Cystic Vestibular Schwannoma

Piccirillo, Enrico; Wiet, Mark; Flanagan, Sean; Dispenza, Francesco; Giannuzzi, Annalisa; Mancini, Fernando; Sanna, Mario

doi:10.1097/mao.0b013e3181b04e18

Cited by 101 publications

(55 citation statements)

References 25 publications

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“…A CVS was labeled and differentiated from SVS depending on two key points [12] (fig. 1): (1) presence of hypodense/hypointense areas on MRI, and (2) identification of cystic elements during surgery by the same senior surgeon.…”

Section: Methodsmentioning

confidence: 99%

“…Also, it is difficult to achieve a postoperative functional outcome in large or giant VSs which is as good as that observed in small or medium VSs. The surgical outcome in VSs depends on several factors: tumor size, cystic degeneration, surgical approach used, surgeon’s experience, use of cranial nerve monitoring, adhesion between tumor and adjacent tissue, and the correct treatment of perioperative complications [5,9,10,11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

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Removal of Large or Giant Sporadic Vestibular Schwannomas via Translabyrinthine Approach: A Report of 115 Cases

Zhang

Wang

Huang

et al. 2012

ORL

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Background/Aims: The present study was a retrospective analysis of surgical outcomes of large or giant vestibular schwannomas (VSs) via a translabyrinthine approach (TLA). Methods: One hundred and fifteen sporadic large or giant VSs (maximal diameter in the cerebellopontine angle ≥31 mm) were operated via TLA between January 2001 and December 2010. We divided patients into two groups: cystic VS (CVS) and solid VS (SVS) group. The surgical outcomes were recorded and compared. Results: Total, near total, and subtotal tumor removal rate was 89.6, 7.8, and 2.6%, respectively. The near total removal rate in CVS was higher than that in SVS (16.7 vs. 3.8%). The anatomical facial nerve (FN) integrity was preserved in 101 patients (87.8%). More FNs in CVS were interrupted (22.2%). There were 29.6, 56.5, and 13.9% of patients who had a short-term (1 month) FN function of House-Brackmann grade I or II, III or IV, and V or VI, respectively. The CVS had worse FN function than the SVS group. The mortality rate was 0.9%. Cerebrospinal fluid leakage occurred in 8 patients (7.0%). Four (3.5%) patients had recurrence. Conclusions: Cyst formation is a crucial factor for surgical outcome of VS. With near total or subtotal tumor removal, worse functional outcomes in large or giant CVSs should be foreseen.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Removal of Large or Giant Sporadic Vestibular Schwannomas via Translabyrinthine Approach: A Report of 115 Cases

Zhang

Wang

Huang

et al. 2012

ORL

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“…It is also postulated that the formation of the cyst is due ITH. [5] This, in addition to the use of anti-coagulants, could have played a role in the formation of the multiple ITHs in this case.…”

Section: Discussionmentioning

confidence: 97%

“…[235] The HB grade was different in all cases, and thus does not seem to be a good prognostic factor. It is nonetheless noteworthy that one group[5] reported a postoperative hemorrhage in one patient with CVS which necessitated surgical interference. However, the authors did not report any preoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of repeated intracranial hemorrhage in vestibular schwannoma

2016

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Background:Symptomatic intratumoral hemorrhage (ITH) in vestibular schwannoma (VS) is rare. A repeated hemorrhage is, therefore, even more exceptional. Repeated ITH has been reported in four cases thus far in English literature. Here, we describe a patient with a Koos grade D VS who presented to our Skull Base team with repeated ITH and an unexpected disease course.Case Description:A 76-year-old woman presented with hearing loss due to polycystic VS on the left side. Five years later, the patient was presented with facial palsy caused by hemorrhage in the VS. The patient had an eventful medical history that necessitated the use of anti-coagulants. The patient suffered from three subsequent hemorrhages preoperatively and one hemorrhage 36 h postoperatively.Conclusion:We have experienced multiple repeated hemorrhages in a patient with a polycystic VS, and despite surgical intervention, the outcome was unfavorable.

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“…[3] Various classification systems have been put forward to describe cystic schwannomas. [23] These tumors are more aggressive, have a shorter duration of symptoms at the time of presentation, poorer outcomes with microsurgical resection and variable responses to radiosurgery. [468122932] The various reasons put forward for rapid tumor growth are possibly necrosis within the tumor core, repeated episodes of intratumoral hemorrhage and coalescence and rupture of microcysts within the tumor.…”

Section: Discussionmentioning

confidence: 99%

Vestibular schwannoma of oscillating size: A case report and review of literature

Rahmathulla¹,

Barnett²

2011

Surg Neurol Int

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Background:Vestibular schwannomas are benign brain tumors arising from the 8th cranial nerve with a varying natural history. Various reports have described discernable growth patterns for these tumors. However, growth predictability remains low because of slow and indeterminate changes over time with follow-up reports not usually exceeding 3 years. Our report describes the long-term follow-up of an unusual cystic schwannoma with growth patterns prior to and following treatment, adding valuable information to the variable natural history and outcome of these infrequent tumors.Case Description:A 68-year-old gentleman presented with a left-sided cystic vestibular schwannoma, initially managed conservatively. Imaging revealed wide variations in the size of his tumor over a period of 3 years. He was finally treated with Gamma Knife radiosurgery, and at 1 year following treatment shows tumor shrinkage with a change in tumor morphology.Conclusion:To our knowledge, the present case represents the first instance of a schwannoma showing wide fluctuations in tumor size and morphology over a period of time, with a good response to radiosurgery. We emphasize in this report that there is no “one size fits all” treatment paradigm for these tumors and each patient requires individualized care and intervention, taking into account their differing natural histories.

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Cystic Vestibular Schwannoma

Cited by 101 publications

References 25 publications

Removal of Large or Giant Sporadic Vestibular Schwannomas via Translabyrinthine Approach: A Report of 115 Cases

Removal of Large or Giant Sporadic Vestibular Schwannomas via Translabyrinthine Approach: A Report of 115 Cases

An unusual case of repeated intracranial hemorrhage in vestibular schwannoma

Vestibular schwannoma of oscillating size: A case report and review of literature

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