIST are similar in clinical features, so they are difficult to differentiate preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST a...

  9. Abducens nerve palsy after schwannoma resection.

    Science.gov (United States)

    Bobbio, Antonio; Hamelin-Canny, Emelyne; Roche, Nicolas; Taillia, Herve; Alifano, Marco

    2015-02-01

    Tumors of the posterior mediastinum are mostly neurogenic and could involve the intervertebral foramen and the medullary canal. We describe the case of a patient who underwent surgery for a nerve sheet tumor originating at the level of the right second neural root. Resection was associated with an incidental dural tear and cerebrospinal fluid leak that was promptly repaired. One week after surgery, horizontal diplopia occurred. A palsy of the left abducens nerve secondary to intracranial hypotension was diagnosed. We present the pathogenic cascade leading to this ocular complication after posterior mediastinal surgery. The surgical techniques to prevent this complication are discussed. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Rare case of palatal schwannoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Uday Shankar Yaga

    2015-01-01

    Full Text Available Schwannomas, also known as neurilemmoma, are benign, slow-growing nerve sheath tumors arising from Schwann cells. Approximately 25-40% of schwannomas occur in the head and neck region. However, schwannomas that present in the oral cavity are relatively rare, constituting around 1% of all described cases in the head and neck region. [1],[2] Here, we report a rare case of an intraoral schwannoma, in a 28-year-old male, with painless swelling located in the posterolateral aspect of the soft palate on the right side. Definitive diagnosis was obtained after histopathology examination. Surgical excision of the tumor was done with no complications or recurrences.

  11. Melanotic schwannoma of the lumbar spine: a case report and literature review

    National Research Council Canada - National Science Library

    Rodrigues, João Bernardo Sancio Rocha; Saleme, Nathália Ambrozim Santos; Jacob Junior, Charbel; Batista Junior, José Lucas; Cardoso, Igor Machado; Motta, Luciene Lage da; Lugão, Rodrigo dos Santos; Rezende, Rodrigo

    2015-01-01

    Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots...

  12. Gastric schwannoma misdiagnosed as GIST: A case report with immunohistochemical and molecular study.

    Science.gov (United States)

    Tatangelo, Fabiana; Cantile, Monica; Collina, Francesca; Belli, Andrea; DE Franciscis, Silvia; Bianco, Franco; Botti, Gerardo

    2016-04-01

    Schwannomas are tumors derived from Schwann cells. Generally, they are benign and their typical site of origin is the subcutaneous tissue of the distal extremities or of the head and neck region. Gastrointestinal localization of schwannomas is extremely rare, and the stomach is the prevalent site. The present study describes the case of a gastric schwannoma in a 61-year-old male who underwent subtotal gastrectomy following a clinical diagnosis of a gastrointestinal stromal tumor (GIST). A histological, immunohistochemical and molecular study was performed to exclude the misdiagnosis of GIST. The histomorphological features of the lesion and absence of c-Kit and PDGFRA mutations indicated the diagnosis of gastric schwannoma.

  13. Clinicopathologic features of incidental prostatic adenocarcinoma in radical cystoprostatectomy specimens

    Directory of Open Access Journals (Sweden)

    Vuruskan Hakan

    2011-07-01

    Full Text Available Abstract Background The aim of this study is to review all features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. Methods The medical charts of 300 male patients who underwent radical cystoprostatectomy for bladder cancer between 1997 and 2005 were retrospectively reviewed. The mean age of the patients was 62 (range 51-75 years. Results Prostate adenocarcinoma was present in 60 (20% of 300 specimens. All were acinar adenocarcinoma. Of these, 40 (66.7% were located in peripheral zone, 20 (33.3% had pT2a tumor, 12 (20% had pT2b tumor, 22(36.7% had pT2c and, 6 (10% had pT3a tumor. Gleason score was 6 or less in 48 (80% patients. Surgical margins were negative in 54 (90% patients, and tumor volume was less than 0.5 cc in 23 (38.3% patients. Of the 60 incidentally detected cases of prostate adenocarcinoma 40 (66.7% were considered clinically significant. Conclusion Incidentally detected prostate adenocarcinoma is frequently observed in radical cystoprostatectomy specimens. The majority are clinically significant.

  14. Incidental versus non-incidental thyroid carcinoma: Clinical presentation, surgical management and prognosis.

    Science.gov (United States)

    González-Sánchez-Migallón, Elena; Flores-Pastor, Benito; Pérez-Guarinos, Carmen Victoria; Miguel-Perelló, Joana; Chaves-Benito, Asunción; Illán-Gómez, Fátima; Carrillo-Alcaraz, Andrés; Aguayo-Albasini, José Luis

    2016-11-01

    Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors. A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves' disease were compared to those with multinodular goiter. Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves' disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery. Early stage thyroid cancer has better survival and prognosis after surgical treatment. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. 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

    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.

  16. Incidental findings are frequent in young healthy individuals undergoing magnetic resonance imaging in brain research imaging studies

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Siebner, Hartwig R; Deuschl, Günther

    2010-01-01

    There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management.......There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management....

  17. Renal Myxoma, an Incidental Finding

    Directory of Open Access Journals (Sweden)

    Parth Thakker

    2017-07-01

    Full Text Available Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm. Immunohistochemical staining for CD-10, Desmin, HMB-45, and Pankeratin were negative.

  18. 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.

  19. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Godwin I Ogbole

    2015-01-01

    Full Text Available Background: Incidental findings on computed tomography (CT scans are occasionally noted in patients presenting with head injury. Since it can be assumed that head injured patients are of normal health status before the accident, these findings may be a representation of their frequency in the general population. Our aim was to determine the prevalence of such incidental findings among head injured patients in Nigeria′s foremost center of clinical neurosciences. Materials and Methods: We conducted a retrospective review of CT scan images of 591 consecutive eligible patients over a 5-year period (2006-2010 to identify incidental findings. The images were evaluated by consensus agreement of two radiologists. Associations with gender and age were explored using appropriate statistical tests with an alpha level of 0.05. Results: The mean patient age was 34.6 ± 21.2 years, and male to female ratio was 3.2: 1. Incidental findings were noted in 503/591 (85.1 % of the scans. Intracranial calcification was the commonest finding occurring in 61.8% of patients. Over 90% of the findings were benign. Compared with older ones, patients under the age of 60 were less likely, (P < 0.001, to have incidental findings. Conclusion: Although the majority of incidental findings in this African cohort of head injury patients are benign some clinically significant lesions were detectable. It is therefore recommended that such findings be adequately described in the radiological reports for proper counseling and follow-up.

  20. Anaesthetic management of a case of schwannoma with intraoral extension

    Directory of Open Access Journals (Sweden)

    Mamta Bhardwaj

    2015-04-01

    Full Text Available Schwannoma is a benign nerve sheath tumour. This benign lesion frequently occurs in the soft tissues of head and neck region and has various complicated growth patterns. These patients can present a challenge to the anaesthesiologist due to intraoral extension, leading to difficult mask ventilation and intubation. We report a 16 year old male with mandibular nerve schwannoma with intraoral extension. Intraoral examination revealed a diffuse swelling in the left side of soft palate with deviation of uvula to right side. He was advised gargles with 4 ml of 2% xylocaine viscous and 2–3 puffs of 10% xylocaine spray done in oral cavity and oropharynx. Check laryngoscopy revealed Cormack and Lehane grade 1 view. Patient was intubated using standard induction technique and successfully managed

  1. Acute Respiratory Distress in Patient with Laryngeal Schwannoma

    Directory of Open Access Journals (Sweden)

    Laura Mannarini

    2012-01-01

    Full Text Available Schwannoma is a neurogenic benign tumour arising from the proliferation of Schwann cells present in the peripheral nerve sheath of myelinated nerves. This proliferation can hypothetically appear in every anatomic region of the human body, but the nerve sheath tumors rarely occur within the larynx. In this paper the authors discuss the case of a 74-year-old female who presented to Emergency Unit (EU for an important acute respiratory distress. Airway flexible endoscopy revealed a bulky mass of the aryepiglottic fold measuring 3.5 cm in diameter. The patient underwent tracheotomy and a single-step surgical excision treatment of the mass which was recognized as a schwannoma at pathological examination. Tracheotomy was closed 2 weeks postoperatively. After 18 months of followup, the patient is alive and free of disease and her voice had improved markedly.

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

    Directory of Open Access Journals (Sweden)

    Zhang Yang

    2012-10-01

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

  3. Gastric schwannoma as a rare differential diagnosis of pleural effusion.

    Science.gov (United States)

    Janowitz, P; Meier, F; Reisig, J

    2002-11-01

    We report a case of solitary gastric schwannoma that initially manifested with recurrent left pleural effusion caused by an inflammatory reaction. A 75-year-old female was primarily admitted with progressive dyspnoea and left sided effusion. History as well as clinical examination, gastroscopy, computed tomography (CT) and transabdominal ultrasound of the abdomen suggested the diagnosis of a benign tumour of the stomach. The tumour was resected and a fundectomy with a security distance of 3-5 cm performed. Histological assessment revealed a large intramural schwannoma of the gastric wall, arising from the submucosal layer. There was no evidence of malignancy. During a three year follow-up the patient has not shown any evidence of relapse or pleural effusion. This is a very rare manifestation of this benign tumour, representing a rare differential diagnosis in a case of left sided pleural effusion.

  4. Non-Syndromic Spinal Schwannomas: A Novel Classification

    Directory of Open Access Journals (Sweden)

    Ibrahim Sun

    2017-07-01

    Full Text Available Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3–0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of non-syndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients’ tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C for tumor volume and four types (I, II, III, and IV for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches.

  5. 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.

  6. Leptomeningeal Carcinomatosis of Gastric Cancer Misdiagnosed as Vestibular Schwannoma

    OpenAIRE

    Kim, Shin-Jae; Kwon, Jeong-Taik; Mun, Seog-Kyun; Hong, Young-Ho

    2014-01-01

    Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when ...

  7. Gastric schwannoma presenting as a casual ultrasonographic findings.

    Science.gov (United States)

    Álvarez Higueras, Francisco Javier; Pereñíguez López, Ana; Estrella Díez, Esther; Muñoz Tornero, María; Egea Valenzuela, Juan; Bas Bernal, Águeda; Garre Sánchez, Carmen; Vargas Acosta, Ángel; Sánchez Velasco, Eduardo; Carballo Álvarez, Luis Fernando

    2016-12-01

    We present the case of a patient under study due to ascites in which a mass located on the gastric wall was observed during ultrasonography. Further studies (upper endoscopy and computed tomography) confirmed this finding. After an ultrasound-guided percutaneous biopsy, diagnosis of gastric schwannoma was made as intense S-100 expression was found. Surgery was rejected due to the bad clinical situation of the patient and because the mass was an asymptomatic benign tumor.

  8. Leptomeningeal carcinomatosis of gastric cancer misdiagnosed as vestibular schwannoma.

    Science.gov (United States)

    Kim, Shin-Jae; Kwon, Jeong-Taik; Mun, Seog-Kyun; Hong, Young-Ho

    2014-07-01

    Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when treating patients with gastric cancer.

  9. 99m-Technetium Sestamibi Uptake in a Gastric Schwannoma.

    Science.gov (United States)

    Shawgi, Mohamed; Ali, Tamir; Scott, Matthew; Petrides, George

    2018-01-01

    We report the case of a 74-year-old woman with primary hyperparathyroidism who underwent 99m-technetium-sestamibi single photon emission computed tomography-computed tomography for preoperative localization of parathyroid adenoma. Unexpected focal sestamibi uptake was observed at a 5 cm submucosal tumor arising from the greater curve of the stomach. The patient underwent partial gastrectomy and the histological and immunohistochemical findings were consistent with the diagnosis of gastric schwannoma.

  10. 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.

  11. Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens

    2010-01-01

    AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine, not previou......AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine......, not previously known or suspected at the time of referral, and not related to inflammatory bowel disease. Through a systematic review of medical charts we analyzed the clinical impact of incidental findings, and compared the MRI findings with subsequent diagnostic procedures. RESULTS: A total of 283 patients...... were included in the analysis, and MRI detected active CD in 31%, fistula in 1.4% and abscess in 0.7%. Extra-intestinal findings not related to CD were recorded in 72 patients (25%), of which 58 patients (20%) had 74 previously unknown lesions. Important or incompletely characterized findings were...

  12. Schwannoma of the Lower Eyelid Resembling a Recurrent Chalazion : A Case Report

    OpenAIRE

    Fukuyama, Junichiro; Hayasaka, Seiji; Setogawa, Tomoichi

    1990-01-01

    A 55-year-old man complained of foreign body sensation and a solid mass in the lower eyelid of the right eye. Clinically, the lesion resembled a chalazion, and it was excised. Histopathologic examination of the excised specimen revealed a schwannoma (neurilemmoma). We believe that this is a rare case of a schwannoma of the lower eyelid simulating a chalazion.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  14. Gastric Schwannoma: Case report from Tanzania and brief review of literature

    OpenAIRE

    Manji, Mohamed; Ismail, Ame; Komba, Ewaldo

    2015-01-01

    Key Clinical Message Upper gastrointestinal bleeding causes significant morbidity and mortality worldwide. We report a rare case of hematemesis secondary to a gastric schwannoma in a Tanzanian female. Gastric schwannomas should be considered in the differential diagnosis of gastric masses and distinguished from other etiologies, given their excellent postresection prognosis.

  15. Gastric Schwannoma: Case report from Tanzania and brief review of literature.

    Science.gov (United States)

    Manji, Mohamed; Ismail, Ame; Komba, Ewaldo

    2015-07-01

    Upper gastrointestinal bleeding causes significant morbidity and mortality worldwide. We report a rare case of hematemesis secondary to a gastric schwannoma in a Tanzanian female. Gastric schwannomas should be considered in the differential diagnosis of gastric masses and distinguished from other etiologies, given their excellent postresection prognosis.

  16. Gastric GIST or gastric schwannoma-A diagnostic dilemma in a young female.

    Science.gov (United States)

    Mohanty, Sudhir Kumar; Jena, Kumarmani; Mahapatra, Tanmaya; Dash, Jyoti Ranjan; Meher, Dibyasingh; John, Ajax; Nayak, Manjushree; Bano, Shafqat

    2016-01-01

    Gastrointestinal stromal tumor (GIST) is the commonest mesenchymal tumor of GI tract and 60-70% of it seen in the stomach, whereas Gastric schwannoma is a benign, slow growing and one of the rare neoplasms of stomach. Age distribution, clinical, radiological features and gross appearance of both tumors are similar. We report a rare case of gastric schwannoma in a 20-year-old girl, who underwent subtotal gastrectomy with the suspicion of a GIST preoperatively but later confirmed to be gastric schwannoma postoperatively after immunohistochemical study. Accordingly, the differential diagnosis for gastric submucosal mass should be gastric schwannoma. Furthermore, Gastric schwannoma is a benign neoplasm with excellent prognosis after surgical resection, whereas 10-30% of GIST has malignant behavior. Therefore, it is important to distinguish between gastric schwannoma and GIST so as to make an accurate diagnosis for optimally guide treatment options. Due to the paucity of gastric schwannoma, the index of suspicion for this diagnosis is low. So it is important to include gastric schwannoma in the differential diagnosis when preoperative imaging studies reveal submucosal exophytic gastric mass and after resection of the tumor with a negative margin, it should be sent for immunohistochemical study for confirmation of diagnosis. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. An evidence-based case of acoustic/vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Girish Gupta

    2015-01-01

    Full Text Available A vestibular schwannoma, often called an acoustic neuroma/schwannoma, is a benign primary intracranial tumor of the myelin-forming cells of the vestibulo-cochlear nerve (8 th cranial nerve. This tumor arises from the Schwann cells responsible for the myelin sheath that helps keep peripheral nerves insulated. [1] Approximately, 3000 cases are diagnosed each year in the United States with a prevalence of about 1 in 100,000 worldwide. It comprises 5-10% of all intracranial neoplasms in adults. Incidence peaks in the fifth and sixth decades and both sexes are affected equally. Studies in Denmark published in 2004 show the incidence of 17.4/million. Most acoustic neuromas are diagnosed in patients between the ages of 30 and 60, and men and women appear to be affected equally. [2] The case illustrated here is a rare one of acoustic/vestibular schwannoma a surgical conditions, treated with Lycopodium, which produced improvement on both subjective and objective parameters.

  18. Castleman’s disease in the retroperitoneal space mimicking a paraspinal schwannoma: a case report

    Science.gov (United States)

    2013-01-01

    -negative and CD79a-positive. Conclusions Although a dumbbell-shaped mass in a paraspinal region is indicative of a schwannoma for orthopedic surgeons, the possibility of Castleman’s disease should be considered if a central low-signal area in fissured and a radial pattern is detected on computed tomography or magnetic resonance imaging. Appropriate preparation for massive bleeding during the treatment of Castleman’s disease, including angiography and embolization, would be helpful for performing surgical procedures safely. PMID:23702327

  19. Castleman's disease in the retroperitoneal space mimicking a paraspinal schwannoma: a case report.

    Science.gov (United States)

    Nagano, Satoshi; Yokouchi, Masahiro; Yamamoto, Takuya; Kaieda, Hideyasu; Setoguchi, Takao; Hiraki, Tsubasa; Tashiro, Yukie; Yonezawa, Suguru; Komiya, Setsuro

    2013-05-23

    -positive. Although a dumbbell-shaped mass in a paraspinal region is indicative of a schwannoma for orthopedic surgeons, the possibility of Castleman's disease should be considered if a central low-signal area in fissured and a radial pattern is detected on computed tomography or magnetic resonance imaging. Appropriate preparation for massive bleeding during the treatment of Castleman's disease, including angiography and embolization, would be helpful for performing surgical procedures safely.

  20. 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.

  1. 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.

  2. Gastric Schwannoma Mimicking Malignant Gastrointestinal Stromal Tumor Exhibiting Increased Fluorodeoxyglucose Uptake.

    Science.gov (United States)

    Oh, Sung Jin; Suh, Byoung Jo; Park, Jong Kwon

    2016-01-01

    A schwannoma is a kind of neurogenic tumor that rarely occurs in the gastrointestinal tract. Gastric schwannomas make up 0.2% of all gastric neoplasms. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors and up to 60-70% of GIST occur in the stomach. Schwannoma and GIST are similar in clinical features, so they are difficult to differentiate preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST and the relatively benign course of gastric schwannomas. We report a 49-year-old woman who was diagnosed after operation with a gastric schwannoma, which was suspected a malignant GIST by fluorine-18-fluorodeoxyglucose positron emission computed tomography imaging.

  3. Gastric Schwannoma Mimicking Malignant Gastrointestinal Stromal Tumor Exhibiting Increased Fluorodeoxyglucose Uptake

    Directory of Open Access Journals (Sweden)

    Sung Jin Oh

    2016-04-01

    Full Text Available A schwannoma is a kind of neurogenic tumor that rarely occurs in the gastrointestinal tract. Gastric schwannomas make up 0.2% of all gastric neoplasms. Gastrointestinal stromal tumors (GIST are the most common mesenchymal tumors and up to 60-70% of GIST occur in the stomach. Schwannoma and GIST are similar in clinical features, so they are difficult to differentiate preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST and the relatively benign course of gastric schwannomas. We report a 49-year-old woman who was diagnosed after operation with a gastric schwannoma, which was suspected a malignant GIST by fluorine-18-fluorodeoxyglucose positron emission computed tomography imaging.

  4. Gastric schwannoma with adjacent external progression harbored aberrant NF2 gene.

    Science.gov (United States)

    Ogasawara, Naotaka; Sasaki, Makoto; Ishiguro, Hideyuki; Itoh, Yukimi; Nojiri, Syunsuke; Kubota, Eiji; Wada, Tsuneya; Kataoka, Hiromi; Kuwabara, Yoshiyuki; Joh, Takashi

    2009-07-01

    Gastric schwannomas are rare benign mesenchymal tumors. We describe a schwannoma of gastric origin with adjacent external progression. Sections showed a spindle cell tumor arranged in interlaced bundles and fascicles that was S-100 and CD34 positive but c-KIT protein negative. Histology and immunohistochemistry revealed the typical appearance of a gastric schwannoma. Genetic evaluation revealed that the tumor harbored a point mutation in exon 6 of the tumor suppressor neurofibromatosis 2 (NF2) gene, which resulted in an amino acid substitution of NF2 protein, and no mutation in exon 4b of the NF1 gene. In conclusion, we identified a rare mutation of the NF2 gene in gastric schwannoma. A diagnosis can only be definitive when based on histological and immunohistochemical findings. Digestive tract schwannomas are rare mesenchymal tumors that are differentiated from gastrointestinal stromal tumors by the absence of KIT protein. Follow up suggested that complete resection is an effective long-term treatment strategy.

  5. Fetal MRI: incidental findings in the mother

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Selwan B. [University of Maryland Medical Center, Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); University of Minnesota, Medical School, Minneapolis, MN (United States); Dietz, Kelly R.; Holm, Tara L. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States)

    2016-11-15

    Fetal magnetic resonance imaging (MRI) is a routinely used tool in prenatal diagnosis; however, there is a lack of studies evaluating incidental findings observed in the mother. This study describes and quantifies incidental findings observed in the mother during fetal MRI. We reviewed all fetal MRI studies at the University of Minnesota Medical Center from February 2008 to September 2014. Two pediatric radiologists retrospectively conducted a consensus evaluation. The maternal findings were categorized into neurologic, gynecologic, urinary, gastrointestinal and musculoskeletal. Hydronephrosis consistent with the stage of pregnancy was recorded but was not included as an abnormal finding. Abnormal findings were classified into three groups, depending on their clinical significance: level I (low), level II (medium) and level III (high). We evaluated 332 pregnant patients with a mean age of 29.3 years and a mean gestational age of 29 weeks. Of these, 55.4% had at least 1 incidental finding, for a total of 262 incidental maternal findings. Of the 262 abnormalities, 113 (43.1%) were neurologic, 69 were gynecologic (26.3%), 36 (13.7%) urinary, 24 (9.2%) gastrointestinal and 20 (7.6%) musculoskeletal. Of the 262 incidental findings, 237 (90.5%) were level I, 24 (9.2%) were level II and 1 (0.4%) was level III. Our results suggest that although the vast majority of incidental maternal findings are benign, more significant findings are still encountered and should be expected. (orig.)

  6. Acoustic schwannoma with intracochlear extension and primary intracochlear schwannoma: removal through translabyrinthine approach with facial bridge cochleostomy and transcanal approach.

    Science.gov (United States)

    Mazzoni, A; Zanoletti, E; Faccioli, C; Martini, A

    2017-05-01

    Intracochlear schwannomas can occur either as an extension of a larger tumor from the internal auditory canal, or as a solitary labyrinthine tumor. They are currently removed via a translabyrinthine approach extended to the basal turn, adding a transotic approach for tumors lying beyond the basal turn. Facial bridge cochleostomy may be associated with the translabyrinthine approach to enable the whole cochlea to be approached without sacrificing the external auditory canal and tympanum. We describe seven cases, five of which underwent cochlear schwannoma resection with facial bridge cochleostomy, one case with the same procedure for a suspect tumor and one, previously subjected to radical tympanomastoidectomy, who underwent schwannoma resection via a transotic approach. Facial bridge cochleostomy involved removing the bone between the labyrinthine and tympanic portions of the fallopian canal, and exposing the cochlea from the basal to the apical turn. Patients' recovery was uneventful, and long-term magnetic resonance imaging showed no residual tumor. Facial bridge cochleostomy can be a flexible extension of the translabyrinthine approach for tumors extending from the internal auditory canal to the cochlea. The transcanal approach is suitable for the primary exclusive intralabyrinthine tumor. The indications for the different approaches are discussed.

