Schwannoma of the Lateral Ventricle: Eight-Year Follow-Up and Literature Review

Abstract

Intracerebral and intramedullary schwannomas are uncommon; but, in general, spinal intramedullary schwannomas are more frequent than intracerebral schwanomas. We present a case of right lateral ventricle schwannoma in a 21-year-old man and review the associated literature. The 21-year-old right-handed man presented with loss of the left-eye vision approximately 8 months before referral to an ophthalmologist. The patient was immediately subjected to computed tomography (CT) scan, which showed an enhanced lesion with cystic component in the right occipital horn of the lateral ventricle. And consecutively, he was admitted to our department. The tumor was evacuated via craniotomy with marked improvement in his clinical state. The postoperative course was uneventful and postoperative CT control showed no residue. On MRI control no recurrence was noted after a follow-up period of 8 years. Intracerebral schwannoma is a rare, benign neoplasm. It is usually located superficially or adjacent to a ventricle. Characteristic imaging features include cyst formation, calcification, and evidence of peritumoral edema or gliosis. The recognition of this benign and potentially curable neoplasm and its differentiation from other neoplasms, some of which have less favourable outcomes, is of obvious importance.

Intracerebral schwannomas: a rare disease with varying natural history

“…12,26,36 On gross pathological examination, intracerebral schwannomas have been described as gray, firm, rubbery, mildly to moderately vascular, occasionally gritty, not infrequently cystic, and with well-defined planes of cleavage. 17,26,31,50 These characteristics were also seen in our case series, although in Case 2 it was the capsule of the tumor, much more than its interior, that demonstrated hypervascularity.…”

Supratentorial intraventricular schwannoma of the choroid plexus

“…It has also been suggested that intra-axial schwannomas could arise from neural crest cells displaced into the nervous system as a result of failed migration in embryonic life 1 . This disordered embryogenesis theory may account for the relationship between intraventricular schwannomas and other neurocutaneous syndromes such as neurofibromatosis, Hirschprung's disease, and Waardenburg's syndrome 3,6 .…”

“…Schwannomas account for approximately 8% of all intracranial neoplasms 6 . Most originate from the vestibular portion of the cranial nerve (CN) VIII.…”

“…There are eleven case reports of ventricular schwannomas 3,[7][8][9] . The majority of these were located in either the lateral or fourth ventricles [4][5][6][7] . Most reported intraventricular schwannomas have been benign, with only two demonstrating malignant features 7,8 (Table).…”

“…As the autonomic nerves are associated with Schwann cells, this has led to the theory that primary intraventricular schwannomas may arise from the autonomic nervous tissue of the plexus choroids [3][4][5][6][7][8] . It has also been suggested that intra-axial schwannomas could arise from neural crest cells displaced into the nervous system as a result of failed migration in embryonic life 1 .…”