  7. Incidental gallbladder cancer: what management?

    Directory of Open Access Journals (Sweden)

    Sidi Mohammed Bouchentouf

    2011-11-01

    Full Text Available Gallbladder cancer (GBC represents 3.8% of all gastrointestinal cancers and usually known to be of a poor prognosis. In 0.2–2.9% of cases, this cancer is found in cholecystectomy specimens. A better understanding of spread mode of this tumor helps a better surgical management. The aim of the present review is to underline the management of GBC based on the comprehension of risk factors and anatomic features. A Medline, PubMed database search was performed to identify articles published from 2000 to 2011 using the keywords ‘carcinoma of gallbladder’, ‘incidental gallbladder cancer’, ‘gallbladder neoplasm’ and ‘cholecystectomy’. Some pathological situations such as chronic lithiasis and biliopancreatic junction abnormalities have been clearly identified as predisposing to GBC. Laparoscopy increases peritoneal and parietal tumor dissemination, thus, it should not be performed when GBC is suspected. Most determinant prognostic factors are nodal, perineural and venous involvement, invasion of the cystic duct and the tumor differentiation. The simple cholecystectomy is sufficient for tumors classified as T1a; for other cancers exceeding the muscularis, radical re-resection is required due to the high risk of recurrence. This aggressive surgery improved the overall survival of patients. There is still no standard adjuvant treatment; patients should be included in prospective trials.

  8. 78 FR 37209 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-06-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC564 Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic Survey in the Beaufort Sea, Alaska...

  9. 78 FR 18965 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-03-28

    ... National Oceanic and Atmospheric Administration RIN 0648-XC494 Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to an Exploration Drilling Program in the Chukchi Sea... Harassment Authorization (IHA) to ConocoPhillips Company (COP) to take small numbers of marine mammals, by...

  10. 78 FR 28411 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-05-14

    ... Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic... Marine Seismic Survey in the Chukchi Sea, Alaska AGENCY: National Marine Fisheries Service (NMFS... can be estimated. The resulting ice gouge information would assist Shell in predicting the probability...

  11. 77 FR 40007 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2012-07-06

    ...'s propellers (or screws) are engaged. To minimize collision risk with marine mammals, vessels shall... National Oceanic and Atmospheric Administration RIN 0648-XY11 Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic Survey in the Beaufort Sea, Alaska...

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

    Directory of Open Access Journals (Sweden)

    Yang Isaac

    2009-10-01

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

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

    Science.gov (United States)

    2009-01-01

    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. PMID:19946504

  14. Endoscopic ultrasound features of gastric schwannomas with radiological correlation: a case series report.

    Science.gov (United States)

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

    2012-12-28

    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.

  15. Experience with Novalis stereotactic radiosurgery for vestibular schwannomas.

    Science.gov (United States)

    Lo, Wei-Lun; Yang, Ka-Yen; Huang, Yu-Jie; Chen, Wu-Fu; Liao, Chen-Chieh; Huang, Yu-Hua

    2014-06-01

    The Novalis linear accelerator system, a well developed modality, can be used for stereotactic radiosurgery (SRS). The aim of this study was to clarify the efficiency and safety of Novalis SRS in treating vestibular schwannomas. This 4-year retrospective study enrolled 23 patients with 26 vestibular schwannomas (3 patients suffered from neurofibromatosis Type II). Five patients had undergone tumor resection. All 26 tumors were treated using Novalis SRS, with a prescription dose that varied between 10 and 16Gy (mean, 11.8±1.7Gy). The average follow-up period was 56.5±22.1 months (range, 17-87 months). There were 9 men and 14 women. Their mean age at the time of treatment was 54.0±14.6 years (range, 27-84 years). On average, the original size of the tumor was 19.0±7.2mm in maximal diameter (range, 4.6-39.9mm). At the last follow-up, 20 tumors had regressed (76.9%), and there was no observed change in the size of 3 tumors (11.5%). Three of 26 tumors (11.5%) enlarged more than 2mm in one direction. Thus the ultimate radiological tumor control rate was 88.5% (23/26). In addition, 20 (87.0%) patients retained their pre-irradiation hearing function. Facial and trigeminal nerve function were both preserved in all patients. No death occurred during the follow-up, and no patient was treated with a second SRS or converted to tumor resection. Novalis SRS is a reliable treatment option for vestibular schwannomas. With an optimal radiation dose, satisfactory tumor control can be achieved while preserving cranial nerve function. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. An Incidental Renal Oncocytoma: 18F-Choline PET/MRI

    Directory of Open Access Journals (Sweden)

    Andrew Mallia

    2016-04-01

    Full Text Available PET/MRI is a new hybrid imaging modality and has the potential to become a powerful imaging tool. It is currently one of the most active areas of research in diagnostic imaging. The characterisation of an incidental renal lesion can be difficult. In particular, the differentiation of an oncocytoma from other solid renal lesions such as renal cell carcinoma (RCC represents a diagnostic challenge. We describe the detection of an incidental renal oncocytoma in a 79-year gentleman who underwent a re-staging 18F-Choline PET/MRI following a rise in PSA values (4.07, nadir 1.3.

  17. Private Arbitration of Incidental Public Law Issues

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2009-01-01

     The article discusses the incidental public law issues which can arise in an arbitration case, e.g. concerning power, heating, natural gas and other public facility legislation, national or Community legal restrictive trade practices law, and rules on state administration approval of the terms...... for withdrawing from joint municipal companies etc. The article makes a distinction between non-arbitrable incidental issues which cannot be decided by an arbitration court, and where any arbitral award which does so is nullifiable for this reason alone, and arbitrable incidental issues which can be decided...... by arbitration, and where the award is nullifiable only if its findings are in violation of public policy, the ordre public. The article relies on UNCITRAL's Model Arbitration Law, the new Danish arbitration act (DAA), national European case law, and literature and case law of the European Court....

  18. 75 FR 32497 - Marine Mammals; Incidental Take During Specified Activities

    Science.gov (United States)

    2010-06-08

    ... process. This authorization establishes monitoring and reporting requirements to evaluate the potential... Wildlife Service, Interior. ACTION: Notice of receipt of application and proposed incidental harassment... for authorization to take small numbers of marine mammals by harassment incidental to the Akutan...

  19. Solitary Schwannoma of the Cecum: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    JoséWilson Benevides de Mesquita Neto

    2013-01-01

    Full Text Available A 78-year-old woman presented with an abdominal mass diagnosed by ultrasound and computed tomography. The patient underwent a laparotomy, during which a retroperitoneal tumor adherent to the cecum wall was identified. Microscopically, it showed spindle-cell proliferation in whorls, with low mitotic count (2 per 50 high-power fields and was strongly positive for S-100 protein and vimentin. The final diagnosis was benign schwannoma of the cecum and no further treatment was required. Large intestine schwannomas are extremely rare tumors and only a few cases of schwannoma of the cecum have been reported to date.

  20. A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient.

    Science.gov (United States)

    Kikuchi, Satoru; Nishizaki, Masahiko; Kuroda, Shinji; Kagawa, Shunsuke; Fujiwara, Toshiyoshi

    2016-06-01

    Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but necessarily...

  5. Sources Of Incidental Events In Collective Water Supply System

    Directory of Open Access Journals (Sweden)

    Szpak Dawid

    2015-11-01

    Full Text Available The publication presents the main types of incidental events in collective water supply system. The special attention was addressed to the incidental events associated with a decrease in water quality, posing a threat to the health and life of inhabitants. The security method against incidental contamination in the water source was described.

  6. 76 FR 69758 - Draft Environmental Assessment, Incidental Take Plan, and Application for an Incidental Take...

    Science.gov (United States)

    2011-11-09

    ... management requirements would be over the life of the incidental take permit. The Service seeks comments on..., Presque Isle, 04769 (Grand Ballroom-Allagash and Aroostook rooms) (207) 768-9502; December 14 at Black...

  7. 76 FR 30110 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2011-05-24

    ... received an application from Statoil USA E&P Inc. (Statoil) for an Incidental Harassment Authorization (IHA... contributed by the operating soil investigation equipment, an inflation factor of 1.5 was applied to arrive at...

  8. Obturator Nerve Schwannoma as a Mimic of Ovarian Malignancy

    Directory of Open Access Journals (Sweden)

    Tyler Gleason

    2017-01-01

    Full Text Available The obturator nerve is an extremely rare location for schwannomas to originate, and such diagnosis is typically not considered among the imaging diagnostic possibilities for a cystic-solid pelvic mass. A 63-year-old female with a known pelvic mass presented with increasing pelvic pain. The mass, which had been followed by serial imaging over five years, was described showing mixed solid and cystic components, likely arising from the left ovary. Although the key diagnosis to be excluded was a primary ovarian malignancy, the patient chose to pursue active surveillance. Over the five years of close observation, the lesion increased slowly, while her CA-125 level showed no significant elevation. Increase in size of the mass and worsening pain and concern for a gynecologic malignancy on MRI led her to ultimately consent to a hysterectomy with bilateral salpingooophorectomy. During the surgery, the mass was noted to be contiguous with the left obturator nerve. Pathologic evaluation revealed a schwannoma (WHO grade I. The patient’s postsurgical course was uneventful, without residual weakness in the left adductor muscles.

  9. ROBOTIC SURGERY FOR GIANT PRESACRAL DUMBBELL-SHAPE SCHWANNOMA

    Directory of Open Access Journals (Sweden)

    Farid Yudoyono

    2015-03-01

    Full Text Available Objective: To demonstrate the feasibility of using da Vinci robotic surgical system to perform spinal surgery. Methods: Magnetic resonance imaging (MRI of a 29-year-old female patient complaining right pelvic pain for 1 month revealed a 17x8x10 cm non-homogeneous dumbbell shape encapsulated mass with cystic change located in the pelvic cavity and caused an anterior displacement of urinary bladder and colon. Results: There was no systemic complication and pain decrease 24 hours after surgery and during 2 years of follow up. The patient started a diet 6 hours after the surgery and was discharged 72 hours after the surgery. The pathological diagnosis of the tumor was schwannoma. Conclusions: Giant dumbbell shape presacral schwannomas are rare tumours and their surgical treatment is challenging because of the complex anatomy of the presacral. Clinical application of da Vinci robotic surgical system in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures. However, robotic surgery is expected to play a practical future role as it is minimally invasive. The advent of robotic technology will prove to be a boon to the neurosurgeon.

  10. Pathogenesis of vestibular schwannoma in ring chromosome 22

    Directory of Open Access Journals (Sweden)

    Debiec-Rychter Maria

    2009-09-01

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

  11. Hyperventilation-induced nystagmus in patients with vestibular schwannoma.

    Science.gov (United States)

    Califano, Luigi; Iorio, Giuseppina; Salafia, Francesca; Mazzone, Salvatore; Califano, Maria

    2015-02-01

    To determine the utility of the hyperventilation test (HVT) in the diagnosis of vestibular schwannoma (VS). A retrospective analysis of hyperventilation-induced nystagmus (HVIN) in 45 patients with unilateral VS. A tertiary referral center. Forty-five patients with VS; 30 patients with chronic vestibular neuritis; 20 healthy subjects with normal hearing and without symptoms or a history of vertigo, migraine, or neurological diseases (control group). Audiological and vestibular examination; "side-stream" measurement of end-tidal CO2 pressure (P(EtCO2)) to standardize the procedure; magnetic resonance imaging (MRI) centered on the cerebellopontine angle. An analysis of HVIN, its patterns, and its appearance threshold via the measurement of P(EtCO2) correlations with the tumor size. HVIN was observed in 40 of 45 cases (88.9%) in the schwannoma group and in 12 of 30 cases (40%) in the chronic vestibular neuritis group; HVIN was not observed in the control group (0/20 cases) (p hyperventilation event causes metabolic changes in the vestibular system and reveals a latent vestibular asymmetry. The presence of an excitatory pattern is the major criterion that suggests VS in patients with signs of unilateral vestibular deficit.

  12. The jugular foramen schwannomas: review of the large surgical series.

    Science.gov (United States)

    Bakar, Bulent

    2008-11-01

    Jugular foramen schwannomas are uncommon pathological conditions. This article is constituted for screening these tumors in a wide perspective. One-hundred-and-ninty-nine patients published in 19 articles between 1984 to 2007 years was collected from Medline/Index Medicus. The series consist of 83 male and 98 female. The mean age of 199 operated patients was 40.4 years. The lesion located on the right side in 32 patients and on the left side in 60 patients. The most common presenting clinical symptoms were hearing loss, tinnitus, disphagia, ataxia, and hoarseness. Complete tumor removal was achieved in 159 patients. In fourteen patients tumor reappeared unexpectedly. The tumor was thought to originate from the glossopharyngeal nerve in forty seven cases; vagal nerve in twenty six cases; and cranial accessory nerve in eleven cases. The most common postoperative complications were lower cranial nerve palsy and facial nerve palsy. Cerebrospinal fluid leakage, meningitis, aspiration pneumonia and mastoiditis were seen as other complications. This review shows that jugular foramen schwannomas still have prominently high morbidity and those complications caused by postoperative lower cranial nerve injury are life threat.

  13. Molecular and immunohistochemical distinction of equine sarcoid from schwannoma.

    Science.gov (United States)

    Bogaert, L; Heerden, M Van; Cock, H E V De; Martens, A; Chiers, K

    2011-05-01

    Ten equine skin tumors that had been classified as schwannomas on routine histological examination were analyzed by polymerase chain reaction for bovine papillomavirus DNA. All 10 were positive for bovine papillomavirus 1 or 2, and all 10 were immunohistochemically negative for S-100 protein and strongly positive for vimentin. Nine tumors were moderately positive for laminin and 8, for smooth muscle actin. Five tumors were variably and weakly positive for type IV collagen. The lack of S-100 protein expression made Schwann cells an unlikely cell of origin, as opposed to peripheral nerve sheath tumors, which typically express S-100 protein, at least in some neoplastic cells. The immunohistochemical reactivity is consistent with myofibroblastic origin of the neoplastic cells, although smooth muscle cell or pericyte origin cannot be ruled out. These tumors represent an atypical form of equine sarcoid. Polymerase chain reaction for bovine papillomavirus and S-100 immunohistochemistry are strongly recommended for all equine skin tumors with histological characteristics typical of schwannoma or peripheral nerve sheath tumor.

  14. 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.

  15. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Directory of Open Access Journals (Sweden)

    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.

  16. Linear accelerator-based stereotactic radiosurgery for bilateral vestibular schwannomas in patients with neurofibromatosis type 2

    NARCIS (Netherlands)

    Meijer, Otto W. M.; Vandertop, W. Peter; Lagerwaard, Frank J.; Slotman, Ben J.

    2008-01-01

    OBJECTIVE: Patients with neurofibromatosis Type 2 (NF2) patients typically have bilateral vestibular schwannomas (VS) and are at risk for developing bilateral deafness, bilateral trigeminal, and bilateral facial nerve function loss. Previous reports suggested that treatment outcomes in these

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Primary schwannoma of the thyroid gland presenting as an asymptomatic cold nodule.

    Science.gov (United States)

    Uri, Ofir; Baron, Elzbieta; Lefel, Oleg; Bitterman, Arie

    2009-01-01

    Schwannomas are benign neoplasms that may arise from Schwann cells of the nerve sheath all over the body. Although schwannomas of the head and neck region are common, the thyroid gland is a rare site for schwannomas, with little documentation in the literature. Presented is a case of a 57-year-old woman who was evaluated in our outpatient clinic for hypothyroidism because of Hashimoto thyroiditis. Thyroid ultrasound revealed a single prominent nodule, which was cold on technetium Tc 99m thyroid scan. Fine needle aspiration of the nodule had aroused suspicion for malignant thyroid neoplasm. Complete thyroidectomy was undertaken without complications. Microscopic examination and immunohistochemical stains supported the diagnosis of a primary thyroid schwannoma.

  19. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Incidental Sequence Learning across the Lifespan

    Science.gov (United States)

    Weiermann, Brigitte; Meier, Beat

    2012-01-01

    The purpose of the present study was to investigate incidental sequence learning across the lifespan. We tested 50 children (aged 7-16), 50 young adults (aged 20-30), and 50 older adults (aged >65) with a sequence learning paradigm that involved both a task and a response sequence. After several blocks of practice, all age groups slowed down…

  2. Incidental Foreign Language Acquisition from Media Exposure

    Science.gov (United States)

    Kuppens, An H.

    2010-01-01

    A number of experimental studies have demonstrated the incidental acquisition of a foreign language by children and adolescents when watching foreign language television. While such experiments can only establish short-term effects, this article investigates the extent to which children's foreign language skills benefit from their long-term…

  3. 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...... on and observed for vestibular schwannoma. However, the negative changes were more frequent among the operated patients, although the differences were surprisingly modest, especially when comparing observed patients with patients operated on for a small tumour....

  4. Case Report: Sciatic nerve schwannoma - a rare cause of sciatica [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2017-03-01

    Full Text Available Herein we report a rare case of a sciatic nerve schwannoma causing sciatica in a 69-year-old female. Sciatic nerve schwannoma is a rare entity. It should always be considered as a possible cause of sciatica in patients that present with symptoms of sciatica with no prolapsed disc in the lumbar spine and a negative crossed straight leg raise test. Timely diagnosis and complete excision of the lesion leads to complete resolution of the symptoms of such patients.

  5. Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.

    2008-01-01

    Aim: To evaluate hearing changes during 'wait and scan' management of patients with vestibular schwannoma. Subjects: Over a 10-year period, 636 patients have prospectively been allocated to 'wait and scan' management, with annual magnetic resonance scanning and audiological examination. Results...... surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7...

  6. Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

    OpenAIRE

    Yoon, William; Paulson, Kari; Mazzara, Paul; Nagori, Sweety; Barawi, Mohammed; Berri, Richard

    2012-01-01

    Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should i...

  7. Gastric GIST or gastric schwannoma?A diagnostic dilemma in a young female

    OpenAIRE

    Mohanty, Sudhir Kumar; Jena, Kumarmani; Mahapatra, Tanmaya; Dash, Jyoti Ranjan; Meher, Dibyasingh; John, Ajax; Nayak, Manjushree; Bano, Shafqat

    2016-01-01

    Introduction: Gastrointestinal stromal tumor (GIST) is the commonest mesenchymal tumor of GI tract and 60–70% of it seen in the stomach, whereas Gastric schwannoma is a benign, slow growing and one of the rare neoplasms of stomach. Age distribution, clinical, radiological features and gross appearance of both tumors are similar. Presentation of case: We report a rare case of gastric schwannoma in a 20-year-old girl, who underwent subtotal gastrectomy with the suspicion of a GIST preoperati...

  8. Intranodal Schwannoma Mimicking a Gastrointestinal Stromal Tumor of the Stomach: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Bum; Namkyoung, Sook; Kim, Heung Cheol [Dept. of Radiology, Chuncheon Scared Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of); Kim, Hae Sung; Ryu, Byoung Yoon [Dept. of General Surgery, Chuncheon Scared Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of); Cha, Young Hee [Dept. of Pathology, Chuncheon Scared Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2011-10-15

    A 66-year-old-woman is presented with intranodal schwannoma of the retroperitoneum. Ultrasonography (US) and computed tomography (CT) results demonstrated a large encapsulated mass with internal cystic or necrotic portions in the gastrosplenic space. The tumor abutted the greater curvature of the gastric body and slightly indented the proximal small bowel loops on a small bowel series. The observations suggested a gastrointestinal stromal tumor. The mass was surgically proven to be a retroperitoneal tumor and histopathologically intranodal ancient schwannoma.

  9. 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......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...

  10. Glucose transporter 3 and 1 may facilitate high uptake of 18F-FDG in gastric schwannoma.

    Science.gov (United States)

    Shimada, Yutaka; Sawada, Shigeaki; Hojo, Shozo; Okumura, Tomoyuki; Nagata, Takuya; Nomoto, Kazuhiro; Tsukada, Kazuhiro

    2013-11-01

    Recently, some gastric schwannomas have been reported to have high uptake of FDG. However, Glut-1 was reported to be negative in gastric schwannomas tested. A 64-year-old female patient received a laparoscopic partial gastrectomy for a FDG PET-positive submucosal tumor (SUVmax 6.61). The resected tumor was diagnosed as a benign gastric schwannoma. Glut family immunohistochemical examination revealed diffuse positive expression of Glut-3 and partial positive expression of Glut-1. On the other hand, Glut-2 and Glut-4 expression in the tumor were negative. This case suggested that Glut-3 and Glut-1 expression were facilitators of high FDG uptake in the benign gastric schwannoma.

  11. 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.

  12. Expression of c-Jun and Sox-2 in human schwannomas and traumatic neuromas.

    Science.gov (United States)

    Shivane, Aditya; Parkinson, David B; Ammoun, Sylwia; Hanemann, Clemens O

    2013-03-01

    Schwann cells myelinate axons of the peripheral nervous system. This process of myelination is regulated by various transcription factors. c-Jun and Sox-2 are negative regulators of myelination and control Schwann cell differentiation and plasticity. Schwannoma cells within tumours no longer express myelin markers, and show increased proliferation and decreased apoptosis. We have shown previously that several signalling pathways are activated in schwannoma cells in situ, in particular the c-Jun N-terminal kinase (JNK) pathway. Both in vitro and in vivo we have demonstrated that c-Jun and Sox-2 are co-regulated in Schwann cells and evidence shows that both these proteins regulate myelination negatively. In this study, we aimed to characterize the expression of c-Jun and Sox-2 in schwannoma and traumatic neuroma. Immunohistochemistry using antibodies to c-Jun and Sox-2 was applied to six schwannomas, and the results were compared with those seen in traumatic neuroma and normal nerve. Increased expression of c-Jun and Sox-2 was seen in schwannoma. We have demonstrated increased expression of c-Jun and Sox-2 in schwannoma compared to traumatic neuroma. There was no expression of c-Jun and Sox-2 in a histologically normal peripheral nerve. © 2012 Blackwell Publishing Ltd.

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

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

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

  14. Role of endoscopic ultrasound and endoscopic resection for the treatment of gastric schwannoma.

    Science.gov (United States)

    Hu, Jinlong; Liu, Xiang; Ge, Nan; Wang, Sheng; Guo, Jintao; Wang, Guoxin; Sun, Siyu

    2017-06-01

    Endoscopic ultrasound (EUS) and endoscopic resection play an important role in gastric submucosal tumor. However, there were few articles regarding EUS and endoscopic resection of gastric schwannomas. Our aim was to evaluate the role of EUS and endoscopic resection in treating gastric schwannomas.We retrospectively reviewed 14 patients between March 2012 and April 2016 with gastric schwannomas and who received EUS and endoscopic resection. EUS characteristics, endoscopic resection, tumor features, and follow-up were evaluated in all the patients.Fourteen patients were enrolled in the present study. The patients' ages ranged from 25 to 72 years (mean age, 52.6 years). On EUS, all tumors were originating from muscularis propria and hypoechoic. Ten tumors have the extraluminal growth patterns and 4 tumors have the intraluminal growth patterns. Marginal halos were observed in 7 lesions. No cystic change and calcification were found inside the lesions. Complete endoscopic resection was performed in all the patients with no complications occurring in any patients. No recurrence or metastases was found in all patients during the follow-up period.Gastric schwannoma has some characteristics on EUS, but it is difficult to differentiate gastric schwannoma from gastrointestinal stromal tumor. Endoscopic resection is an effective and safe treatment for gastric schwannoma with an excellent follow-up outcome.

  15. Imaging features and treatment of an intradural lumbar cystic schwannoma Achados imagenológicos e tratamento de um schwannoma cístico intradural lombar

    Directory of Open Access Journals (Sweden)

    Guilherme Borges

    2005-09-01

    Full Text Available Spinal schwannomas are frequently observed among patients treated in a reference neurosurgery center. Cystic spinal schwannomas, however, are very scantly found. Due to its indolent behavior and benign course, the diagnosis of schwannomas may pose a challenge to the care giver, and the imaging findings can be misleading. In this article, we illustrate an example of a pauci-symptomatic 55 year-old male patient whose complaint was solely a non specific lumbar pain. Investigation revealed a large cystic lesion comprising the lower lumbar intradural space. He was then treated with microneurosurgical technique involving complete removal of the tumor and reconstruction of the duramater. Histological and immunohystochemical diagnosis were consistent with cystic schwannoma. The patient presented with complete recovery of his symptom. In this article we aim to emphasize the clinical presentation and treatment of lumbar spine schwannomas, and to illustrate the imaging findings within this uncommon case.O schwannoma cístico intra-espinal é tumor muito raro e poucos casos estão descritos na literatura: são usualmente assintomáticos e somente diagnosticados quando atingem grande tamanho causando compressão radicular. Com o intuito de ilustrar as armadilhas existentes referentes ao diagnóstico e tratamento desse tipo de tumor, nós relatamos um caso raro, focando nos passos da investigação e terapêutica. É descrito o caso de um paciente de 55 anos que apresentava apenas queixas de dor lombar. A investigação revelou uma lesão cística extensa na região intradural lombar inferior. O tumor foi totalmente ressecado por técnica microneurocirúrgica, sendo a dura-máter reconstruída. O diagnóstico patológico e imuno-histoquímico evidenciou tratar-se de um schwannoma cístico. Neste artigo, nós procuramos enfatizar as características clínicas e tratamento de schwannomas lombares, ilustrando os achados imagenológicos desse caso incomum.

  16. Efficacy of endoscopic ultrasound-guided fine-needle aspiration for schwannoma: six cases of a retrospective study.

    Science.gov (United States)

    Takasumi, Mika; Hikichi, Takuto; Takagi, Tadayuki; Suzuki, Rei; Watanabe, Ko; Nakamura, Jun; Sugimoto, Mitsuru; Kikuchi, Hitomi; Konno, Naoki; Waragai, Yuichi; Asama, Hiroyuki; Obara, Katsutoshi; Ohira, Hiromasa

    2017-08-09

    Schwannomas are difficult to diagnose using imaging alone. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an effective and safe tissue sampling technique. Nevertheless, few reports have described EUS-FNA for schwannoma. This study evaluates the efficacy of EUS-FNA for diagnosing schwannoma. This retrospective study examined six consecutive schwannoma patients who were diagnosed as having schwannoma either from EUS-FNA results or from surgically resected specimens. The primary endpoint was diagnostic accuracy of EUS-FNA for schwannoma. The secondary endpoint was EUS-FNA safety. Based on cytomorphologic features and immunocytochemistry results after EUS-FNA, 4 out of 6 patients (66.7%) were diagnosed with schwannoma. The diagnoses before EUS-FNA were the following: 3 cases of gastric subepithelial lesion (SEL, suspicious for gastrointestinal stromal tumor), 1 case of intraperitoneal tumor, 1 case of retroperitoneal tumor, and 1 case of pancreatic tumor, with sizes of 15-44 mm (median 36 mm). No case was diagnosed as schwannoma solely based on image findings. Two cases of gastric SELs could not be diagnosed as schwannoma by EUS-FNA before surgery. Inadequate sampling and a lack of additional material for immunohistochemical studies could have engendered less-definite diagnoses in those cases. No procedural adverse events occurred. The diagnostic accuracy rate of EUS-FNA for schwannoma is somewhat low. However, tissue samples were obtained safely using this method. Moreover, it is an important procedure for diagnosing schwannoma, which cannot be diagnosed solely from image findings.

  17. VESTIBULAR SCHWANNOMA (ACOUSTIC NEUROMA) MIMICKING TEMPOROMANDIBULAR DISORDERS: A CASE REPORT

    Science.gov (United States)

    Bisi, Maurício A.; Selaimen, Caio M. P.; Chaves, Karen D.; Bisi, Melissa C.; Grossi, Márcio L.

    2006-01-01

    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. PMID:19089251

  18. Isolated cochlear neuritis from varicella reactivation mimicking a vestibular schwannoma

    Directory of Open Access Journals (Sweden)

    Adam D. Goodale

    2016-09-01

    Full Text Available We present a case of a patient with progressive unilateral sensorineural hearing loss and tinnitus with internal auditory canal enhancement on magnetic resonance imaging (MRI secondary to isolated cochlear neuritis from varicella reactivation. MRI following antiviral treatment showed resolution of enhancement. Varicella reactivation is commonly seen in the form of Ramsay Hunt syndrome, which is known to produce abnormal MRI enhancement from facial and vestibulocochlear neuritis; however, its characteristic clinical signs aid the diagnosis. This case is unique in that the only manifestation of varicella infection was unilateral hearing loss. This case outlines the importance of maintaining a broad differential diagnosis in the evaluation of unilateral hearing loss as well as recognizing the limited specificity of MRI. Keywords: Vestibular schwannoma, Acoustic neuroma, Vestibular neuritis, Ramsay Hunt syndrome, Varicella zoster virus

  19. Gastrik Schwannoma: Bilgisayarlı Tomografi Bulguları

    OpenAIRE

    Bulut, H.Taner; Ara, Cengiz; Yılmaz, Mehmet

    2015-01-01

    Schwannoma, gastrointestinal duvar nöral pleksusunun Schwann hücrelerinden kaynaklanan, sindirim sisteminin mezenkim kaynaklı, nadir tümörlerinden biridir. Üst gastrointestinal sistem endoskopisi ilk değerlendirme için önemli olmakla beraber ekzofitik uzanım gösteren subserozal lezyonlarda tanısal olmayabilir. Bu durumda; kesitsel görüntüleme yöntemleri tümörün karakterizasyonu ve komşu organlar ile olan ilişkisini göstermede faydalı olabilir. Biz 56 yaşındaki bir erkek hastad...

  20. Incidental Cardiac Findings on Thoracic Imaging.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan

    2013-02-07

    The cardiac structures are well seen on nongated thoracic computed tomography studies in the investigation and follow-up of cardiopulmonary disease. A wide variety of findings can be incidentally picked up on careful evaluation of the pericardium, cardiac chambers, valves, and great vessels. Some of these findings may represent benign variants, whereas others may have more profound clinical importance. Furthermore, the expansion of interventional and surgical practice has led to the development and placement of new cardiac stents, implantable pacemaker devices, and prosthetic valves with which the practicing radiologist should be familiar. We present a collection of common incidental cardiac findings that can be readily identified on thoracic computed tomography studies and briefly discuss their clinical relevance.

  1. Colon in the Chest: An Incidental Dextrocardia

    Science.gov (United States)

    Abd Elrazek, Abd Elrazek; Shehab, Abdullah; Elnour, Asim A.; Al Nuaimi, Saif K.; Baghdady, Shazly

    2015-01-01

    Abstract Diaphragmatic injury is an uncommon traumatic injury (Dextrocardia was an incidental finding, diagnosed by electrocardiography, chest radiograph, and CT chest. Parts of the colon, small intestine, and stomach were within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause. Acquired incidental dextrocardia was the main problem due to displacement of the heart to contralateral side by the GI (gastrointestinal) viscera (left diaphragmatic hernia). The patient was prepared for the laparoscopic surgical repair, using a polyethylene mesh 20 cm to close the defect, and the patient recovered with accepted general condition. However, 5 days postoperative, the patient passed away suddenly due to unexplained cardiac arrest. Intrathoracic herniation of abdominal viscera should be considered in patients presented with sudden chest pain concomitant with a history of increased intra-abdominal pressure. PMID:25674744

  2. Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma.

    Science.gov (United States)

    Zolal, Amir; Juratli, Tareq A; Podlesek, Dino; Rieger, Bernhard; Kitzler, Hagen H; Linn, Jennifer; Schackert, Gabriele; Sobottka, Stephan B

    2017-11-01

    Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size. Twenty-one patients with large vestibular schwannomas were recruited. The probabilistic tracking was run preoperatively and the position of the potential depictions of the facial and cochlear nerves was estimated postoperatively by 3 independent observers in a blinded fashion. The true position of the nerve was determined intraoperatively by the surgeon. Thereafter, the imaging-based estimated position was compared with the intraoperatively determined position. Tumor size, cystic appearance, and postoperative House-Brackmann score were analyzed with regard to the accuracy of the depiction of the nerves. The probabilistic tracking showed a connection that correlated to the position of the facial nerve in 81% of the cases and to the position of the cochlear nerve in 33% of the cases. Altogether, the resulting depiction did not correspond to the intraoperative position of any of the nerves in 3 cases. In a majority of cases, the position of the facial nerve, but not of the cochlear nerve, could be estimated by evaluation of the probabilistic tracking results. However, false depictions not corresponding to any nerve do occur and cannot be discerned as such from the image only. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Hypervascular Vestibular Schwannomas: Clinical Characteristics, Angiographical Classification, and Surgical Considerations.

    Science.gov (United States)

    Teranishi, Yu; Kohno, Michihiro; Sora, Shigeo; Sato, Hiroaki; Nagata, Osamu

    2017-12-07

    There is a rare type of vestibular schwannoma, scarcely discussed in the literature, known as a hypervascular vestibular schwannoma (HVS). To evaluate its biological characteristics, angiographical classification, surgical outcomes, and the significance for surgical consideration, using a large series of this clinical entity. The definition for HVS in this study was the tumor stain from the vertebrobasilar system (VBS) in angiography. The authors conducted a retrospective analysis of 36 patients who were angiographically diagnosed with HVS and underwent surgery between 2008 and 2015. Their biological findings and their surgical outcomes were compared with non-HVS subjects. With regard to the tumor feeders and AV shunt, we classified HVS into 5 types. HVS occurred more commonly in younger subjects (mean: 39.4 yr), as a larger solid tumor with multiple flow voids (mean: 34.1 mm), and involved higher levels of cerebrospinal fluid protein (mean: 202 mg/dl) and a higher MIB1-index (mean: 4.3%). The average resection rate for these 36 cases was 95.3%, and recurrence was seen in 6 cases (16.7%). Compared with non-HVS, the extent of tumor resection was significantly lower, and the recurrence rate was significantly higher. Especially in HVS type 2B (the tumor stain is fed by the VBS and the external carotid artery, with an arteriovenous shunt from the VBS), the recurrence-free survival duration was significantly shorter compared with other HVS types and non-HVS, and HVS type 2B exhibited an identifiable risk factor for recurrence. HVS have the distinct clinical characteristics compared with those of non-HVS subjects.

  4. Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-01

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

  5. Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma.

    Science.gov (United States)

    Coughlin, Adam R; Willman, Tyler J; Gubbels, Samuel P

    2018-01-16

    To determine the long-term hearing preservation rate for spontaneous vestibular schwannoma treated by primary radiotherapy. The MEDLINE/PubMed, Web of Science, Cochrane Reviews, and EMBASE databases were searched using a comprehensive Boolean keyword search developed in conjunction with a scientific librarian. English language papers published from 2000 to 2016 were evaluated. Inclusion criteria: full articles, pretreatment and posttreatment audiograms or audiogram based scoring system, vestibular schwannoma only tumor type, reported time to follow-up, published after 1999, use of either Gamma Knife or linear accelerator radiotherapy. case report or series with fewer than five cases, inadequate audiometric data, inadequate time to follow-up, neurofibromatosis type 2 exceeding 10% of study population, previous treatment exceeding 10% of study population, repeat datasets, use of proton beam therapy, and non-English language. Two reviewers independently analyzed papers for inclusion. Class A/B, 1/2 hearing was defined as either pure tone average less than or equal to 50 db with speech discrimination score more than or equal to 50%, American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) Hearing Class A or B, or Gardner-Robertson Grade I or II. Aggregate data were used when individual data were not specified. Means were compared with student t test. Forty seven articles containing a total of 2,195 patients with preserved Class A/B, 1/2 hearing were identified for analysis. The aggregate crude hearing preservation rate was 58% at an average reporting time of 46.6 months after radiotherapy treatment. Analysis of time-based reporting shows a clear trend of decreased hearing preservation extending to 10-year follow-up. This data encourages a future long-term controlled trial.

  6. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    Science.gov (United States)

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  7. [Gastric schwannoma: rare differenzial diagnosis of acute upper gastrointestinal (GI) bleeding].

    Science.gov (United States)

    Lyros, Orestis; Schickel, Stephan; Schierle, Katrin; Hoffmeister, Albrecht; Gockel, Ines

    2017-08-01

    Schwannomas are benign tumors derived from Schwann cells and their typical site of origin is the subcutaneous tissue of the extremities. Gastrointestinal localization of Schwannomas is extremely rare and the stomach is the prevalent site. Gastric schwannomas primarily occur in the gastric submucosa and are usually asymptomatic.We present a rare case of a solitary gastric schwannoma in a 51-year old male, which initially manifested with hematemesis by acute upper gastrointestinal (GI) bleeding. The upper GI-Endoscopy revealed a gastric submucosal tumor, 7 cm in size, located in the proximal corpus and fundus. In the endoscopical Ultrasound (EUS-Examination), the lesion appeared to arise from the fourth proper muscle layer (Muscularis propria). The fourth layer origin and the isoechogenicity, as compared to the normal muscle layer, are endoscopic ultrasonographic characteristics of gastric schwannomas and help in distinguishing them from gastrointestinal tumors (GIST). Because of the unclear histological identity, the patient underwent a "rendezvous" endoscopic-laparoscopic surgical resection of the tumor in toto. The histomorphological features of the lesion and the strong expression of S100 in combination with absence of DOG1 expression indicated the diagnosis of gastric schwannoma. There was no evidence of malignancy. The postoperative course was uncomplicated.This is a very rare manifestation of gastric schwannoma, representing a rare differenzial diagnosis in a case of acute upper GI-Bleeding. Only 14 % of gastric schwanommas are presented with gastrointestinal bleeding, including mainly melena rather than hematemesis. This case is considered to be worthy of presentation owing to the rare and unusual cause of upper GI bleeding implied in it. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Pathological Methods and Prognostic Factors in Vestibular Schwannomas.

    Science.gov (United States)

    Sughrue, Michael E; Fung, Kar-Ming; Van Gompel, Jamie J; Peterson, Jo Elle G; Olson, Jeffrey J

    2017-12-20

    Adults diagnosed with vestibular schwannomas. What is the prognostic significance of Antoni A vs B histologic patterns in vestibular schwannomas? No recommendations can be made due to a lack of adequate data. What is the prognostic significance of mitotic figures seen in vestibular schwannoma specimens? No recommendations can be made due to a lack of adequate data. Are there other light microscopic features that predict clinical behavior of vestibular schwannomas? No recommendations can be made due to a lack of adequate data. Does the KI-67 labeling index predict clinical behavior of vestibular schwannomas? No recommendations can be made due to a lack of adequate data. Does the proliferating cell nuclear antigen labeling index predict clinical behavior of vestibular schwannomas? No recommendations can be made due to a lack of adequate data. Does degree of vascular endothelial growth factor expression predict clinical behavior of vestibular schwannomas? No recommendations can be made due to a lack of adequate data.  The full guideline can be found at: https://www.cns.org/guidelines/guidelines-management-patients-vestibular-schwannoma/chapter_6.

  9. Gastric Schwannoma mimicking malignant gastrointestinal stromal tumor and misdiagnosed by (18)F-FDG PET/CT.

    Science.gov (United States)

    Zhang, Yiqiu; Li, Beilei; Cai, Liang; Hou, Xiaoguang; Shi, Hongcheng; Hou, Jun

    2015-01-01

    Gastric Schwannoma is a rare benign mesenchymal tumor that accounts for only 0.2% of all gastric tumors. The current study presents a case of gastric Schwannoma misdiagnosed as malignant gastrointestinal stromal tumor (GIST) by esophagogastroduodenoscopy, endoscopic ultrasonography, and contrast-enhanced or not enhanced and (18)F-FDG PET/CT imaging.

  10. 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.

  11. Positive Predictive Values in Diagnosis of Incidental Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Caner Ediz

    2016-03-01

    Full Text Available Objective: Although the incidence of incidental prostate cancer (IPCa decreases in recent years; for patients who performed by transurethral resection of the prostate (TURP due to bladder outlet obstruction with or without prostatism symptoms (BPH, it is still can be seen. This article purposes to answer two questions a for urologist, which clinical parameters including obesity and smoking have positive predictive value. b for pathologists; which materials are wholly sampled for reducing the cancer ? Methods: We evaluated 1315 cases who were per­formed by TURP due to bladder outlet obstruction with or without prostatism symptoms the years 2006-2015. The ages of the patients, smoking, body mass index (BMI, digital rectal examination (DRE findings, preoperative prostate specific antigen (PSA levels, uroflow values, to­tal prostate volume determined by suprapubic ultrasound and Gleason score were recorded. We analyzed the re­lationship between these parameters and IPCa. These situation compared with benign prostate tissue materials. Results: Totally 31 cases (2.35% were found in the IPCa. While the cases of 24 were pT1a, 7 cases were pT1b. Age, body mass index, PSA, peak current speed and mean flow rate parameters respectively 8.887, 5.668, 9.660, 4.814 and 3.716 times as an incidental effect in detecting prostate cancer has been concluded. Conclusion: Older patient age, over the 25 kg/m2 of BMI, over the 4 ng/dl of PSA levels, the peak flow rate less than 10 ml/sec and the mean flow rate less than 5 ml/sec might be independent risk factors for detecting IPCa. More ex­ternal validation is needed for confirming our results.

  12. Incidental pineal cysts in children who undergo 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Whitehead, Matthew T. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Le Bonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States); Oh, Christopher C. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Choudhri, Asim F. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States)

    2013-12-15

    Pineal cysts, both simple and complex, are commonly encountered in children. More cysts are being detected with MR technology; however, nearly all pineal cysts are benign and require no follow-up. To discover the prevalence of pineal cysts in children at our institution who have undergone high-resolution 3-T MRI. We retrospectively reviewed 100 consecutive 3-T brain MRIs in children ages 1 month to 17 years (mean 6.8 {+-} 5.1 years). We evaluated 3-D volumetric T1-W imaging, axial T2-W imaging, axial T2-W FLAIR (fluid attenuated inversion recovery) and coronal STIR (short tau inversion recovery) sequences. Pineal parenchymal and cyst volumes were measured in three planes. Cysts were analyzed for the presence and degree of complexity. Pineal cysts were present in 57% of children, with a mean maximum linear dimension of 4.2 mm (range 1.5-16 mm). Of these cysts, 24.6% showed thin septations or fluid levels reflecting complexity. None of the cysts demonstrated complete T2/FLAIR signal suppression. No cyst wall thickening or nodularity was present. There was no significant difference between the ages of children with and without cysts. Cysts were more commonly encountered in girls than boys (67% vs. 52%; P = 0.043). There was a slight trend toward increasing pineal gland volume with age. Pineal cysts are often present in children and can be incidentally detected by 3-T MRI. Characteristic-appearing pineal cysts in children are benign, incidental findings, for which follow-up is not required if there are no referable symptoms or excessive size. (orig.)

  13. 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...

  14. 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...

  15. Incidental findings on cone beam computed tomography: Relate and relay

    Directory of Open Access Journals (Sweden)

    Suhas P Pande

    2015-01-01

    Full Text Available Objective: To evaluate the presence of incidental findings on cone beam computed tomography (CBCT images and to recognize their clinical importance. Materials and Methods: A total of 700 CBCT scans between January 2013 to August 2014 at Government Dental College and Hospital were evaluated retrospectively. Results: 459 incidental findings (65.57% were observed in 700 patients. Most common individual incidental finding was mucosal thickening (119 followed by pineal/habenula calcification (99 and choroid plexus (77. Conclusion: The oral and maxillofacial radiologist should carefully interpret all scans and should not ignore the incidental findings and hence avoid untoward snowballing effects.

  16. The test-retest reliability of habitual incidental physical activity.

    Science.gov (United States)

    McCormack, Gavin; Giles-Corti, Billie; Milligan, Rex

    2003-01-01

    To determine the test-retest reliability of items measuring habitual incidental physical activity, incidental physical activity behaviour and sedentary behaviours. Eighty-four subjects aged 18-65 years were interviewed from randomly selected households within metropolitan and rural Western Australia. Subjects were administered the interview on two separate occasions 10 days apart. Subjects were asked about habitual incidental physical activity (i.e. bouts performed for 10 minutes or less) performed during the week and on weekends. Intraclass correlations performed for items measuring incidental physical activity were generally found to be low to moderate. The frequency of incidental physical activity was more reliably recalled than the average duration spent on short trips (ICC 0.582 to 0.872 compared with 273 to 0.551). Kappa coefficients for habitual incidental physical activity behaviour items were observed to have moderate-to-high (0.478 to 0.939) agreement between administrations. Sedentary behaviours overall showed high test-retest reliability (ICC 0.646 to 0.925). These findings demonstrate that adults can reliably recall the frequency, but not the duration, of habitual incidental physical activity. Thus, the frequency measured by these items could be used to determine the effectiveness of current Australian physical activity guidelines and possibly identify shifts in incidental physical activity behaviour over time. Measurement of physical activity in all domains including incidental physical activity is required to determine the effectiveness of current guidelines and implemented health promotion interventions.

  17. 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.

  18. [Expression of S518 phosphorylated Merlin and its interaction with CD44 in vestibular schwannoma].

    Science.gov (United States)

    Cai, Li-hui; Wu, Hao; Lü, Jing-rong; Wang, Zhao-yan

    2008-12-01

    To investigate the impact of S518 phosphorylation in Merlin on the interaction with CD44 in vestibular schwannoma and the tumor growth. Thirty-five samples of vestibular schwannoma were identified by pathology. Immunohistopathology and western blot were employed to analyze the expression and localization of S518 phosphorylated Merlin in the tumor tissues. Nerve tissues that were collected during other surgical operation were used as control. The expression level of S518 phosphorylated Merlin was compared with clinical stages, tumor size, clinical course and cystic degeneration. Immunoprecipitation was used to evaluate the impact of S518 phosphorylation in Merlin on the interaction with CD44. In vestibular schwannoma, Merlin was phosphorylated at S518 and demonstrated perinuclear localization. The S518 phosphorylation level was much lower in the normal control nerve tissues than that in vestibular schwannoma tissues. There was no correlation between the phosphorylation level on Merlin and clinical stages, tumor size, clinical course and cystic degeneration. The S518 phosphorylated Merlin bound CD44 was higher than wild-type Merlin bound CD44 in vestibular schwannoma tissues. The affinity of Merlin to CD44 was increased after phosphorylation at S518. Different cellular biological results might be triggered through binding to wild type Merlin and S518 phosphorylated Merlin.

  19. Does Hospital Volume Affect Outcomes in Patients Undergoing Vestibular Schwannoma Surgery?

    Science.gov (United States)

    Hatch, Jonathan L; Bauschard, Michael J; Nguyen, Shaun A; Lambert, Paul R; Meyer, Ted A; McRackan, Theodore R

    2018-01-16

    To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. Retrospective case review. University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012-2015) grouped by race, age, comorbidities, payer, and sex. Surgical resection of vestibular schwannoma. Morbidity and mortality following vestibular schwannoma excision are compared by hospital volume (low, medium, and high) including deciles. There was significantly longer length of stay (p ≤ 0.005) among groups with low-volume hospitals followed by medium-volume hospitals and high-volume hospitals. Low-volume hospitals had a significantly higher rate of complications including stroke, aspiration, and respiratory failure (p ≤ 0.0175). Patient characteristics of age, sex, sex, and baseline comorbidities were similar between hospital groups. However, patients at high-volume hospitals were more likely to be Caucasian (83.1%, p = 0.0001) and have private insurance (76.7%, p < 0.0001). There was a strong negative correlation between complication rates and hospital volume (r = -0.8164, p = 0.0040). The volume of vestibular schwannoma surgeries performed at a hospital impacts length of stay and rates of postoperative complications. Demographics among hospital groups were similar though high-volume hospitals had significantly more patients who were privately insured and Caucasian.

  20. Clinicopathologic Features of Gastric Schwannoma: 8-Year Experience at a Single Institution in China.

    Science.gov (United States)

    Tao, Kaixiong; Chang, Weilong; Zhao, Ende; Deng, Rui; Gao, Jinbo; Cai, Kailin; Wang, Guobin; Zhang, Peng

    2015-11-01

    To explore the clinicopathologic characteristics, diagnosis, treatment, and prognosis of gastric schwannoma in the imatinib era.The clinicopathologic characteristics and postoperative outcomes of patients diagnosed with gastric schwannoma at our institution between January 2007 and February 2015 were retrospectively collected and analyzed.The main patient complaint was epigastric pain or discomfort. Tumor sizes ranged from 15 to 80 mm (mean, 57.1 mm). In 17 patients, the tumors were located in the body of the stomach. A total of 20 patients were preoperatively misdiagnosed with a gastrointestinal stromal tumor. The rate of correct preoperative diagnosis was only 3.3%. All patients underwent surgical resection and showed strong S-100 protein positivity. Laparoscopic surgery for gastric schwannoma was associated with less blood loss and a shorter postoperative hospital stay than open surgery (P Gastric schwannoma is often preoperatively misdiagnosed as gastric gastrointestinal stromal tumor. Laparoscopic resection of gastric schwannoma is considered safe and effective, and it may be the preferred surgery for most small- and moderate-sized tumors. The long-term outcome is excellent, as this type of neoplasm is uniformly benign.

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

    Science.gov (United States)

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

    2013-01-01

    Abstract Schwannomas are tumors formed by proliferation of dedifferentiated Schwann cells. Patients with neurofibromatosis 2 (NF2) and schwannomatosis develop multiple schwannomas in peripheral and cranial nerves. Although benign, these tumors can cause extreme pain and compromise sensory/motor functions, including hearing and vision. At present, surgical resection is the main treatment modality, but it can be problematic because of tumor inaccessibility and risk of nerve damage. We have explored gene therapy for schwannomas, using a model in which immortalized human NF2 schwannoma cells expressing a fluorescent protein and luciferase are implanted in the sciatic nerve of nude mice. Direct injection of an adeno-associated virus (AAV) serotype 1 vector encoding caspase-1 (ICE) under the Schwann-cell specific promoter, P0, leads to regression of these tumors with essentially no vector-mediated neuropathology, and no changes in sensory or motor function. In a related NF2 xenograft model designed to cause measurable pain behavior, the same gene therapy leads to tumor regression and concordant resolution of tumor-associated pain. This AAV1-P0-ICE vector holds promise for clinical treatment of schwannomas by direct intratumoral injection to achieve reduction in tumor size and normalization of neuronal function. PMID:23140466

  2. 75 FR 20481 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2010-04-19

    ... observer on the drillship; Incidental ice data provided by commercial ships transiting the area; and... in theory, temporary or permanent hearing impairment (Richardson et al., 1995a). However, for reasons...-breaking activities than ships of similar size during normal operation in open water (Richardson et al...

  3. 78 FR 33357 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-06-04

    ... oxide, cyanic acid, and carbon dioxide (Becker, 1995). However, reactions quickly occur between the... Force Base in the Gulf of Mexico AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... Force Base (Eglin AFB), for an Incidental Harassment Authorization (IHA) to take marine mammals, by...

  4. 76 FR 43267 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental To...

    Science.gov (United States)

    2011-07-20

    ... Gulf of Mexico AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... harassment, incidental to conducting air-to-surface (A-S) gunnery missions in the Gulf of Mexico (GOM). The... by various researchers often do not contain adjustments for perception or availability bias...

  5. 75 FR 80773 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2010-12-23

    ... Operations at Kodiak Launch Complex, Alaska AGENCY: National Marine Fisheries Service (NMFS), National.... SUMMARY: NMFS has received an application, pursuant to the Marine Mammal Protection Act (MMPA), from the Alaska Aerospace Corporation (AAC) for authorization to take small numbers of marine mammals incidental...

  6. 76 FR 16311 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2011-03-23

    ... of small numbers of marine mammals incidental to rocket launches from the Kodiak Launch Complex (KLC... Operations at Kodiak Launch Complex, AK AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Final rule. SUMMARY: NMFS, upon application...

  7. 76 FR 9250 - Taking of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2011-02-17

    ... the Gulf of Mexico Range Complex AGENCY: National Marine Fisheries Service (NMFS), National Oceanic... incidental to activities conducted by the Navy's Atlantic Fleet within the Gulf of Mexico (GOMEX) Range...., sperm whales and bottlenose dolphins), while a few (e.g., fin whales and killer whales) have accidental...

  8. Cubital Tunnel Syndrome Caused by Ulnar Nerve Schwannoma in a Patient with Diabetic Sensorimotor Polyneuropathy.

    Science.gov (United States)

    Liu, Meng-Ta; Lee, Jiunn-Tay; Wang, Chih-Hsin; Lin, Yu-Chieh; Chou, Chung-Hsing

    2016-06-15

    An uncommon ulnar nerve schwannoma should not be neglected in a diabetic patient with cubital tunnel syndrome, the second most common cause of entrapment neuropathy. A 61-year-old woman with a past history of type 2 diabetes mellitus complicated with sensorimotor polyneuropathy presented with progressive numbness and weakness of the left ring and little fingers for one year. A provisional diagnosis of cubital tunnel syndrome was made according to physical examination and electrophysiological studies. The magnetic resonance imaging showed a nodular lesion over ulnar aspect of the left elbow, which was demonstrated to be a schwannoma by histopathology. The patient had moderate improvement after surgical decompression of the left cubital tunnel. This case illustrates the heterogeneous group of pathologies causing peripheral neuropathy. The diagnosis of ulnar nerve schwannoma with cubital tunnel syndrome, superimposed with diabetic sensorimotor polyneuropathy, was made carefully according to clinical manifestations as well as a series of electrophysiological, imaging, and pathological studies.

  9. Schwannoma of the penis, presenting as a scrotal mass, rare entity with an uncommon presentation.

    Science.gov (United States)

    Kumar, Ujwal; Jha, Nawal Kishore

    2017-01-01

    Schwannomas are benign nerve sheath tumors that are seen either sporadically or in patients of neurofibromatosis. This tumor is common in head, neck, and extremities. Penis is a rare site for this tumor. To the very best of our knowledge, <34 cases of penile schwannoma have been reported in literature till now, but none had presented as scrotal mass. Here, we report a case of penile schwannoma in a 16-year-old male boy who presented in our outpatient department with a slowly growing scrotal mass. Our patient did not have any other feature of neurofibromatosis. The patient after investigation underwent surgical excision and had no recurrence on follow-up of 5 years.

  10. Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss.

    Science.gov (United States)

    Mandalà, Marco; Giannuzzi, Annalisa; Astore, Serena; Trabalzini, Franco; Nuti, Daniele

    2013-07-01

    We evaluated the incidence and characteristics of hyperventilation-induced nystagmus (HVN) in 49 patients with gadolinium-enhanced magnetic resonance imaging evidence of vestibular schwannoma and 53 patients with idiopathic unilateral sensorineural hearing loss and normal radiological findings. The sensitivity and specificity of the hyperventilation test were compared with other audio-vestibular diagnostic tests (bedside examination of eye movements, caloric test, auditory brainstem responses) in the two groups of patients. The hyperventilation test scored the highest diagnostic efficiency (sensitivity 65.3 %; specificity 98.1 %) of the four tests in the differential diagnosis of vestibular schwannoma and idiopathic unilateral sensorineural hearing loss. Small tumors with a normal caloric response or caloric paresis were associated with ipsilateral HVN and larger tumors and severe caloric deficits with contralateral HVN. These results confirm that the hyperventilation test is a useful diagnostic test for predicting vestibular schwannoma in patients with unilateral sensorineural hearing loss.

  11. The molecular biology of vestibular schwannomas and its association with hearing loss: a review.

    Science.gov (United States)

    Celis-Aguilar, Erika; Lassaletta, Luis; Torres-Martín, Miguel; Rodrigues, F Yuri; Nistal, Manuel; Castresana, Javier S; Gavilan, Javier; Rey, Juan A

    2012-01-01

    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.

  12. 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.

  13. Gastric Schwannoma Presenting as an Incidentaloma on CT-Scan and MRI.

    Science.gov (United States)

    Raber, Menno H; Ziedses des Plantes, Cathelijne M P; Vink, Robert; Klaase, Joost M

    2010-12-01

    A 67 year old female was referred because of an incidentaloma on CT-scan and MRI which showed a 5.0 cm large mass in the wall of the distal stomach. After an initial work-up which suggested a gastrointestinal stromal tumor (GIST), a partial gastrectomy with a Billroth II gastrojejunostomy was performed. The histological diagnosis was a schwannoma. Gastric schwannomas are rare tumors which comprise 0.2% of all gastric tumors and 4% of all benign gastric neoplasms with a peak of incidence in the 4th and 5th decade of life. Gastric schwannomas are usually asymptomatic, but can present with ulceration and/or gastrointestinal bleeding. Clinical, endoscopical, surgical, radiological and histological features of this case are described and the relevant literature is reviewed.

  14. Gastric malignant schwannoma presenting with upper gastrointestinal bleeding: a case report.

    Science.gov (United States)

    Takemura, Masashi; Yoshida, Kayo; Takii, Mamiko; Sakurai, Katsunobu; Kanazawa, Akishige

    2012-01-25

    We report a case of gastric malignant schwannoma presenting with gastrointestinal bleeding. A 70-year-old Japanese man presented with gastrointestinal bleeding to our hospital. Gastrointestinal endoscopy revealed a protruding lesion in the gastric body. Hematoxylin and eosin staining of biopsy specimens from this lesion revealed sheets of spindle cells. Immunohistochemistry revealed that these cells were positive for S-100 protein and negative for c-Kit and smooth muscle actin. Because mitosis was diffusely visible, this tumor was diagnosed as a gastric malignant schwannoma. Distal gastrectomy with lymph node dissection was performed and the patient's postoperative course was uneventful. However, five months after the surgery, he died from multiple liver metastases. Cases of gastric malignant schwannoma have rarely been reported. The efficacy of surgical resection and postoperative prognosis continues to remain unclear and should be investigated further.

  15. Gastric schwannoma presenting with perforation and abscess formation: a case report and literature review.

    Science.gov (United States)

    Euanorasetr, Chakrapan; Suwanthanma, Weerapat

    2011-11-01

    Gastric schwannoma represent only 0.2% of all gastric tumors and 4% of all benign gastric neoplasms. They are usually asymptomatic but can present with variable symptoms. The authors report a case of a 29-year-old male patient who presented with fever and abdominal pain with epigastric mass. Pre-operative diagnosis was gastric lymphoma with perforation and an abscess formation. Hemigastrectomy with Billroth II anastomosis was performed The pathologic examination and immunohistochemical studies confirmed gastric schawannoma as the diagnosis. The post-operative course was uneventful. Gastric schwannoma are difficult if not impossible to diagnose preoperatively as endoscopic and radiologic findings are nonspecific. The treatment of choice is complete surgical resection because of diagnostic uncertainty and the long-term outcome is excellent. This is the first report of gastric schwannoma presenting with concealed perforation and an abscess formation. The literature was reviewed.

  16. Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report.

    Science.gov (United States)

    Wang, Guangyao; Chen, Ping; Zong, Liang; Shi, Lei; Zhao, Wei

    2014-02-01

    Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm 3 solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers.

  17. Small bud of probable gastrointestinal stromal tumor within a laparoscopically-resected gastric schwannoma.

    Science.gov (United States)

    Cho, Haruhiko; Watanabe, Takafumi; Aoyama, Toru; Hayashi, Tsutomu; Yamada, Takanobu; Ogata, Takashi; Yoshikawa, Takaki; Tsuburaya, Akira; Sekiguchi, Hironobu; Nakamura, Yoshiyasu; Sakuma, Yuji; Kameda, Yoichi; Miyagi, Yohei

    2012-06-01

    Submucosal tumors (SMTs) of the gastrointestinal (GI) tract can be potentially difficulty to diagnose pathologically. We report a case of a gastric SMT that was resected by laparoscopic partial gastrectomy. Although the initial histological and immunohistochemical examinations considered the tumor as a schwannoma, mRNA-based KIT genotyping indicated that the tumor included cells with KIT gene expression, and that a small number of cells carried a deletion mutation in exon 11. Additional histopathological investigations revealed small aggregates of enlarged spindle to epithelioid cells, which were positive for KIT, CD34 and DOG1, and negative for S-100, scattered among the S-100-positive schwannoma cells. We consider that the cells carrying the KIT gene mutation are microscopic buds of a gastrointestinal stroma tumor (GIST), and to the best of our knowledge, this is the first report of probable GIST tissues identified in a schwannoma. Our observations raised the significance of genotyping for diagnosis of GI tract SMTs.

  18. Gastric malignant schwannoma presenting with upper gastrointestinal bleeding: a case report

    Directory of Open Access Journals (Sweden)

    Takemura Masashi

    2012-01-01

    Full Text Available Abstract Introduction We report a case of gastric malignant schwannoma presenting with gastrointestinal bleeding. Case presentation A 70-year-old Japanese man presented with gastrointestinal bleeding to our hospital. Gastrointestinal endoscopy revealed a protruding lesion in the gastric body. Hematoxylin and eosin staining of biopsy specimens from this lesion revealed sheets of spindle cells. Immunohistochemistry revealed that these cells were positive for S-100 protein and negative for c-Kit and smooth muscle actin. Because mitosis was diffusely visible, this tumor was diagnosed as a gastric malignant schwannoma. Distal gastrectomy with lymph node dissection was performed and the patient's postoperative course was uneventful. However, five months after the surgery, he died from multiple liver metastases. Conclusion Cases of gastric malignant schwannoma have rarely been reported. The efficacy of surgical resection and postoperative prognosis continues to remain unclear and should be investigated further.

  19. 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

  20. Clinical course of vestibular schwannoma in pediatric neurofibromatosis Type 2.

    Science.gov (United States)

    Choi, Jung Won; Lee, Ji Yeoun; Phi, Ji Hoon; Wang, Kyu-Chang; Chung, Hyun-Tai; Paek, Sun Ha; Kim, Dong Gyu; Park, Sung-Hye; Kim, Seung-Ki

    2014-06-01

    Neurofibromatosis Type 2 (NF2) is an autosomal-dominant inherited disease, characterized by multiple neoplasia syndromes, including meningioma, schwannoma, glioma, and ependymoma. In this report, the authors present their clinical experience with pediatric NF2 patients. In particular, they focused on the clinical course of vestibular schwannoma (VS), including the natural growth rate, tumor control, and functional hearing outcomes. From May 1988 to June 2012, the authors recruited patients who were younger than 18 years and fulfilled the Manchester criteria. In total, 25 patients were enrolled in this study. The authors analyzed the clinical course of these patients. In addition, they measured the natural growth rate of VS before any treatment in these children with NF2. Then, they evaluated the tumor control rate and functional hearing outcomes after the treatment of VS. The mean age at the onset of NF2-related symptoms was 9.9 ± 4.5 years (mean ± SD, range 1-17 years). The mean age at the diagnosis of NF2 was 12.9 ± 2.9 years (range 5-17 years). The mean follow-up period was 89.3 months (range 12-311 months). As initial manifestations, nonvestibular symptoms were frequently observed in pediatric patients with NF2. The mean natural growth rate of VS was 0.33 ± 0.41 cm(3)/year (range 0-1.35 cm(3)/year). The tumor control rate of VS was 35.3% at 3 years after Gamma Knife surgery (GKS). The actuarial rate of useful hearing preservation was 67% in the 1st year and 53% in the 5th year after GKS. Clinical manifestations in children with NF2 were highly variable, compared with their adult counterparts. The natural growth rate of VS in children is slow, and this oncological feature may explain the diverse clinical manifestations besides vestibular symptoms in children with NF2. The treatment outcome of GKS for VS in children with NF2 was not favorable compared with previous reports of affected adults.

  1. Unusual incidental findings on intra- and extra-oral radiographs in North Indian Population: A radiographic study

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    Gaurav Goyal

    2016-01-01

    Full Text Available Aims and Objectives: To detect the prevalence of unusual incidental findings on intra- and extra-oral radiographs in North Indian Population: A radiographic study. Methods: All the intra- and extra-oral conventional dental radiographs were analyzed for the period of 2 year along with the radiographic findings related to patient's chief complaint. Results: A total of 6780 conventional intra- and extra-oral dental radiographs were screened and 90 radiographs showed incidental findings. A total of 10 varieties and 95 numbers of incidental findings were noted, 50 (55.55% affected mandible, and 24 (44.44% affected maxilla. Out of 90, 44 (48.88% were bony findings and 46 (51.11% were dental findings. Most common type of incidental pathology was idiopathic osteosclerosis. The most uncommon type of incidental pathology was regional odontodysplasia with 35 (38.88%, 25 (27.77 cases of cysts, 16 cases of supernumerary teeth (17.77%, 9 (10% cases of sinus abnormality, 4 (5.40% of each findings were of odontome, dense in dente, internal resorption, and calcifications. About 1 (1.11% of each findings were regional odontodysplasia, focal cemental dysplasia. Conclusions: Conventional radiography is still most commonly used tool to primarily investigate lesions quickly with low cost to patient and then further diagnostic and advanced radiological or other examinations can be performed for comparison, periodic follow up, management, and research purposes.

  2. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. The incidental pulmonary nodule in a child. Part 2: Commentary and suggestions for clinical management, risk communication and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Westra, Sjirk J. [Massachusetts General Hospital, Division of Pediatric Radiology, Boston, MA (United States); Thacker, Paul G. [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Podberesky, Daniel J. [Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Lee, Edward Y. [Boston Children' s Hospital, Department of Pediatric Radiology, Boston, MA (United States); Iyer, Ramesh S. [Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States); Hegde, Shilpa V. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States); Guillerman, R.P. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Mahani, Maryam Ghadimi [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States)

    2015-05-01

    The incidental detection of small lung nodules in children is a vexing consequence of an increased reliance on CT. We present an algorithm for the management of lung nodules detected on CT in children, based on the presence or absence of symptoms, the presence or absence of elements in the clinical history that might explain these nodules, and the imaging characteristics of the nodules (such as attenuation measurements within the nodule). We provide suggestions on how to perform a thoughtfully directed and focused search for clinically occult extrathoracic disease processes (including malignant disease) that may present as an incidentally detected lung nodule on CT. This algorithm emphasizes that because of the lack of definitive information on the natural history of small solid nodules that are truly detected incidentally, their clinical management is highly dependent on the caregivers' individual risk tolerance. In addition, we present strategies to reduce the prevalence of these incidental findings, by preventing unnecessary chest CT scans or inadvertent inclusion of portions of the lungs in scans of adjacent body parts. Application of these guidelines provides pediatric radiologists with an important opportunity to practice patient-centered and evidence-based medicine. (orig.)

  4. Impact of reading purpose on incidental word learning from context

    NARCIS (Netherlands)

    Swanborn, MSL; de Glopper, Kees

    Children read texts for various reasons. We examined how reading texts for different purposes affected amounts of incidental word learning. Grade 6 students were asked to read texts for fun, to learn about the topic of the text, and for text comprehension. Proportions of words learned incidentally

  5. Histologic Analysis of Incidental Carcinomas of The Prostate Gland ...

    African Journals Online (AJOL)

    Background: Incidental prostate cancers, i.e. cancers found in the specimens of men undergoing surgery for benign prostatic hyperplasia (BPH), have been regarded ... Conclusion: The incidence of incidental carcinomas of the prostate in our environment is significant, consequently urologists should exercise high index of ...

  6. Managing incidental genomic findings: legal obligations of clinicians.

    Science.gov (United States)

    Clayton, Ellen Wright; Haga, Susanne; Kuszler, Patricia; Bane, Emily; Shutske, Krysta; Burke, Wylie

    2013-08-01

    Clinical whole-exome and whole-genome sequencing will result in a broad range of incidental findings, but clinicians' obligations to identify and disclose such findings are a matter of debate. We sought legal cases that could offer insights into clinicians' legal liability. We searched for cases in which incidental findings were related to the cause of action, using the search engines WestLaw, WestLaw Next, Lexis, and Lexis Advance. We found no case law related to incidental findings from genetic testing but identified eight cases involving incidental findings in medical imaging. These cases suggest that clinicians may face liability for failing to disclose incidental findings that would have offered an opportunity for interventions to improve health outcome, if under the applicable standard of care, they fail to identify or appreciate the significance of the incidental finding or they negligently fail to notify other clinicians and/or the patient of the identified incidental finding. Other cases support liability for failure to refer appropriately to a clinician with greater expertise. Clinicians may face liability if they fail to disclose incidental information that could inform interventions to improve health outcome; information lacking clinical actionability is likely to have less import.

  7. Incidental Exposure and L3 Learning of Morphosyntax

    Science.gov (United States)

    Grey, Sarah; Williams, John N.; Rebuschat, Patrick

    2014-01-01

    Evidence of learning following incidental exposure has been found for aspects of nonnative syntax in adults (Rebuschat & Williams, 2006, 2012; Williams & Kuribara, 2008). However, little research has tested delayed effects of learning under an incidental condition or moved beyond word order. This study investigated learning of third…

  8. Incidental Focus on Form in University Spanish Literature Courses

    Science.gov (United States)

    Zyzik, Eve; Polio, Charlene

    2008-01-01

    Incidental focus on form is one of several ways to direct language learners' attention to formal aspects of language within meaningful communicative contexts. Learners can benefit from focus on form, but the extent to which incidental focus on form, or any other type, is available to learners in advanced foreign language literature classes has not…

  9. A case of multiple schwannomas in nerves of the lower extremities

    Directory of Open Access Journals (Sweden)

    Mehmet Dadaci

    2016-08-01

    Full Text Available Schwannoma, also known as neurilemma, is a rare benign tumor on a nerve sheath consisting of Schwann cells and a capsule. These tumors are the most common peripheral nerve tumors. Their manifestation is often a single swelling across the nerve, yet there may be more than one lesion in Neurofibromatosis type 2 cases. The present work discusses a case of multiple schwannomas developing in both sensory and motor nerves simultaneously with involvement of three different nerves in a non-syndromic patient. [Hand Microsurg 2016; 5(2.000: 79-83

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

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    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.

  11. 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.

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

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    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.

  13. An update on the diagnosis and treatment of vestibular schwannoma.

    Science.gov (United States)

    Halliday, Jane; Rutherford, Scott A; McCabe, Martin G; Evans, Dafydd G

    2018-01-01

    Vestibular schwannomas (VS) account for approximately 85% of tumors in the cerebello-pontine angle, with a lifetime incidence of approximately 1 in 1000. Most are sporadic, with approximately 5% related to the tumor predisposition syndrome Neurofibromatosis Type 2 (NF2). The mainstays of management strategies are: observation, surgery, radiosurgery/radiotherapy and, for patients with NF2 and rapidly growing tumors or deteriorating neurologic function the targeted therapy bevacizumab. While morbidity and mortality rates related to treatment of VS have improved dramatically over the last decades, there are still significant improvements that could be made, in particular with regards to long-term facial nerve and hearing outcomes. Areas covered: The epidemiology and diagnosis of VS are discussed, followed by the different management strategies and outcomes of those for both sporadic and NF2 related tumors. An extensive literature review has been performed to inform this review article using PubMed and Google Scholar. Expert commentary: The future direction of VS management lies in obtaining longer-term follow-up data for patients with treated VS, and in improved understanding of cellular pathways and targeted therapies.

  14. Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies.

    Science.gov (United States)

    Sahyouni, Ronald; Moshtaghi, Omid; Haidar, Yarah M; Mahboubi, Hossein; Moshtaghi, Afsheen; Lin, Harrison W; Djalilian, Hamid R

    2017-12-01

    To report findings from a cohort of vestibular schwannoma (VS) patients presenting with vertigo from a secondary comorbid vestibular disorder; and to discuss management strategies for this subset of patients presenting with both episodic vertigo and VS. All VS patients who presented with vertigo as the primary symptom from 2012 to 2015 and endorsing no other major complaints were examined. Treatment with migraine lifestyle and prophylactic therapy, or Epley maneuver. Resolution of vertigo following medical treatment alone. Of the nine patients studied, seven (78%) suffered from vestibular migraine, and two (22%) experienced benign positional vertigo. All patients experienced complete resolution of symptoms after treatment. As a result of symptomatic improvement, seven patients (78%) avoided surgery in favor of observation, while two patients (22%) underwent radiosurgery due to continued tumor growth and other nonvertigo symptoms. VS patients can sometimes present with a history of recurrent episodic vertigo. The etiology of the vertigo could be due to the tumor itself or may be due to an underlying comorbidity such as vestibular migraine or benign positional vertigo. VS patients presenting with vertigo should undergo a standard vertigo history and examination to identify other potential causes of vertigo. Most VS patients in our cohort avoided intervention and had resolution of their vertigo.

  15. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on Emerging Therapies for the Treatment of Patients With Vestibular Schwannomas.

    Science.gov (United States)

    Van Gompel, Jamie J; Agazzi, Siviero; Carlson, Matthew L; Adewumi, Dare A; Hadjipanayis, Constantinos G; Uhm, Joon H; Olson, Jeffrey J

    2017-12-20

    Adults with histologically proven or suspected vestibular schwannomas with neurofibromatosis type 2 (NF2). What is the role of bevacizumab in the treatment of patients with vestibular schwannomas? Level 3: It is recommended that bevacizumab be administered in order to radiographically reduce the size or prolong tumor stability in patients with NF2 without surgical options. Level 3: It is recommended that bevacizumab be administered to improve hearing or prolong time to hearing loss in patients with NF2 without surgical options. Is there a role for lapatinib, erlotinib, or everolimus in the treatment of patients with vestibular schwannomas? Level 3: Lapatinib may be considered for use in reducing vestibular schwannoma size and improvement in hearing in NF2. Level 3: Erlotinib is not recommended for use in reducing vestibular schwannoma size or improvement in hearing in patients with NF2. Level 3: Everolimus is not recommended for use in reducing vestibular schwannoma size or improvement in hearing in NF2. What is the role of aspirin, to augment inflammatory response, in the treatment of patients with vestibular schwannomas? Any patient with a vestibular schwannoma undergoing observation. Level 3: It is recommended that aspirin administration may be considered for use in patients undergoing observation of their vestibular schwannomas. Is there a role for treatment of vasospasm, ie, nimodipine or hydroxyethyl starch, perioperatively to improve facial nerve outcomes in patients with vestibular schwannomas? Adults with histologically proven or suspected vestibular schwannomas. Level 3: Perioperative treatment with nimodipine (or with the addition of hydroxyethyl starch) should be considered to improve postoperative facial nerve outcomes and may improve hearing outcomes. Is there a role for preoperative vestibular rehab or vestibular ablation with gentamicin for patients surgically treated for vestibular schwannomas? Adults with histologically proven or suspected

  16. CASE REPORT: Papillary Adenoma of Kidney- An Incidental Autopsy Finding: Report of Two Cases

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    Bhakti D. Deshmukh

    2012-01-01

    Full Text Available Background: Renal papillary adenoma is usually an incidental finding at autopsy with an incidence of 7% to 23%. The frequency of small papillary tumours of kidney increases with age to approximately 40% of the population over the age of 65. These tumours occur morefrequently in scarred kidneys, acquired renal cystic disease and in children with von Hippel-Lindau syndrome. Case history: In this report we describe renal papillary adenoma incidentally detected during autopsies of two elderly males. Gross examination of kidneyshowed two tiny subcapsular yellowish nodules in one case and single nodule with similar morphology in the other. Microscopic examination in both the cases showed a well circumscribed tumour composed of densely packed tubules and papillae lined by small cuboidal to columnar cells with rounded uniform nuclei. However there was no nuclear atypia, mitosis or necrosis.

  17. Two Invasive Thymomas Incidentally Found during Coronary Artery Bypass Graft Surgery

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    Navid Omidifar

    2016-01-01

    Full Text Available Thymoma, the most common neoplasm of the anterior mediastinum, is a rare tumor of thymic epithelium that can be locally invasive. We reported 2 cases of invasive thymoma incidentally found during routine coronary artery bypass graft (CABG surgery at Faghihee Hospital of Shiraz University of Medical Sciences of Iran in a period of about 6 months. The 2 patients were male and above 60 years old. They had no clinical symptoms and radiological evidence of mediastinal mass before detection of the tumor during operation. For both patients mass was completely excised and sent to the laboratory. The ultimate pathological diagnosis of both masses was invasive thymoma (stage 2. There are few reports in which thymomas were found incidentally during cardiac surgery. In spite of rare coincidence, due to being asymptomatic and possibly invasive, special attention to thymus gland during cardiac surgery or other mediastinal surgery and preoperative imaging studies seem to be reasonable approach.

  18. The management impact of clinically significant incidental lesions detected on staging FDG PET-CT in patients with non-small cell lung cancer (NSCLC): an analysis of 649 cases.

    Science.gov (United States)

    Lin, Michael; Ambati, Chaitanya

    2012-06-01

    To evaluate FDG PET-CT in the detection of unexpected pre-malignancy or second malignancy at the initial staging of patients with histologically proven non-small cell lung cancer (NSCLC) and its impact on management. Staging FDG PET-CT scans acquired between February 2006 and July 2010 in 649 patients (M=389; F=260) with NSCLC were reviewed for the presence of unexpected pre-malignancy or second primary. A "True-Positive" lesion represented a second primary or pre-malignant lesion. A "False-Positive" lesion was due to benign causes or an atypical site of metastasis from NSCLC. 77 (12%) patients were identified on PET-CT as having a potential pre-malignancy or second primary. 39 out of 77 (51%) patients had diagnostic verification where histopathology served as reference standard in 33 patients (85%) and the rest had endoscopy and progress PET-CT scans. 20 patients (3.1%) had a second primary (n=11) or pre-malignant lesions comprising dysplastic colorectal polyps (n=9), and additional therapy and/or management change for the index tumour was instigated in 17 patients (85%). In patients with a second primary, 3 (27%) patients had a high impact change in management from an initial curative intent to palliative. Staging FDG PET-CT is highly valuable in identifying second primary cancers or pre-malignant lesions in patients with NSCLC. When a second primary is detected on PET-CT, there is a high impact change in management in 27% of patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

    Science.gov (United States)

    Klersy, P C; Arlt, F; Hofer, M; Meixensberger, J

    2018-01-01

    A 'wait and see' strategy is an option when managing patients with small vestibular schwannomas (VS). A risk of growth and worsening of hearing may influence a patient's daily quality of life (QOL). Therefore, the present study focused on QOL parameters in patients who are on a 'wait and see' strategy following magnetic resonance imaging (MRI)-based diagnosis of small unilateral VS. Sixty-five patients (mean age 64.4 years; male:female, 32:33) who suffered from a small unilateral VS (9.34 mm, range 1.5-23 mm) between 2013 and 2016 were included in a prospective single center study. During follow-up, in addition to clinical and neurological examinations and MRI imaging, all patients answered the Short Form 36 questionnaire once to characterize QOL. Additionally, the severity of tinnitus was determined by the Mini-TQ-12 from Hiller and Goebel. It was found during follow-up that there was no lowering of QOL in patients with small VS who were on 'wait and see' strategy compared with Germany's general population and no tumor growth was detected in 53 patients (81.5%). Patients with a tumor diameter larger than 10 mm did not suffer from stronger tinnitus, vertigo or unsteadiness than the group with an average tumor size, which is smaller than 10 mm. Sixty-two patients (95.4%) showed ipsilateral hearing loss and three of these reported deafness (4.6%). Severe vertigo or tinnitus is connected with lower levels of mental component scale and physical component scale. These findings reduced the QOL (p = 0.05). In our series, QOL is not influenced in patients with unilateral untreated small VS in comparison to Germany's general population. This is helpful information when advising patients during follow-up and finding out the optimal timing of individual treatment.

  1. A comparison of semi-automated volumetric vs linear measurement of small vestibular schwannomas.

    Science.gov (United States)

    MacKeith, Samuel; Das, Tilak; Graves, Martin; Patterson, Andrew; Donnelly, Neil; Mannion, Richard; Axon, Patrick; Tysome, James

    2018-01-15

    Accurate and precise measurement of vestibular schwannoma (VS) size is key to clinical management decisions. Linear measurements are used in routine clinical practice but are prone to measurement error. This study aims to compare a semi-automated volume segmentation tool against standard linear method for measuring small VS. This study also examines whether oblique tumour orientation can contribute to linear measurement error. Experimental comparison of observer agreement using two measurement techniques. Tertiary skull base unit. Twenty-four patients with unilateral sporadic small (< 15 mm maximum intracranial dimension) VS imaged with 1 mm-thickness T1-weighted Gadolinium enhanced MRI. (1) Intra and inter-observer intraclass correlation coefficients (ICC), repeatability coefficients (RC), and relative smallest detectable difference (%SDD). (2) Mean change in maximum linear dimension following reformatting to correct for oblique orientation of VS. Intra-observer ICC was higher for semi-automated volumetric when compared with linear measurements, 0.998 (95% CI 0.994-0.999) vs 0.936 (95% CI 0.856-0.972), p < 0.0001. Inter-observer ICC was also higher for volumetric vs linear measurements, 0.989 (95% CI 0.975-0.995) vs 0.946 (95% CI 0.880-0.976), p = 0.0045. The intra-observer %SDD was similar for volumetric and linear measurements, 9.9% vs 11.8%. However, the inter-observer %SDD was greater for volumetric than linear measurements, 20.1% vs 10.6%. Following oblique reformatting to correct tumour angulation, the mean increase in size was 1.14 mm (p = 0.04). Semi-automated volumetric measurements are more repeatable than linear measurements when measuring small VS and should be considered for use in clinical practice. Oblique orientation of VS may contribute to linear measurement error.

  2. Incidental emotions influence risk preference and outcome evaluation.

    Science.gov (United States)

    Zhao, Ding; Gu, Ruolei; Tang, Ping; Yang, Qiwei; Luo, Yue-Jia

    2016-10-01

    Incidental emotions, which are irrelevant to the current decision, play a significant role in the decision-making process. In this study, to investigate the influence of incidental emotions on behavioral, psychological, and electrophysiological responses in the process of decision making, participants were required to perform a monetary gambling task. During the selection stage, an emotional picture, which was chosen from the Chinese Affective Picture System and fell into one of three categories: negative, neutral, and positive, was presented between two alternatives (small/large amount of bet). The pictures were provided to induce incidental emotions. ERPs and self-rating emotional experiences to outcome feedback were recorded during the task. Behavioral results showed that positive incidental emotions elicited risk preference, but emotional experiences to outcome feedback were not influenced by incidental emotions. The feedback-related negativity amplitudes were larger in the positive emotion condition than in the negative and neutral emotion conditions for small outcomes (including wins and losses), whereas there was no difference between the three conditions for large outcomes. In addition, the amplitudes of P3 were reduced overall in the negative emotion condition. We suggest that incidental emotions have modulated both the option assessment stage (manifested in behavioral choices) and the outcome evaluation stage (manifested in ERP amplitudes) of decision making unconsciously (indicated by unchanged subjective emotional experiences). The current findings have expanded our understanding of the role of incidental emotion in decision making. © 2016 Society for Psychophysiological Research.

  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

  4. 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

  5. A Rare Case of Paediatric Neck Swelling: Cervical Sympathetic Chain Schwannoma

    Directory of Open Access Journals (Sweden)

    E. Keane

    2013-01-01

    Full Text Available Schwannomas are indolent benign lesions arising from schwann cells in the nerve. They are especially rare in the paediatric population. We report an interesting case of a swelling in the upper neck, which highlights an atypical presentation of this tumour, as well as the complex details of its clinical, radiological, and surgical management.

  6. 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.

  7. 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...

  8. 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...

  9. Giant mediastinal schwannoma located in the lower right side of the ...

    African Journals Online (AJOL)

    2016-01-18

    Jan 18, 2016 ... 88 Jiefang Road, Hangzhou 310009, China. E-mail: chai_y@126. ... Department of Thoracic Surgery, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, China. Access this article .... Tsutsumi Z, et al. Retroperitoneal ancient schwannoma presenting as an adrenal incidentaloma:.

  10. Vestibular schwannoma and cell-phones. Results, limits and perspectives of clinical studies.

    Science.gov (United States)

    Mornet, E; Kania, R; Sauvaget, E; Herman, P; Tran Ba Huy, P

    2013-11-01

    The widespread development of cell-phones entails novel user exposure to electromagnetic fields. Health impact is a public health issue and a source of anxiety in the population. Some clinical studies reported an association between cell and cordless phone use and vestibular schwannoma; others found none. A systematic review was performed of all published clinical studies (cohort, registry, case-control and validation studies), with analysis of results, to determine the nature of the association and the level of evidence. Cohort studies were inconclusive due to short exposure durations and poor representativeness. Registry studies showed no correlation between evolution of cell-phone use and incidence of vestibular schwannoma. Case-control studies reported contradictory results, with methodological flaws. Only a small number of subjects were included in long-term studies (>10 years), and these failed to demonstrate any indisputable causal relationship. Exposure assessment methods were debatable, and long-term assessment was lacking. An on-going prospective study should determine any major effect of electromagnetic fields; schwannoma being a rare pathology, absence of association will be difficult to prove. No clinical association has been demonstrated between cell and cordless phone use and vestibular schwannoma. Existing studies are limited by their retrospective assessment of exposure. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Molecular pathogenesis of vestibular schwannomas: insights for the development of novel medical therapies.

    Science.gov (United States)

    Miller, Craig; Igarashi, Suzu; Jacob, Abraham

    2012-01-01

    Vestibular schwannomas (VS), benign intracranial tumors originating from the vestibulocochlear nerve, usually present with hearing loss, tinnitus, and balance dysfunction. Rarely, however, if untreated, these neoplasms can cause significant patient compromise - resulting in facial paralysis, brainstem compression, and even death. Those with vestibular schwannomas currently choose between surgery and stereotactic radiation therapy as available treatment options. Unfortunately, no medical therapies are presently U.S. Food & Drug Administration approved, representing an urgent and unmet clinical need. Recent breakthroughs in research have discovered key cell surface receptors and intracellular signaling pathways that drive vestibular schwannoma tumorigenesis, proliferation, and survival. A number of promising inhibitors targeting these signaling molecules have also now shown efficacy in preclinical VS cell culture models and animal experiments, with some recently entering human clinical trials. In this review, we summarize ErbB receptor signaling, PDGF receptors, MAP kinase signaling, AKT, p21-activated kinase signaling, mTOR, and VEGF signaling in the context of vestibular schwannoma drug development efforts worldwide. Today, it is truly an exciting time as our specialty stands on the verge of major breakthroughs in the development of medical therapies for VS. Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  12. A Case of Benign Schwannoma of the Transverse Colon with Granulation Tissue

    Directory of Open Access Journals (Sweden)

    Chihiro Tsunoda

    2009-04-01

    Full Text Available Schwannomas occurring in the gastrointestinal tract are rare, and among them, schwannomas of the large intestine are extremely rare. In this paper, we report a case of a macroscopically atypical schwannoma of the transverse colon. The case is a female aged 67. Stool occult blood test was positive, and colonoscopy revealed a protruded lesion resembling a type 1 carcinoma measuring 4 cm with a reddish and uneven surface on the transverse colon. The surface was smooth and lobulated in observation with indigo carmine spray, and granulation tissue was revealed by biopsies. CT of the abdomen showed an irregular mass, and clinical examinations could not rule out malignancy. Therefore, partial transverse colectomy with peripheral lymph node dissection was performed. Histologically, proliferation of spindle cells was observed originating from the muscularis propria, and most of the upper part of the lesion was replaced by granulation tissue. In immunohistochemical staining, S-100 protein and NSE were positive while KIT, CD34, desmin and smooth muscle actin were negative, and the tumor was therefore diagnosed to be a schwannoma. In addition, since the MIB-1 labeling index was low and virtually no mitosis was observed, it was diagnosed as benign tumor.

  13. Pilocytic astrocytoma of the cerebellopontine angle mimicking vestibular schwannoma: report of a rare entity.

    Science.gov (United States)

    Dutta, Gautam; Singh, Daljit; Singh, Hukum; Sachdeva, Deepashu; Kumar, Vikas; Chaturvedi, Ashutosh

    2017-12-26

    We present a rare case of a 55-yr old patient of pilocytic astrocytoma of the cerebello-pontine angle mimicking a vestibular schwannoma. The tumor protruded into the porus acusticus causing enlargement of the internal auditory meatus, which is quite an unusual feature of glial tumours.

  14. 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...

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

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    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.

  16. Schwannoma extending from the umbilical region to the mid-thigh ...

    African Journals Online (AJOL)

    They commonly arise from the cranial nerves as acoustic schwannomas and are extremely rare in the pelvis and retroperitoneal area (<0.5% of reported cases) unless they are combined with Von Recklinghausen disease (type 1 neurofibromatosis). We report the case of a 23-year-old woman with a mass extending from the ...

  17. 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.

  18. A Rare Case of Vagus Nerve Schwannoma Presenting as a Neck Mass.

    Science.gov (United States)

    Ramdass, Adesh A; Yao, Mike; Natarajan, Suneetha; Bakshi, Parampreet K

    2017-08-21

    BACKGROUND Vagus nerve schwannoma is a benign neoplasm that usually presents as an asymptomatic slow growing mass, and its presentation as a neck mass is rare. The diagnosis can be difficult to make and complete surgical excision is challenging due to the proximity of the vagus nerve fibers from which it originates. The most common symptom associated with vagus nerve schwannoma arising in the neck is hoarseness due to vocal cord palsy. CASE REPORT We report a case of a 55-year-old woman who presented to the clinic complaining of throat irritation and feeling of something stuck in her throat for the past three months. On examination, a bulging left parapharyngeal mass was noted, displacing the left tonsil and uvula medially. A contrast-enhanced computed tomography (CT) scan of the neck showed a large, hypervascular soft tissue mass with splaying of the left internal carotid artery. Intraoperatively, the tumor was found to be arising from the vagus nerve. Macroscopic surgical pathology examination showed a tan-red, ovoid, and firm mass. Histopathology showed a benign spindle cell tumor with Antoni A areas with palisading cell nuclei and some degenerative change, confirming the diagnosis of vagus nerve schwannoma. CONCLUSIONS Vagus nerve schwannomas should be distinguished from other tumors that arise in the neck before planning surgery, to minimize the risk of nerve injury. Physicians need to be aware of the differential diagnosis of a neck mass, investigations required, the surgical treatment and the potential postoperative complications.

  19. Melanotic schwannoma of the lumbar spine: a case report and literature review

    Directory of Open Access Journals (Sweden)

    João Bernardo Sancio Rocha Rodrigues

    2015-06-01

    Full Text Available Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots. The melanotic schwannoma is a variant of these tumors whose location in almost one third of cases is on the posterior spinal nerve root, with a nonspecific clinical presentation. Magnetic resonance imaging is the most widely used test for the diagnosis, revealing hyperintense T1-weighted sequences and hypointense T2-weighted sequences. Diagnostic confirmation is obtained by histological and immunohistochemical studies, in which there is intense cytoplasmatic pigmentation. There are two distinct types of melanotic schwannomas: sporadic and psammomatous, the latter related to the called Carney complex, a form of multiple endocrine neoplasm with familiar character. In literature we found few cases of these neoplasms, the largest series consisting of five cases. The objective of this study is to report a rare case of melanotic schwannoma of the lumbar spine of the sporadic type of extramedullary location. We also present a brief review of the literature containing the main characteristics of the tumor, including its different forms, differential diagnoses, data from histological and immunohistochemical studies as well as the currently recommended approach in order to contribute to a better understanding of this neoplasm.

  20. 50 CFR 216.107 - Incidental harassment authorization for Arctic waters.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Incidental harassment authorization for... Incidental to Specified Activities § 216.107 Incidental harassment authorization for Arctic waters. (a... authorized under § 216.105, incidental harassment authorizations may be issued, following a 30-day public...

  1. Autosomal-dominant osteopetrosis: An incidental finding

    Directory of Open Access Journals (Sweden)

    Rajathi Maria

    2010-01-01

    Full Text Available Osteopetrosis is a descriptive term that refers to a group of rare, heritable disorders of the skeleton. Osteopetrotic conditions vary greatly in their presentation and severity, from just as an incidental finding on radiographs to causing life-threatening complications such as bone marrow suppression. It is caused by failure of osteoclast development and function. Osteopetrosis can be inherited as autosomal-recessive, autosomal-dominant or as X-linked traits, with the most severe forms being the autosomal-recessive ones. The severity of the disease is mild to moderate in the autosomal-dominant forms, with normal life expectancy. Diagnosis is largely based on clinical and radiographic evaluation. The present paper reports a case of autosomal-dominant osteopetrosis complicated by osteomyelitis with a short review of the condition.

  2. Incidental bony pathology when reporting trauma orthopantomograms

    Energy Technology Data Exchange (ETDEWEB)

    Macanovic, M., E-mail: mladenmaca@gmail.co [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Gangidi, S.; Porter, G.; Brown, S.; Courtney, D. [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Porter, J. [Community Dental Service, Plymouth Primary Care Trust, Plymouth, Devon (United Kingdom)

    2010-10-15

    Radiologists frequently report orthopantomograms (OPTs) and other views of the mandible, most often in patients who have suffered facial trauma. These examinations may reveal incidental pathology. It is important that radiologists are aware of the radiological appearances and the clinical significance of these lesions. In this review we will present examples of the more common odontogenic lesions including: radicular cyst, odontogenic keratocyst, dentigerous cyst, ameloblastoma, and also examples of non-odontogenic pathology: bisphosphonate-related osteonecrosis of the jaw (BRONJ) and chronic osteomyelitis. Although some of the lesions will require computed tomography (CT) or magnetic resonance imaging (MRI) for further lesion characterization and evaluation of the surrounding tissues, we are going to focus on the plain film appearances. We will also briefly discuss the pathogenesis, epidemiology, and treatment of these lesions.

  3. Incidental Reflector Comparison of Containerized Dry Fire Extinguishing Agents

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Bryan Scott [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wysong, Andrew Russell [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-14

    This document addresses the incidental reflector reactivity worth of containerized fire extinguishing agents authorized for use in PF-4 at Los Alamos National Laboratory (LANL). The intent of the document is to analyze dry fire extinguishing agent that remains in a container and is not actively being used in a fire emergency. The incidental reflector reactivity worth is determined by comparison to various thicknesses of close fitting water reflection which is commonly used to bound incidental reflectors in criticality safety evaluations. The conclusion is that even in unlimited quantities, when containerized the authorized dry fire extinguishing agents are bound by 0.4 inches of close fitting water.

  4. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

    Science.gov (United States)

    Saman, Yougan; Mclellan, Lucie; Mckenna, Laurence; Dutia, Mayank B; Obholzer, Rupert; Libby, Gerald; Gleeson, Michael; Bamiou, Doris-Eva

    2016-01-01

    Evidence is emerging for a significant clinical and neuroanatomical 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. (1) 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. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS 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 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 afterward 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 patients with VS in situ 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. In Experiment 1, a significant difference (p handicap (p < 0.001). Anxiety

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

    Science.gov (United States)

    Schüz, Joachim; Steding-Jessen, Marianne; Hansen, Søren; Stangerup, Sven-Eric; Cayé-Thomasen, Per; Johansen, Christoffer

    2010-12-01

    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 35 308 974 person-years under risk, with data accrued from 1993 to 2006. Complete ascertainment of cases was ensured by using population-based and clinical cancer registries. Information on sociodemographic indicators was obtained on an annually updated individual level from Statistics Denmark. Log-linear Poisson regression models were used to estimate incidence rate ratios (IRRs). Linear regression models were used to examine the association between sociodemographic indicators and tumor size. We found that IRRs decreased gradually with decreasing level of education, with values of 0.62 (95% CI: 0.49-0.78) for men and 0.62 (95% CI: 0.50-0.77) for women with a basic education compared with a higher education. Similar results were found for disposable income. Marital status was associated with a higher incidence of VS in men but not women; nonmarried men with a basic education had an IRR of 0.34 (95% CI: 0.23-0.50) compared with married men with a higher education. Lower incidence rates were also observed among unemployed or early-retirement pensioners, whereas there were no differences in incidence rates across the broad groups of occupations and across the types of districts. Sociodemographic indicators were not associated with the tumor size. The magnitude of the differences in incidence rates across the groups of different socioeconomic indicators suggests a high potential for earlier diagnosis of VS by improving the awareness of early symptoms.

  6. Vestibular schwannoma management: Part II. Failed radiosurgery and the role of delayed microsurgery.

    Science.gov (United States)

    Pollock, Bruce E; Lunsford, L Dade; Kondziolka, Douglas; Sekula, Raymond; Subach, Brian R; Foote, Robert L; Flickinger, John C

    2013-12-01

    The indications, operative findings, and outcomes of vestibular schwannoma microsurgery are controversial when it is performed after stereotactic radiosurgery. To address these issues, the authors reviewed the experience at two academic medical centers. During a 10-year interval, 452 patients with unilateral vestibular schwannomas underwent gamma knife radiosurgery. Thirteen patients (2.9%) underwent delayed microsurgery at a median of 27 months (range 7–72 months) after they had undergone radiosurgery. Six of the 13 patients had undergone one or more microsurgical procedures before they underwent radiosurgery. The indications for surgery were tumor enlargement with stable symptoms in five patients, tumor enlargement with new or increased symptoms in five patients, and increased symptoms without evidence of tumor growth in three patients. Gross-total resection was achieved in seven patients and near-gross-total resection in four patients. The surgery was described as more difficult than that typically performed for schwannoma in eight patients, no different in four patients, and easier in one patient. At the last follow-up evaluation, three patients had normal or near-normal facial function, three patients had moderate facial dysfunction, and seven had facial palsies. Three patients were incapable of caring for themselves, and one patient died of progression of a malignant triton tumor. Failed radiosurgery in cases of vestibular schwannoma was rare. No clear relationship was demonstrated between the use of radiosurgery and the subsequent ease or difficulty of delayed microsurgery. Because some patients have temporary enlargement of their tumor after radiosurgery, the need for surgical resection after radiosurgery should be reviewed with the neurosurgeon who performed the radiosurgery and should be delayed until sustained tumor growth is confirmed. A subtotal tumor resection should be considered for patients who require surgical resection of their tumor after

  7. Quality of Life in 807 Patients with Vestibular Schwannoma: Comparing Treatment Modalities.

    Science.gov (United States)

    Soulier, Géke; van Leeuwen, Bibian M; Putter, Hein; Jansen, Jeroen C; Malessy, Martijn J A; van Benthem, Peter Paul G; van der Mey, Andel G L; Stiggelbout, Anne M

    2017-07-01

    Objective In vestibular schwannoma treatment, the choice among treatment modalities is controversial. The first aim of this study was to examine the quality of life of patients with vestibular schwannoma having undergone observation, radiation therapy, or microsurgical resection. The second aim was to examine the relationship between perceived symptoms and quality of life. Last, the association between quality of life and time since treatment was studied. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods A total of 1208 patients treated for sporadic vestibular schwannoma between 2004 and 2014 were mailed the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and additional questions on symptoms associated with vestibular schwannoma. Total and domain scores were calculated and compared among treatment groups. Propensity scores were used, and results were stratified according to tumor size to control for potential confounders. Correlations were calculated to examine the relationship between self-reported symptoms and quality of life, as well as between quality of life and time since treatment. Results Patients with small tumors (≤10 mm) under observation showed a higher PANQOL score when compared with the radiation therapy and microsurgical resection groups. A strong negative correlation was found between self-reported symptoms and quality of life, with balance problems and vertigo having the largest impact. No correlation was found between PANQOL score and time since treatment. Conclusion This study suggests that patients with small vestibular schwannomas experience better quality of life when managed with observation than do patients who have undergone active treatment.

  8. Favorable Swallowing Outcomes following Vagus Nerve Sacrifice for Vagal Schwannoma Resection.

    Science.gov (United States)

    Patel, Mira A; Eytan, Danielle F; Bishop, Justin; Califano, Joseph A

    2017-02-01

    Objective To determine the impact of unilateral vagal sacrifice for vagal schwannoma on postoperative swallowing function. Study Design Case series, chart review. Setting Academic medical institution. Subjects and Methods Ten patients underwent vagus nerve sacrifice for vagal schwannoma resection. Archived pathology records dating from 1985 through 2012 at our institution were retrospectively queried for cases of vagal schwannoma with vagus nerve sacrifice. Medical records were abstracted for demographic and disease information as well as cranial nerve and swallowing function. Preoperative and postoperative cranial nerve function, subjective and objective measures of swallowing function, Functional Oral Intake Scale (FOIS) level, and need for vocal fold medialization were variables collected. Data were analyzed with summary statistics. Results The patients who underwent vagal sacrifice for vagal schwannoma at our institution had a mean age of 42.3 years (median, 44 years; range, 15-63 years) and follow-up of 35.6 months (median, 9 months; range, 1-115 months). Most presented with no preoperative cranial nerve deficit or difficulty swallowing. Immediately postoperatively, 90% had a vagus nerve deficit, but 50% had no subjective difficulty swallowing, and 70% had a FOIS level of 7 at postoperative hospital discharge. Within 1 month after surgery, 70% had normal swallowing function according to a modified barium swallow study. A full diet was tolerated by mouth within an average of 2.7 days (median, 2 days; range, 1-6 days) after surgery in this cohort. Seventy percent required vocal fold medialization postoperatively for incomplete glottic closure. Conclusion Vagal nerve sacrifice during resection of vagal schwannoma can be performed with normal postoperative swallowing function.

  9. 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

  10. Merlin/NF2 regulates angiogenesis in schwannomas through a Rac1/semaphorin 3F-dependent mechanism.

    Science.gov (United States)

    Wong, Hon-Kit; Shimizu, Akio; Kirkpatrick, Nathaniel D; Garkavtsev, Igor; Chan, Annie W; di Tomaso, Emmanuelle; Klagsbrun, Michael; Jain, Rakesh K

    2012-02-01

    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. Laparoscopic management of an obturator schwannoma mimicking a lymph node metastasis in a patient with renal cell carcinoma: case report

    Directory of Open Access Journals (Sweden)

    Burhan Coskun

    2016-12-01

    Full Text Available Obturator nerve schwannoma is a rare condition. Preoperative imaging modalities may not able to provide an accurate diagnosis in these masses. Here, we report laparoscopic management of an obturator nerve schwannoma in a 47-year-old man, which was initially considered lymph node metastasis of renal cell carcinoma. The patient had no complication and neurological deficit. He was recurrence free at one-year follow up.

  12. 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.

  13. 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....

  14. Incidental identification of Strongyloides stercoralis infection by broad-range 28S rDNA gene sequencing in a patient with a hematolymphoid malignancy.

    Science.gov (United States)

    Konnick, Eric Q; Chow, Siu-Kei; Reder, Nicholas P; Sengupta, Dhruba J; Hoogestraat, Daniel R; Pottinger, Paul S; Abbott, April N; Monsaas, Peter W; Kurosawa, Kyoko; Stephens, Karen; Salipante, Stephen J; Yeung, Cecilia C S

    2016-12-01

    Strongyloides stercoralis is an important human parasite, especially in rural areas and developing countries. Infected immunosuppressed patients are at risk for hyperinfection, with severe clinical consequences. Here we describe the incidental detection and diagnosis of an unexpected S. stercoralis infection by methods designed to detect fungal 28S ribosomal DNA. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Fostering incidental experiences of nature through green infrastructure planning

    DEFF Research Database (Denmark)

    Beery, Thomas H; Raymond, Christopher M; Kyttä, Marketta

    2017-01-01

    Concern for a diminished human experience of nature and subsequent decreased human well-being is addressed via a consideration of green infrastructure's potential to facilitate unplanned or incidental nature experience. Incidental nature experience is conceptualized and illustrated in order...... to consider this seldom addressed aspect of human interaction with nature in green infrastructure planning. Special attention has been paid to the ability of incidental nature experience to redirect attention from a primary activity toward an unplanned focus (in this case, nature phenomena). The value...... of such experience for human well-being is considered. The role of green infrastructure to provide the opportunity for incidental nature experience may serve as a nudge or guide toward meaningful interaction. These ideas are explored using examples of green infrastructure design in two Nordic municipalities...

  16. 76 FR 18232 - Marine Mammals; Incidental Take During Specified Activities

    Science.gov (United States)

    2011-04-01

    ... through this authorization process. This authorization establishes monitoring and reporting requirements... harassment authorization; request for comments. SUMMARY: We, the Fish and Wildlife Service (Service), have... harassment incidental to airport construction on Akun Island and hovercraft operation between Akun Island and...

  17. Incidental right Bochdalek hernia with interruption of the inferior ...

    African Journals Online (AJOL)

    Incidental right Bochdalek hernia with interruption of the inferior vena cava and ... SA Journal of Radiology ... A 36-year-old asymptomatic female had a routine chest radiograph to exclude pulmonary tuberculosis, as part of an employee ...

  18. Incidental mortality of seabirds in selected commercial fisheries in Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Fishery-seabird observers monitored the incidental mortality of seabirds between 1989 and 1993 in three groundfish longline, trawl, and pot fisheries in the Bering...

  19. Neurinoma del plexo braquial simulando metastasis de adenocarcinoma de mama Schwannoma of the brachial plexus resembling a breast adenocarcinoma metastasis

    Directory of Open Access Journals (Sweden)

    Gregorio Rodríguez Boto

    2011-10-01

    Full Text Available Los neurinomas del plexo braquial son tumores infrecuentes que pueden confundirse con otras lesiones de índole tumoral. Se presenta el caso de una mujer de 40 años, tratada previamente de un adenocarcinoma de mama derecha en el pasado, que en el estudio de extensión realizado 5 años después se detectó una lesión localizada en el plexo braquial derecho. La paciente se encontraba asintomática. El diagnóstico radiológico de presunción fue metástasis de adenocarcinoma mamario. Se realizó un abordaje axilar derecho descubriendo una lesión bien delimitada en el plexo braquial. Con ayuda de la monitorización neurofisiológica intraoperatoria, se observó que la lesión dependía de la rama cubital y se pudo realizar una resección completa preservando la función de dicho nervio. El estudio anatomopatológico confirmó que se trataba de un neurinoma, descartando así la existencia de metástasis. La evolución postoperatoria fue satisfactoria. Seis años después de la intervención no existe recidiva tumoral. En nuestro conocimiento este es el primer caso publicado en la literatura de un neurinoma del plexo braquial dependiente de la rama cubital. La monitorización neurofisiológica intraoperatoria resulta fundamental para abordar este tipo de lesiones con baja morbilidad.Schwa nomas originating from the brachial plexus, although rare, may be mistaken for another type of tumour. A 40 year-old woman, who had been treated years earlier for a breast adenocarcinoma, showed in the 5-year follow-up magnetic resonance examination a localized lesion in the right brachial plexus. The presumptive radiological diagnosis was a metastasis from the primary adenocarcinoma. Following surgical access via the right axilla, a well-circumscribed mass in the brachial plexus was detected. Under intraoperative electrophysiological guidance, the lesion was observed to depend on the ulnar nerve and its complete resection was possible without compromising nerve

  20. Cooperative Research to Evaluate an Incidental Catch Distribution Forecast

    Directory of Open Access Journals (Sweden)

    Sara M. Turner

    2017-05-01

    Full Text Available Concern over incidental catches in commercial fisheries has been increasing, and while simple mitigation strategies have been effective, few effective mitigation strategies have been established for more complex species interactions. Incidental catches of alewife (Alosa pseudoharengus and blueback herring (A. aestivalis in the commercial Atlantic herring (Clupea harengus fishery have received substantial attention on the Northeast U.S. continental shelf, despite an existing bycatch avoidance program. This study evaluates the utility of existing species distribution forecasts to predict river herring catches in the southern New England small mesh bottom trawl Atlantic herring fishery, with the ultimate goal of incorporating incidental catch forecasts into the bycatch avoidance program. Commercial Atlantic herring bottom trawl vessels assisted with field-based evaluation of alewife, blueback herring, and Atlantic herring species distribution forecast models. Vessels were equipped with conductivity, temperature, and depth probes, and sampling occurred throughout the fishery season (January–March. Locations of expected low and high forecasted incidental catches were sampled, as well as locations the captain expected to find low and high incidental catches. This allowed us to sample within the spatial area the fishery occurs, and to evaluate the forecasted conditions, and predictions, at the spatial scale of the fishery. Catch differences between high and low probability stations were small and variable, as were differences in modeled probability of species presence. No differences were observed between observations at model-predicted stations and captain-selected stations. The sampling provided a better understanding of the potential effectiveness of distribution forecasts for further reducing incidental catches. Existing models have limited use at the spatial scale of this fishery, but could be improved by developing models with fishery

  1. Esplenectomía incidental: ¿Está justificada?

    Directory of Open Access Journals (Sweden)

    Eddy Sierra Enrique

    1997-12-01

    Full Text Available Se revisaron 77 historias clínicas de pacientes que presentaban lesiones incidentales del bazo ocurridas entre 1985 y 1994, durante operaciones intraabdominales y por examen laparoscópico. Las funciones inmunológicas del bazo y su papel contra las infecciones están bien definidas, por lo cual al ser suprimido este órgano a consecuencia de lesiones incidentales, favorecen las infecciones en dichos pacientes de por vida. De las 77 lesiones incidentales se realizaron 47(61 % esplenectomías incidentales y 30(39 % cirugías conservadoras. La úlcera duodenal y la hernia hiatal son las causas principales de esplenectomía incidental. Se presentaron 11 infecciones (23,4 % y 1 fallecido (2,1 % en la esplenectomía incidental contra 1 infección (3,3 % y ningún fallecido en la cirugía conservadora. Se llega a la conclusión de que la esplenectomía no está justificada dadas las desventajas que presenta77 medical histories of patients who presented incidental injuries of the spleen occurred between 1985 and 1994, during intraabdominal operations and by laparoscopic examination, were reviewed. The immunological functions of the spleen and its role against infections are well defined, so the removal of this organ due to incidental injuries favors the appearance of infections in these patients for the rest of their lives. Of the 77 incidental injuries 47 (61 % incidental splenectomies and 30 (39 % conservative surgeries were performed. Duodenal ulcer and hiatal hernia proved to be the main causes of incidental splenectomy. There were 11 infections (23.4 % and 1 death (2.1 % in the incidental splenectomy compared with 1 infection (3.3 % and no death in the conservative surgery. It is concluded that splenectomy is not justified because of its disadvantages

  2. An interpretation on Aristotle's concept of incidental perception

    OpenAIRE

    堀江, 聡

    1986-01-01

    In De Anima B6, Aristotle divides objects of perception into essential and incidental ones. Furthermore, he divides objects of incidental perception into three kinds. (1) common objects, (2) proper objects of heterogeneous perception, and (3) objects such as "son of Diares". Many Commentators think that the latter two are irrelevant to Aristotle's theory of perception. I think, however, these kinds of perception play the most important part not only in recognizing the existence of individual ...

  3. Incidental mood state before dissonance induction affects attitude change.

    Science.gov (United States)

    Martinie, Marie-Amélie; Almecija, Yves; Ros, Christine; Gil, Sandrine

    2017-01-01

    The way that incidental affect impacts attitude change brought about by controlled processes has so far been examined when the incidental affective state is generated after dissonance state induction. We therefore investigated attitude change when the incidental mood occurs prior to dissonance state induction. We expected a negative mood to induce systematic processing, and a positive mood to induce heuristic processing. Given that both systematic processing and attitude change are cognitively costly, we expected participants who experienced the dissonance state in a negative mood to have insufficient resources to allocate to attitude change. In our experiment, after mood induction (negative, neutral or positive), participants were divided into low-dissonance and high-dissonance groups. They then wrote a counterattitudinal essay. Analysis of their attitudes towards the essay topic indicated that attitude change did not occur in the negative incidental mood condition. Moreover, written productivity-one indicator of cognitive resource allocation-varied according to the type of incidental mood, and only predicted attitude change in the high-dissonance group. Our results suggest that incidental mood before dissonance induction influences the style of information processing and, by so doing, affects the extent of attitude change.

  4. Olfactory dysfunction in incidental Lewy body disease and Parkinson's disease.

    Science.gov (United States)

    Driver-Dunckley, Erika; Adler, Charles H; Hentz, Joseph G; Dugger, Brittany N; Shill, Holly A; Caviness, John N; Sabbagh, Marwan N; Beach, Thomas G

    2014-11-01

    Olfactory dysfunction in Parkinson's disease (PD) is well-established and may represent one of the earliest signs of the disease. The objective of this study was to evaluate the relationship of olfactory dysfunction, using the University of Pennsylvania Smell Identification Test (UPSIT), to clinical and pathological parameters of clinicopathologically diagnosed PD (n = 10), incidental Lewy body disease (ILBD) (n = 13), and identically assessed controls who lacked a neurodegenerative disease (n = 69). Mean UPSIT scores were significantly lower in PD (16.3, p < 0.001) and ILBD (22.2, p = 0.004) compared to controls (27.7). Using an UPSIT cutoff score of <22 (the 15th percentile) the sensitivity for detecting PD was 9/10 (90%) and ILBD 6/13 (46%), while the specificity was 86% (Controls with score of <22 = 10/69). These results add to the growing body of evidence suggesting that olfactory testing could be useful as a screening tool for identifying early, pre-motor PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Incidental learning and memory for three basic tastes in food.

    Science.gov (United States)

    Köster, M A; Prescott, J; Köster, E P

    2004-06-01

    Forty three subjects were invited under the pretence that they would take part in an experiment on hunger feelings. They came without having eaten anything that morning and received a standard breakfast containing orange juice, cream cheese on crackers and yoghurt. These products were later (when subjects returned after scoring hunger feelings during the day) used as targets amidst a set of distractors varied by adding or subtracting different amounts of two basic tastes. Orange juice was varied in sweetness and bitterness, cream cheese in sourness and bitterness and yoghurt in sweetness and sourness. The changes were made comparable by using just noticeable differences, determined in preliminary experiments with other subjects, as units of change. Two measurements of memory were compared, an absolute (indicating which were the targets) and a relative one (indicating whether the targets and distractors were more, less or equally pleasant, sweet, sour, bitter or salty as the item eaten at breakfast). Both methods showed incidental learning, but relative memory was superior. Memory differed between tastes and was partly product dependent. These experiments suggest that taste memory is tuned to detect novel and potentially dangerous stimuli rather than to remember features of earlier experienced stimuli with great precision.

  6. Gorlin syndrome – an incidental radiographic detection | Shetty | SA ...

    African Journals Online (AJOL)

    Gorlin-Goltz syndrome (also known as nevoid basal cell carcinoma syndrome) was first reported in 1894, but described by Gorlin and Goltz in 1960 as a distinct entity consisting of ectodermal and mesodermal abnormalities.1 It is an hereditary autosomal dominant disease with a prevalence estimated in various studies to ...

  7. 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

    2017-11-01

    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

  8. 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

  9. 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

  10. Incidental sounds of locomotion in animal cognition.

    Science.gov (United States)

    Larsson, Matz

    2012-01-01

    The highly synchronized formations that characterize schooling in fish and the flight of certain bird groups have frequently been explained as reducing energy expenditure. I present an alternative, or complimentary, hypothesis that synchronization of group movements may improve hearing perception. Although incidental sounds produced as a by-product of locomotion (ISOL) will be an almost constant presence to most animals, the impact on perception and cognition has been little discussed. A consequence of ISOL may be masking of critical sound signals in the surroundings. Birds in flight may generate significant noise; some produce wing beats that are readily heard on the ground at some distance from the source. Synchronization of group movements might reduce auditory masking through periods of relative silence and facilitate auditory grouping processes. Respiratory locomotor coupling and intermittent flight may be other means of reducing masking and improving hearing perception. A distinct border between ISOL and communicative signals is difficult to delineate. ISOL seems to be used by schooling fish as an aid to staying in formation and avoiding collisions. Bird and bat flocks may use ISOL in an analogous way. ISOL and interaction with animal perception, cognition, and synchronized behavior provide an interesting area for future study.

  11. Incidental Vocabulary Learning: A Semantic Field Approach

    Directory of Open Access Journals (Sweden)

    Parvaneh Khosravizadeh

    2011-10-01

    Full Text Available

    This study is an attempt to explore the difference between acquiring new words with different semantic fields to which they belong. In other words, the purpose of this study is to scrutinize the contribution of semantic field theory in learning new vocabulary items in an EFL setting. Thirty-eight students of three different levels of education took part in this research. They were exposed to some new words from four different semantic fields, and then they were tested on their acquisition of the words meaning. This exposure was through reading texts and the aim of reading was just comprehension, therefore the words were acquired incidentally. The outcome showed significant differences between groups with different levels of education regarding retention of words from different semantic fields.

  12. Incidental mastoid opacification in children on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Kuruva, Manohar [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States); Rettiganti, Mallikarjuna Rao [University of Arkansas for Medical Sciences and Arkansas Children' s Hospital Research Institute, Biostatistics Program, Department of Pediatrics, Little Rock, AR (United States); Qin, Curtis [Georgetown University Hospital, Radiology, Washington, DC (United States); Hegde, Shilpa V. [University of Pittsburgh Medical Centre, Section of Neuroradiology, Pittsburgh, PA (United States)

    2016-05-15

    The opacification the mastoid cavity is frequently reported by radiologists on cross-sectional imaging done for non-otological indications. It is well known that presence of fluid the mastoid does not amount to mastoiditis. This study seeks to provide an evidence-based confirmation of this known finding. The purpose of our study was to determine the prevalence of mastoid opacification in children undergoing outpatient brain MRI examination. Our study included 515 outpatient children who had brain MRI for indications other than mastoiditis or otitis media from January 2014 to March 2014. Children with history of skull base trauma or radiation were excluded. The age range was 15 days to 18 years. The overall prevalence of mastoid opacification was determined using one sample proportion and exact 95% Clopper-Pearson confidence intervals. The prevalence of mastoid opacification was analyzed based on gender, age and presenting symptoms using chi-square test of association. One hundred ten children (21.4%) had mastoid opacification. Younger patients tended to have higher opacification rates with the prevalence in children younger than 1 year of age and between 1 and 2 years of age as high as 41.7% (20/48) and 47.5% (38/80), respectively. The diagnosis of mastoiditis in children should not be based upon a radiologist's report of finding fluid or mucosal thickening in the mastoid air cells as incidental opacification the mastoid is seen frequently. (orig.)

  13. Incidental finding of a precaval right renal artery on CT: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hae Seung; Kim, Hyun Cheol; Shin, Hyeong Cheol; Kim, Young Hwa; Nam, Deok Ho; Kim, Il Young; Kim, Hyung Hwan; Bae, Won Kyung [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)

    2005-07-15

    The right renal artery passing anterior to the inferior vena cava is a rare variant of the normal renal arterial anatomy, and identifying this anomaly is important for the planning of minimally invasive renal surgery. The presence of this precaval right renal artery was detected on the contrast-enhanced CT scan by identifying the right renal artery passing anterior to the inferior vena cava. We report here on a case of a precaval right renal artery as a main supplying artery, and this was incidentally found on CT.

  14. An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus

    Energy Technology Data Exchange (ETDEWEB)

    Manoj, Krishnan Sarojam [Metroscans, Trivandrum (India); Krishnamoorthy, Thamburaj; Thomas, Bejoy; Kapilamoorthy, Tirur Raman [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India)

    2006-01-01

    An incidental persistent falcine sinus was detected in an otherwise normal brain on MRI in a 12-year-old girl who underwent imaging after clinical suspicion of acute disseminated encephalomyelitis. The falcine sinus was associated with a hypoplastic posterior third of the superior sagittal sinus and a dominant straight sinus. Generally, atresia or hypoplasia of the straight sinus is associated with a persistent falcine sinus in postnatal life; otherwise, the falcine sinus disappears before birth. We discuss the embryological basis for such an association in this case. (orig.)

  15. Robotic paravertebral schwannoma resection at extreme locations of the thoracic cavity.

    Science.gov (United States)

    Pacchiarotti, Giacomo; Wang, Michael Y; Kolcun, John Paul G; Chang, Ken Hsuan-Kan; Al Maaieh, Motasem; Reis, Victor S; Nguyen, Dao M

    2017-05-01

    Solitary paravertebral schwannomas in the thoracic spine and lacking an intraspinal component are uncommon. These benign nerve sheath tumors are typically treated using complete resection with an excellent outcome. Resection of these tumors is achieved by an anterior approach via open thoracotomy or minimally invasive thoracoscopy, by a posterior approach via laminectomy, or by a combination of both approaches. These tumors most commonly occur in the midthoracic region, for which surgical removal is usually straightforward. The authors of this report describe 2 cases of paravertebral schwannoma at extreme locations of the posterior mediastinum, one at the superior sulcus and the other at the inferior sulcus of the thoracic cavity, for which the usual surgical approaches for safe resection can be challenging. The tumors were completely resected with robot-assisted thoracoscopic surgery. This report suggests that single-stage anterior surgery for this type of tumor in extreme locations is safe and effective with this novel minimally invasive technique.

  16. 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.

  17. [Oculomotor nerve schwannoma in a child: Case report and literature review].

    Science.gov (United States)

    Jibia, A; Chenin, L; Lefranc, M; Peltier, J

    2015-08-01

    An isolated schwannoma of the oculomotor nerve is rare in children without an associated neurofibromatosis. A 13-year-old girl, with a previous medical history of migraine, was admitted for disabling ophthalmic migraine with oblique diplopia. The clinical examination showed a right incomplete ophthalmoplegia with reduced ipsilateral visual acuity (8/10). There was no particular skin reaction. The MRI revealed a right (isosignal-T1 and isosignal-T2) nodular schwannoma located within the cisternal segment of the oculomotor nerve. The angio-CT performed later confirmed the absence of any vascular malformation. The treatment consisted of analgesics and corticotherapy, with complete regression of symptoms three weeks later and a normal MRI follow-up. Therefore, radiosurgery was not performed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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

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

    1997-12-01

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

  19. Case Report: Facial Nerve Bifurcation Noted During Resection of Vestibular Schwannoma.

    Science.gov (United States)

    Sokolowski, Jennifer D; Ruhl, Douglas S; Kesser, Bradley W; Asthagiri, Ashok R

    2018-01-13

    Resection of cerebellopontine angle tumors is challenging because the proximity of the facial nerve puts it at risk of inadvertent injury and subsequent dysfunction. It is critical to consider variations in anatomy and be aware of the potential deviations in the course of the nerve in order to avoid damage. We present a case of a facial nerve bifurcation identified during resection of a vestibular schwannoma. This is the only reported case of proximal facial nerve bifurcation. We review what is known about variations in proximal facial nerve anatomy, the rates of facial nerve injury after schwannoma resection, and the importance of neuromonitoring in identifying the nerve and predicting function postoperatively. Ultimately, understanding possible anatomic variations in the nerve is critical to minimize iatrogenic injury during surgery.

  20. 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.

  1. ErbB2 Trafficking and Signaling in Human Vestibular Schwannomas

    Science.gov (United States)

    2009-10-01

    collaboration with Dr. John Lee. 2 We have already verified that our Ad-merlin vectors effectively replace merlin in these cells (Fig. 4) and will use...2008 17 The Laryngoscope Lippincott Williams & Wilkins © 2008 The American Laryngological, Rhinological and Otological Society, Inc. Fowler Award...breast cancer cells. J Biol Chem 2008;283:1026-33. 33. Moon KS, Jung S, Seo SK, et al. Cystic vestibular schwannomas: a possible role of matrix

  2. Preoperative Identification of Facial Nerve in Vestibular Schwannomas Surgery Using Diffusion Tensor Tractography

    OpenAIRE

    Choi, Kyung-Sik; Kim, Min-Su; Kwon, Hyeok-Gyu; Jang, Sung-Ho; Kim, Oh-Lyong

    2014-01-01

    Objective Facial nerve palsy is a common complication of treatment for vestibular schwannoma (VS), so preserving facial nerve function is important. The preoperative visualization of the course of facial nerve in relation to VS could help prevent injury to the nerve during the surgery. In this study, we evaluate the accuracy of diffusion tensor tractography (DTT) for preoperative identification of facial nerve. Methods We prospectively collected data from 11 patients with VS, who underwent pr...

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

    OpenAIRE

    Erika Celis-Aguilar; Luis Lassaletta; Miguel Torres-Martín; F. Yuri Rodrigues; Manuel Nistal; CASTRESANA, JAVIER S.; Javier Gavilan; Rey, Juan A.

    2012-01-01

    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 pl...

  4. Assessing Readability and Reliability of Online Patient Information Regarding Vestibular Schwannoma.

    Science.gov (United States)

    Spiers, Harry; Amin, Nikul; Lakhani, Raj; Martin, Andrew J; Patel, Parag M

    2017-12-01

    The aim of this study is to objectively assess the quality and readability of websites related to vestibular schwannomas. Patients are increasingly seeking information on confirmed or suspected diagnoses through the Internet. Clinicians are often concerned regarding the accuracy, quality, and readability of web-based sites. Online information relating to vestibular schwannoma was searched using the three most popular search engines. The terms "acoustic neuroma" and "vestibular schwannoma" were used. The top 50 results from each site were assessed for readability using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Gunning-Fog Index. Quality of website information was scored using the DISCERN tool. Of 300 search results analyzed, 58 separate appropriate websites were identified. The mean readability score using Flesch-Kincaid Grade Level was 10.27 (95% confidence interval [CI] 9.84-10.70). The mean Flesch Reading Ease Score was 48.75 (95% CI 46.57-50.92). The Gunning-Fog Index was 13.40 (95% CI 12.92-13.89). These scores equate to someone finishing secondary school/first year university student. DISCERN scores were highly variable but consistently demonstrated great variability in quality of information. Online patient information on vestibular schwannoma is highly variable in quality. Although there are a wide range of different websites easily available to patients on their condition and its treatment options, the information is written at a difficult level which may exceed the understanding level of many patients as it is written at a higher than average level of expected reading ability.

  5. Gastric malignant schwannoma presenting with upper gastrointestinal bleeding: a case report

    OpenAIRE

    Takemura, Masashi; Yoshida, Kayo; Takii, Mamiko; Sakurai, Katsunobu; Kanazawa, Akishige

    2012-01-01

    Abstract Introduction We report a case of gastric malignant schwannoma presenting with gastrointestinal bleeding. Case presentation A 70-year-old Japanese man presented with gastrointestinal bleeding to our hospital. Gastrointestinal endoscopy revealed a protruding lesion in the gastric body. Hematoxylin and eosin staining of biopsy specimens from this lesion revealed sheets of spindle cells. Immunohistochemistry revealed that these cells were positive for S-100 protein and negative for c-Kit...

  6. Endoscopic interventional treatment for gastric schwannoma: a single-center experience.

    Science.gov (United States)

    Li, Bin; Liang, Tiejun; Wei, Lili; Ma, Mingze; Huang, Ya; Xu, Hongwei; Shi, Xiuju; Qin, Chengyong

    2014-01-01

    Endoscopic Interventional Treatment is of little trauma and less complications in the treatment of gastric schwannoma and leads to faster recovery and fewer days of hospitalization. This study was aimed to investigate the safety and efficacy of endoscopic interventional therapy for gastric schwannoma, including endoscopic submucosal excavation, non-laparoscopic-assisted endoscopic full-thickness resection, endoscopic tunneling submucosal resection, and so on. Six patients of gastric schwannoma diagnosed by pathology examination were retrospectively analyzed ranging from Oct 2011 to Feb 2014 at Shandong Provincial Hospital affiliated to Shandong University. Five of the six patients accepted endoscopic interventional therapy. Among the five patients, there were four males and one female, aged from 48 to 65 years old (the average age was 58 ± 6.4). The lesions located at the fundus, the fundus-cardia, gastric body or gastric antrum, respectively, with the diameters ranged from 8 to 25 millimeter (the average was 17.1 ± 7.8 mm). All the patients were performed endoscopic interventional therapy successfully. Among five patients, one patient was treated by endoscopic tunneling submucosal resection, two by endoscopic submucosal excavation, and the other two were given endoscopic full-thickness resection. Operation duration was about 43 to 83 minutes (the average was 57.6 ± 16.1 minutes). The mass were completely removed, with limited bleeding. During the operation, perforation and pneumoperitoneum occurred in two patients, who finally recovered by endoscopic and conservative treatment. No bleeding, inflammation or infection occurred in these patients. The average follow-up time was (7.4 ± 4.4) months. Neither recurrence nor metastasis was found during follow-up. Endoscopic interventional therapy is a safe and effective treatment for gastric schwannoma.

  7. Increased growth rate of vestibular schwannoma after resection of contralateral tumor in neurofibromatosis type 2

    OpenAIRE

    Peyre, Matthieu; Goutagny, Stephane; Imbeaud, Sandrine; Bozorg-Grayeli, Alexis; Felce, Michele; Sterkers, Olivier; Kalamarides, Michel

    2011-01-01

    Surgical management of bilateral vestibular schwannomas (VS) in neurofibromatosis type 2 (NF2) is often difficult, especially when both tumors threaten the brainstem. When the largest tumor has been removed, the management of the contralateral VS may become puzzling. To give new insights into the growth pattern of these tumors and to determine the best time point for treatment (surgery or medical treatment), we studied radiological growth in 11 VS (11 patients with NF2) over a long period (me...

  8. 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.

  9. Incidental giant renal oncocytoma: a case report

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    Dimitriadis Georgios

    2010-11-01

    Full Text Available Abstract Introduction Large renal oncocytomas are not very rare entities. To the best of our knowledge, we report one of the largest oncocytomas in the English literature. The tumor was incidentally diagnosed and, based on the preoperative clinical and radiographic findings, was therefore considered to be a renal cell carcinoma. Case presentation A 48-year-old Caucasian diabetic man had an abdominal ultrasound for chronic abdominal discomfort, which revealed a large mass on the left kidney. An abdominal computed tomography scan revealed a contrast enhancing, well defined, heterogenous large mass (16.5 × 13.9 cm originating from the left lower pole with cystic and solid areas. A magnetic resonance imaging scan was performed with no evidence of renal vein or caval thrombus or embolus. A radical nephrectomy was performed through a left flank intercostal incision and the pathology diagnosed renal oncocytoma. The postoperative course was uneventful and the patient was discharged six days later. Conclusion Several reports have characterised this essentially benign renal histiotype, which represents 5% to 7% of all solid renal masses. Unfortunately, most renal oncocytomas cannot be differentiated from malignant renal cell carcinomas by clinical or radiographic criteria. Central stellate scar and a spoke-wheel pattern of feeding arteries are unreliable diagnostic signs and are of poor predictive value. These tumors are treated operatively with radical or partial nephrectomy or thermal ablation, depending on the clinical circumstances. We report on, to the best of our knowledge, the fourth largest lesion of this type of renal pathology.

  10. Extended lateral parascapular approach for resection of a giant multi-compartment thoracic schwannoma.

    Science.gov (United States)

    Vecil, Giacomo G; McCutcheon, Ian E; Mendel, Ehud

    2008-12-01

    Resection of giant thoracic schwannomas is challenging and usually requires a staged approach. The resection of the intraspinal component, usually via laminectomy, is done in one sitting and the intrathoracic component, via thoracotomy, follows at another. We describe the complete resection of a massive multi-compartmental thoracic schwannoma by an extended lateral parascapular approach. The tumor, which presented with local pain and scapular displacement, had intrathoracic paraspinal (10 x 5 x 4 cm), posterolateral upper thoracic paramuscular (19 x 7 x 4 cm), foraminal, and epidural components. It was removed at a single sitting, via a posterior extended lateral parascapular approach that did not require staged procedures, multiple incisions, or repositioning of the patient. This operation included resection of the thoracic, foraminal, and intraspinal components and posterior stabilization with pedicle screws and rods. There were no postoperative neurological complications. The extended lateral parascapular approach allows complete resection of giant multi-compartment schwannomas of the thoracic spine that extend from the canal into the thoracic cavity. It also permits posterior stabilization through the same incision used for tumor removal.

  11. Vestibular compensation after vestibular schwannoma surgery: normalization of the subjective visual vertical and disability.

    Science.gov (United States)

    Batuecas-Caletrio, Angel; Santacruz-Ruiz, Santiago; Muñoz-Herrera, Angel; Sousa, Pablo; Otero, Alvaro; Perez-Fernandez, Nicolas

    2013-05-01

    The degree of caloric weakness before surgery influences faster or slower recovery of patients undergoing vestibular schwannoma surgery. The Dizziness Handicap Inventory (DHI) is a good index to show the recovery of patients as it relates directly to an improvement or not of the subjective visual vertical (SVV). To evaluate the process of recovery of patients as measured by the SVV and the DHI after surgical removal of vestibular schwannoma. We studied 24 consecutive patients of the University Hospital of Salamanca who underwent vestibular schwannoma surgery. We assessed age, tumour size, degree of canalicular weakness and preoperative SVV, and their relationship with DHI and SVV at discharge and also at 1, 3 and 6 months postoperatively. Patients with lesser degrees of caloric weakness took longer to normalize SVV than those with a higher caloric weakness before surgery (p < 0.05). There was a significant correlation between DHI and improvements in SVV with time. The differences disappeared in 6 months where all patients, with greater or lesser degree of caloric weakness, had the same results.

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

    Science.gov (United States)

    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.

  13. 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.

  14. Correlations between postural control and psychological factors in vestibular schwannoma patients.

    Science.gov (United States)

    Ribeyre, Laurence; Spitz, Elisabeth; Frère, Julien; Gauchard, Gerome; Parietti-Winkler, Cécile

    2016-11-03

    Various individual factors have been described to influence postural performances related to vestibular schwannoma. However, psychological factors may also be involved in postural variations. To identify relationships between postural performances, illness perceptions, coping, anxiety-depression and quality of life of patients with vestibular schwannoma. Twenty-six patients who were scheduled for a surgical removal of a vestibular schwannoma underwent posturography tests and were asked to complete psychological questionnaires three days prior to surgery.The Sensory Organization Test, the Illness Perceptions Questionnaire-Revised, the Brief-COPE, the Hospital Anxiety Depression Scale and the World Health Organization Quality of Life instrument were used for assessments. Correlations between posturography and psychological questionnaires were calculated. Balance disorders were associated with (i) impaired quality of life of patients, (ii) anxiety and depression affects, (iii) greater daily consequences, and with (iv) denial coping response. Given the association between balance disorders and psychological factors, health practitioners should be attentive to the deterioration of both aforementioned issues.

  15. Malignancy in vestibular schwannoma after stereotactic radiotherapy: a case report and review of the literature.

    Science.gov (United States)

    Tanbouzi Husseini, Sami; Piccirillo, Enrico; Taibah, Abdelkader; Paties, Carlo T; Rizzoli, Roberto; Sanna, Mario

    2011-05-01

    A relation between conventional radiotherapy and the development of intracranial neoplasma is well known, but radiation-associated tumor following stereotactic radiotherapy of vestibular schwannoma is underestimated. In this article we will study this relation by doing a complete literature review on all the malignant intracranial tumors that appeared following radiosurgery and adding a case of malignant vestibular schwannoma following stereotactic radiotherapy in a Neurofibromatosis type 2 patient. Literature review and discussion. We found 26 cases of malignant brain tumor following stereotactic radiotherapy including our case. In 13 cases the tumor occurred in context of Neurofibromatosis type 2. None of the patients had a tumor size less than 2.5 cm. and the mean latency period between the radiotherapy and malignant tumor development was 5.8 years. Patients with vestibular schwannoma should be made aware of the low incidence of the radiation-induced malignant changes and long-term follow-up is mandatory. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  16. Development of drug treatments for neurofibromatosis type 2-associated vestibular schwannoma.

    Science.gov (United States)

    Blakeley, Jaishri

    2012-10-01

    To review the discoveries in molecular pathophysiology contributing to the development of neurofibromatosis type 2 (NF2)-associated vestibular schwannomas and the recent experiences with drug therapies for these tumors. The review includes discussion of diagnostic criteria for NF2, populations to clinically consider for drug therapy and drug targets currently under consideration for NF2. Increased insight into the complex pathways that underlie both the genetic syndrome of NF2 and the specific pathogenesis of vestibular schwannomas has highlighted multiple potential therapeutic targets. These discoveries have been translated into clinical trials with some early promising results. Inhibition of angiogenesis as well as regulation of mammalian target of rapamycin and the epidermal growth factor receptor family of receptors are the focus of current clinical investigations. Although a great deal of work is ongoing to understand the multiple effects of the lack of the regulating protein Merlin on tumorgenesis in patients with NF2, advances are ongoing with clinical therapeutics. There is cause for enthusiasm based on recent results with antiangiogenesis therapy in select patients with NF2 and progressive vestibular schwannomas; however, awareness of the notable risks and limitations of therapies currently in development is required.

  17. Unique Surgical Issues in the Management of a Giant Retroperitoneal Schwannoma and Brief Review of Literature

    Directory of Open Access Journals (Sweden)

    Santhosh Kuriakose

    2014-01-01

    Full Text Available Ancient Schwannoma, though benign, can cause diagnostic dilemma because of its clinical presentation and imaging features. We report the management of a giant retroperitoneal schwannoma in a 19-year-old young lady who presented with lower abdominal distension. CT scan reported a large heterogenous lesion in the abdominopelvic retroperitoneum (42 cm × 16 cm × 16 cm as a malignant tumor. The unique problems we encountered were the enormous size, the location of major part of the tumor in the pelvis, the need for fertility preservation, the external iliac vessels stretching over the tumor making mobilization surgically demanding, and the prospects of neurological deficits. An en bloc resection of schwannoma with common iliac, external iliac and internal iliac veins, internal iliac artery, femoral and obturator nerves, and iliopsoas muscle was done maintaining oncological principles. External iliac artery that was cut to facilitate tumor mobilization was reanastomosed at the end of the procedure. Postoperatively patient had uneventful recovery with patchy sensory loss, foot drop, and quadriceps weakness which was rehabilitated with a foot drop splint and active physiotherapy.

  18. Unique surgical issues in the management of a giant retroperitoneal schwannoma and brief review of literature.

    Science.gov (United States)

    Kuriakose, Santhosh; Vikram, Syam; Salih, Surij; Balasubramanian, Satheesan; Mangalasseri Pareekutty, Nizamudeen; Nayanar, Sangeetha

    2014-01-01

    Ancient Schwannoma, though benign, can cause diagnostic dilemma because of its clinical presentation and imaging features. We report the management of a giant retroperitoneal schwannoma in a 19-year-old young lady who presented with lower abdominal distension. CT scan reported a large heterogenous lesion in the abdominopelvic retroperitoneum (42 cm × 16 cm × 16 cm) as a malignant tumor. The unique problems we encountered were the enormous size, the location of major part of the tumor in the pelvis, the need for fertility preservation, the external iliac vessels stretching over the tumor making mobilization surgically demanding, and the prospects of neurological deficits. An en bloc resection of schwannoma with common iliac, external iliac and internal iliac veins, internal iliac artery, femoral and obturator nerves, and iliopsoas muscle was done maintaining oncological principles. External iliac artery that was cut to facilitate tumor mobilization was reanastomosed at the end of the procedure. Postoperatively patient had uneventful recovery with patchy sensory loss, foot drop, and quadriceps weakness which was rehabilitated with a foot drop splint and active physiotherapy.

  19. mTORC1 inhibition delays growth of neurofibromatosis type 2 schwannoma

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  1. Gastric schwannoma in a female patient with pulmonary tuberculosis - a clinicopathological assessment and diagnosis.

    Science.gov (United States)

    Tahir, Tariq Mahmood; Anwar, Sadia; Naseem, Nadia; Mansoor-Ul-Haq, Hafiz; Saqib, Muhammad

    2010-04-01

    Schwannomas, or neurinomas, are generally benign, slow-growing, asymptomatic neoplasms originating from the Schwann cells of a nerve sheath. As a part of spindle cell mesenchymal tumours, schwannomas arising from the gastrointestinal tract (GIT) are unusual; however, when they occur, the most common site involved is the stomach, which represents 0.2% of all gastric tumours. We report the case of a 35-year-old female patient with a history of pulmonary tuberculosis presenting with a large palpable abdominal mass reaching up to the peritoneal cavity. The initial clinical impression was a tuberculous abdominal mass, a cyst, or a teratoma. However, intra-operative findings during a subtotal gastrectomy revealed an exophytic gastric serosal mass, which suggested a gastrointestinal stromal tumour (GIST). Post-operative histopathological findings showed a fascicular arrangement of neoplastic spindle cells with pallisading nuclei that showed intense positivity for S-100 protein, and were negative for CD117 and desmin in immunohistochemistry studies. These results confirmed the final diagnosis of a gastric schwannoma.

  2. Gastric Schwannoma in a Female Patient with Pulmonary Tuberculosis — A Clinicopathological Assessment and Diagnosis

    Science.gov (United States)

    Tahir, Tariq Mahmood; Anwar, Sadia; Naseem, Nadia; Mansoor-Ul-Haq, Hafiz; Saqib, Muhammad

    2010-01-01

    Schwannomas, or neurinomas, are generally benign, slow-growing, asymptomatic neoplasms originating from the Schwann cells of a nerve sheath. As a part of spindle cell mesenchymal tumours, schwannomas arising from the gastrointestinal tract (GIT) are unusual; however, when they occur, the most common site involved is the stomach, which represents 0.2% of all gastric tumours. We report the case of a 35-year-old female patient with a history of pulmonary tuberculosis presenting with a large palpable abdominal mass reaching up to the peritoneal cavity. The initial clinical impression was a tuberculous abdominal mass, a cyst, or a teratoma. However, intra-operative findings during a subtotal gastrectomy revealed an exophytic gastric serosal mass, which suggested a gastrointestinal stromal tumour (GIST). Post-operative histopathological findings showed a fascicular arrangement of neoplastic spindle cells with pallisading nuclei that showed intense positivity for S-100 protein, and were negative for CD117 and desmin in immunohistochemistry studies. These results confirmed the final diagnosis of a gastric schwannoma. PMID:22135537

  3. mTORC1 inhibition delays growth of neurofibromatosis type 2 schwannoma.

    Science.gov (United States)

    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

    2014-04-01

    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. 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. 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. 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.

  4. Dose verification to cochlea during gamma knife radiosurgery of acoustic schwannoma using MOSFET dosimeter.

    Science.gov (United States)

    Sharma, Sunil D; Kumar, Rajesh; Akhilesh, Philomina; Pendse, Anil M; Deshpande, Sudesh; Misra, Basant K

    2012-01-01

    Dose verification to cochlea using metal oxide semiconductor field effect transistor (MOSFET) dosimeter using a specially designed multi slice head and neck phantom during the treatment of acoustic schwannoma by Gamma Knife radiosurgery unit. A multi slice polystyrene head phantom was designed and fabricated for measurement of dose to cochlea during the treatment of the acoustic schwannoma. The phantom has provision to position the MOSFET dosimeters at the desired location precisely. MOSFET dosimeters of 0.2 mm x 0.2 mm x 0.5 μm were used to measure the dose to the cochlea. CT scans of the phantom with MOSFETs in situ were taken along with Leksell frame. The treatment plans of five patients treated earlier for acoustic schwannoma were transferred to the phantom. Dose and coordinates of maximum dose point inside the cochlea were derived. The phantom along with the MOSFET dosimeters was irradiated to deliver the planned treatment and dose received by cochlea were measured. The treatment planning system (TPS) estimated and measured dose to the cochlea were in the range of 7.4 - 8.4 Gy and 7.1 - 8 Gy, respectively. The maximum variation between TPS calculated and measured dose to cochlea was 5%. The measured dose values were found in good agreement with the dose values calculated using the TPS. The MOSFET dosimeter can be a suitable choice for routine dose verification in the Gamma Knife radiosurgery.

  5. Fostering incidental experiences of nature through green infrastructure planning.

    Science.gov (United States)

    Beery, Thomas H; Raymond, Christopher M; Kyttä, Marketta; Olafsson, Anton Stahl; Plieninger, Tobias; Sandberg, Mattias; Stenseke, Marie; Tengö, Maria; Jönsson, K Ingemar

    2017-11-01

    Concern for a diminished human experience of nature and subsequent decreased human well-being is addressed via a consideration of green infrastructure's potential to facilitate unplanned or incidental nature experience. Incidental nature experience is conceptualized and illustrated in order to consider this seldom addressed aspect of human interaction with nature in green infrastructure planning. Special attention has been paid to the ability of incidental nature experience to redirect attention from a primary activity toward an unplanned focus (in this case, nature phenomena). The value of such experience for human well-being is considered. The role of green infrastructure to provide the opportunity for incidental nature experience may serve as a nudge or guide toward meaningful interaction. These ideas are explored using examples of green infrastructure design in two Nordic municipalities: Kristianstad, Sweden, and Copenhagen, Denmark. The outcome of the case study analysis coupled with the review of literature is a set of sample recommendations for how green infrastructure can be designed to support a range of incidental nature experiences with the potential to support human well-being.

  6. Patient- versus physician-reported facial disability in vestibular schwannoma: an international cross-sectional study.

    Science.gov (United States)

    Tveiten, Øystein Vesterli; Carlson, Matthew L; Goplen, Frederik; Myrseth, Erling; Driscoll, Colin L W; Mahesparan, Rupavathana; Link, Michael J; Lund-Johansen, Morten

    2017-11-01

    OBJECTIVE Patient-reported outcomes are increasingly used in studies of vestibular schwannoma (VS); however, few studies have examined self-evaluated facial nerve function and its relation to physician-reported outcomes. The primary objective of this study was to compare patient self-evaluations of facial disability with physician-evaluated facial nerve status and with self-evaluations of a healthy control group. The second objective was to provide insight into the controversial subject of the optimal initial management of small- and medium-sized VSs; consequently, the authors compared patient-reported facial nerve disability following treatment via observation (OBS), Gamma Knife surgery (GKS), or microsurgery (MS). Lastly, the authors sought to identify risk factors for facial nerve dysfunction following treatment for small- and medium-sized VSs. METHODS All patients with a VS 3 cm or smaller that was singly treated with OBS, GKS, or MS at either of 2 independent treatment centers between 1998 and 2008 were retrospectively identified. Longitudinal facial nerve measures and clinical data, including facial nerve evaluation according to the House-Brackmann (HB) grading system, were extracted from existing VS databases. Supplementing the objective data were Facial Disability Index (FDI) scores, which were obtained via survey of patients a mean of 7.7 years after initial treatment. RESULTS The response rate among the 682 eligible patients was 79%; thus, data from a total of 539 patients were analyzed. One hundred forty-eight patients had been managed by OBS, 247 with GKS, and 144 with MS. Patients who underwent microsurgery had larger tumors and were younger than those who underwent OBS or GKS. Overall, facial nerve outcomes were satisfactory following treatment, with more than 90% of patients having HB Grade I function at the last clinical follow-up. Treatment was the major risk factor for facial nerve dysfunction. Almost one-fifth of the patients treated with MS had

  7. Single-port transumbilical laparoscopic excision of retroperitoneal schwannoma mimicking a nonfunctional endocrine tumor in the body of the pancreas: a case report.

    Science.gov (United States)

    Kameyama, Noriaki; Tomita, Masato; Mitsuhashi, Hiroaki; Matsumoto, Nobuaki; Obuchi, Toru; Yoshikawa, Yusuke; Tagaya, Nobumi; Kitagawa, Yuko

    2013-12-01

    Schwannomas are benign tumors that arise from neural sheath Schwann cells. Solitary benign schwannoma is generally located in the head and neck and is a rare neoplasm among the tumors of the retroperitoneal space. Reports of laparoscopic excision of retroperitoneal schwannomas have recently been on the increase. However, few cases of single-port laparoscopic excision of these tumors have been reported. Moreover, there are no reports of single-port excision of schwannomas attached to the body of pancreas and around the splenic vessels. This is the first report of a schwannoma lying adjacent to the body of the pancreas between the splenic artery and vein that was excised by single-port laparoscopic surgery. The most notable aspect of our procedure is the use of bipolar forceps. Single-port laparoscopic excision using bipolar forceps is a feasible and safe procedure for retroperitoneal solitary tumors, even when they are close to the splenic artery and vein.

  8. Research malpractice and the issue of incidental findings.

    Science.gov (United States)

    Milstein, Alan C

    2008-01-01

    Human subject research involving brain imaging is likely to reveal significant incidental findings of abnormal brain morphology. Because of this fact and because of the fiduciary relationship between researcher and subject, board-certified or board-eligible radiologists should review the scans to look for any abnormality, the scans should be conducted in accordance with standard medical practice for reviewing the clinical status of the whole brain, and the informed consent process should disclose the possibility that incidental findings may be revealed and what consequences will follow. In the event such findings are revealed, qualified physicians should explain to the subject the significance of the findings and the alternatives available.

  9. Incidental findings in musculoskeletal radiology; Zufallsbefunde in der muskuloskeletalen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Wuennemann, F.; Rehnitz, C.; Weber, M.A. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2017-04-15

    Increasing numbers of conventional X-rays, computed tomography and magnetic resonance imaging in the inpatient, outpatient and scientific routine leads to an increasing number of incidental findings. The correct interpretation of these incidental findings with respect to the relevance and the evaluation concerning further work-up is an important task of radiologists. Description of common incidental findings in musculoskeletal imaging and their clinical classification. A PubMed literature search was performed using the following terms: incidental findings, population-based imaging, musculoskeletal imaging, non-ossifying fibroma, enchondroma, osteodystrophia deformans, chondrosarcoma, fibrous dysplasia, simple bone cyst, unicameral bone cyst, solitary bone cyst, aneurysmal bone cyst, vertebral hemangioma, bone island, osteopoikilosis, Tarlov cyst and diffuse idiopathic skeletal hyperostosis (DISH). Incidental findings are observed in up to 40% of imaging procedures. In up to 6% these incidental findings involve the skeletal system. Common incidental findings are discussed and their clinical relevance is explained. (orig.) [German] Mit steigender Menge an konventionellen Roentgen- sowie CT- und MRT-Bildern im stationaeren, ambulanten und wissenschaftlichen Alltag steigt unweigerlich auch die Zahl der Zufallsbefunde. Die korrekte Einordnung bzgl. deren Relevanz, ob eine weitere Abklaerung notwendig ist oder nicht, stellt eine wichtige Aufgabe des Radiologen dar. Vorstellung haeufiger Zufallsbefunde des muskuloskeletalen Systems und deren klinische Einordnung. Pubmed-Literaturrecherche zu den Stichworten ''incidental findings'', ''population-based imaging'', ''musculoskeletal imaging'', ''non-ossifying fibroma'', ''enchondroma'', ''osteodysthrophia deformans'', ''chondrosarcoma'', ''fibrous dysplasia'', &apos

  10. A Review of Effect of Different Tasks on Incidental Vocabulary Acquisition

    Science.gov (United States)

    Liu, Chen L.

    2015-01-01

    Studies of incidental vocabulary acquisition in second language learning have got more and more attention both at home and abroad. By first introducing the definition and theoretical foundations of incidental vocabulary acquisition, this paper reviews empirical studies of effect of different tasks on incidental vocabulary acquisition and points…

  11. 50 CFR 216.108 - Requirements for monitoring and reporting under incidental harassment authorizations for Arctic...

    Science.gov (United States)

    2010-10-01

    ... under incidental harassment authorizations for Arctic waters. 216.108 Section 216.108 Wildlife and... for monitoring and reporting under incidental harassment authorizations for Arctic waters. (a) Holders of an incidental harassment authorization in Arctic waters and their employees, agents, and designees...

  12. 75 FR 20344 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Rocket Launches from...

    Science.gov (United States)

    2010-04-19

    ... Marine Mammals Incidental to Rocket Launches from Kodiak, AK AGENCY: National Marine Fisheries Service... (Eumetopias jubatus) and Pacific harbor seals (Phoca vitulina richardsi) incidental to rocket launches from... Steller sea lions and harbor seals, by harassment, incidental to rocket launches at KLC, became effective...

  13. 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.

  14. Removal of pelvic schwannoma using a retroperitoneoscopic and open double approach: description of an effective novel technique.

    Science.gov (United States)

    Lacarriere, Emeric; Le Long, Erwann; Caremel, Romain; Grise, Phillippe

    2012-04-01

    Schwannomas are rare tumors and are exceptionally retroperitoneal. In the event of clinical signs or uncertainty in the diagnosis, their removal is justified. A risk of neoplastic transformation exists. Three patients had a retroperitoneal schwannoma located next to or under the sacral promontory. A double approach using an initial retroperitoneoscopy and an iliac abdominal incision had been decided preoperatively. This approach has not been described previously in the medical literature. The double approach enabled the complete removal of tumors in all patients. The iliac incision, described within, enabled the removal of the tumors despite major attachments and difficulties in exposure, due to the tumors' distal situations. A double approach by retroperitoneoscopy and laparotomy can enable removal of difficult low-seated retroperitoneal schwannomas without increasing intraoperative risk or perioperative morbidity.

  15. INCIDENCE AND CLINICAL COURSE OF INCIDENTAL PROSTATIC ADENOCARCINOMA: A PROSPECTIVE INDIAN STUDY

    Directory of Open Access Journals (Sweden)

    Bikram

    2015-10-01

    Full Text Available BACKGROUND: Incidental Prostatic adenocarcinoma (IPC or Prostatic Incidentalomas are early stage cancers which are clinically silent and are incidentally diagnosed at histopathological study of operated specimens of benign prostatic disease or screen - detected in asymptomatic individuals . This study investigates the incidence of IPC i n operated specimens of patients with benign prostatic hyperplasia and their clinical behaviour. MATERIALS AND METHODS: Operated specimens (both Open Prostatectomy and Transurethral Resection of Prostate [TURP] of all patients with benign prostatic hyperpl asia treated in VSS medical college between 2010 - 2015, were studied prospectively for evidence of IPC on histopathology and the cases were followed up to a period of five years. RESULTS: The incidence of IPC came out to be 6% (12 out of 200 cases. Eight c ases (66.67% were found in the 8 th decade. The average IPSS (International Prostate Symptom Score score of cases with IPC was 18, compared to 13.76 in cases with BPH. All the cases with IPC had a serum PSA (Prostate Specific Antigen value more than 10ng /ml while, only 10.6% (20 out of 198 of cases with BPH had values more than 10ng/ml. Average weight of the enucleated specimens in cases of IPC was 37gm whereas that of cases with BPH was 44.58gm. Again, the average weight of TURP specimens in cases of IP C was 35 gm whereas that of cases with BPH was 27.88gm. In none of the cases of IPC there was any evidence of local recurrence or metastases during this follow up either clinically or radiologically or by other laboratory investigations. CONCLUSION: A majo rity of these patients with incidentally diagnosed disease having carcinomatous focus in the enucleated prostate, do not exhibit disease progression and therefore these patients do not necessarily require any specific therapy other than a “wait and watch” policy

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

    Science.gov (United States)

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

    2015-01-24

    A clinical overlap exists between mosaic Neurofibromatosis Type 2 and sporadic Schwannomatosis conditions. In these cases a molecular analysis of tumors is recommended for a proper genetic diagnostics. This analysis is challenged by the fact that schwannomas in both conditions bear a somatic double inactivation of the NF2 gene. However, SMARCB1-associated schwannomas follow a four-hit, three-step model, in which both alleles of SMARCB1 and NF2 genes are inactivated in the tumor, with one of the steps being always the loss of a big part of chromosome 22 involving both loci. Here we report a 36-year-old woman who only presented multiple subcutaneous schwannomas on her right leg. To help discriminate between both possible diagnoses, an exhaustive molecular genetic and genomic analysis was performed on two schwannomas of the patient, consisting in cDNA and DNA sequencing, MLPA, microsatellite multiplex PCR and SNP-array analyses. The loss of a big part of chromosome 22 (22q12.1q13.33) was identified in both tumors. However, this loss involved the NF2 but not the SMARCB1 locus. SNP-array analysis revealed the presence of the same deletion breakpoint in both schwannomas, indicating that this alteration was actually the first NF2 inactivating hit. In addition, a distinct NF2 point mutation in each tumor was identified, representing independent second hits. In accordance with these results, no deletions or point mutations in the SMARCB1 gene were identified. None of the mutations were present in the blood. Two of the patient's children inherited chromosome 22 deleted in schwannomas of the mother, but in its wild type form. These results conclusively confirm the segmental mosaic NF2 nature of the clinical phenotype presented.

  17. Hydrocephalus associated with large vestibular schwannoma: Management options and factors predicting requirement of cerebrospinal fluid diversion after primary surgery

    Directory of Open Access Journals (Sweden)

    A R Prabhuraj

    2017-01-01

    Full Text Available Objective: Obstructive hydrocephalus (HCP related to vestibular schwannoma occurs in large tumors compressing the fourth ventricle. Symptoms related to HCP are expected to alleviate after resection of the tumor and decompression of the cerebrospinal fluid (CSF pathways. However, some patients may require permanent cerebrospinal diversion even after surgery due to persistent HCP. In this study, the authors try to find out the factors associated with the requirement of CSF diversion after vestibular schwannoma surgery in cases of persistent HCP. Materials and Methods: This was a retrospective study involving 193 cases of vestibular schwannoma operated between 2010 and 2013 in our institute. Cases that underwent ventriculoperitoneal (VP shunts before surgery were compared to cases which were operated directly. In cases where vestibular schwannomas were operated without prior VP shunts, factors which were associated with persistent postoperative HCP were analyzed. Results: Comparing the group who underwent direct surgery to the group who underwent VP shunt before definitive vestibular schwannoma surgery, the facial nerve preservation rates and surgical morbidity rates were comparable. In cases who underwent direct surgery, 10 out of 75 patients required postoperative permanent CSF diversion. Older age, male gender, duration of symptoms, larger tumor size, solid lesions, severe HCP, and clinical features of HCP were associated with postoperative requirement of CSF diversion but were not statistically significant. The most significant factor that correlated with the need for additional HCP treatment was the presence of postoperative hematoma of volume >10cc. Conclusions: Primary tumor removal is the optimal treatment for vestibular schwannoma associated with HCP. Postoperative hematoma may warrant close observation as these patients are at an increased risk of persistence of HCP.

  18. High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial

    Energy Technology Data Exchange (ETDEWEB)

    Treskes, K.; Bos, S.A.; Sierink, J.C.; Luitse, J.S.K.; Goslings, J.C. [Academic Medical Center, Trauma Unit, Department of Surgery, Amsterdam (Netherlands); Beenen, L.F.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Edwards, M.J.R. [Radboud University Medical Center, Department of Trauma and emergency surgery, Nijmegen (Netherlands); Beuker, B.J.A. [University Medical Center Groningen, Trauma Unit, Department of Surgery, Groningen (Netherlands); Muradin, G.S.R. [University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); Hohmann, J. [University of Basel Hospital, Department of Radiology and Nuclear Medicine, Basel (Switzerland); Hollmann, M.W. [Academic Medical Center, Department of Anaesthesiology, Amsterdam (Netherlands); Dijkgraaf, M.G.W. [Academic Medical Center, Clinical Research Unit, Amsterdam (Netherlands); Collaboration: REACT-2 study group

    2017-06-15

    To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning. Trauma patients from five trauma centres were randomized between April 2011 and January 2014 to TBCT imaging or STWU consisting of conventional imaging with selective CT scanning. Incidental findings were divided into three categories: 1) major finding, may cause mortality; 2) moderate finding, may cause morbidity; and 3) minor finding, hardly relevant. Generalized estimating equations were applied to assess differences in incidental findings. In total, 1083 patients were enrolled, of which 541 patients (49.9 %) were randomized for TBCT and 542 patients (50.1 %) for STWU. Major findings were detected in 23 patients (4.3 %) in the TBCT group compared to 9 patients (1.7 %) in the STWU group (adjusted rate ratio 2.851; 95%CI 1.337-6.077; p < 0.007). Findings of moderate relevance were detected in 120 patients (22.2 %) in the TBCT group compared to 86 patients (15.9 %) in the STWU group (adjusted rate ratio 1.421; 95%CI 1.088-1.854; p < 0.010). Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning. (orig.)

  19. Patrones de expresión genética y metilación en el schwannoma vestibular

    OpenAIRE

    Torres Martín, Miguel

    2014-01-01

    Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de lectura: 14/07/2014 Los schwannomas vestibulares son tumores de bajo grado que se desarrollan a partir de las células de Schwann del VIII nervio craneal. Estos tumores pueden aparecer de forma esporádica y unilateral, o bilaterales asociados a la Neurofibromatosis tipo 2. Molecularmente, la única característica que se da de manera frecuente en los schwannomas vestib...

  20. 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.