Usefulness of PRESTO Magnetic Resonance Imaging for the Differentiation of Schwannoma and Meningioma in the Cerebellopontine Angle

Tomogane, Yusuke; Mori, Kanji; Izumoto, Shuichi; Kaba, Keizo; Ishikura, Reiichi; Ando, Kenji; Wakata, Yuki; Fujita, Shigekazu; Shirakawa, Manabu; Arita, Norio

doi:10.2176/nmc.53.482

Cited by 25 publications

(14 citation statements)

References 16 publications

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“…After surgical resection, a thin not-nodular enhancement is often visualized in surgical resection field. It can persist for years but usually reduces over the time [11]. Fat grafts, fibrin glue, and muscle grafts, used to reconstruct the IAC, can generate a nodular enhancement which usually appear within the first 3 days after surgery.…”

Section: Radiological Diagnosismentioning

confidence: 99%

Vestibular Schwannomas: Diagnosis and Surgical Treatment

Jung¹,

Ramina²

2019

Primary Intracranial Tumors

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Over the last decades, significant advances in skull base surgery have enabled many neurosurgical centers around the world to perform surgical resection of vestibular schwannomas; otherwise, clinical observation and radiotherapy/radiosurgery can be possible management options. Auditory pattern, the presence of bilateral tumors, tumor size, and neurological symptoms are deeply considered in the decision-making process. In this chapter, we expanded the general discussion of vestibular schwannomas, discussing bases for an accurate diagnose and the technical aspects for the surgical approaches, drilling of internal auditory canal, and its reconstruction as well as the technical nuances when handling very small and large/ residual tumors.

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Section: Radiological Diagnosismentioning

confidence: 99%

Vestibular Schwannomas: Diagnosis and Surgical Treatment

Jung¹,

Ramina²

2019

Primary Intracranial Tumors

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“…About 10 % of intracranial tumors originate in the cerebellopontine angle (CPA), most of which are schwannomas and meningiomas [62]. Meningiomas are the second most common (3-10 %) CPA tumors, much less than schwannomas which account for 80-94 % [50].…”

Section: Introductionmentioning

confidence: 99%

Microsurgical management of primary jugular foramen meningiomas: a series of 22 cases and review of the literature

Tang

Zhang

et al. 2016

Neurosurg Rev

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This study summarized clinical manifestations, surgical management, histological grading, and long-term outcome of jugular foramen meningiomas (JFMs). Retrospective study was performed in 22 consecutive patients with primary JFMs from January 2004 to October 2010, enrolling 10 men and 12 women with average age of 39.4 (14-57 years). The most common initial symptom is hearing disorder, followed by lower cranial nerve dysfunctions. The tumor was classified into type I (intracranial) in 1, type II (intracranial) in 15, type IV (intracranial-extracranial) in 6, and none type III (extracranial). Surgical approaches mainly included retrosigmoid in 7, far lateral in 10, and juxtacondylar in 5, with some variations. The gross total resection was achieved in 15 cases and subtotal resection in 7. Fourteen patients (63.6 %) developed new or worse neurological deficits immediately after operation, of whom 11 (78.6 %) got alleviation. Postoperatively, keeping airway patency and prevention from aspiration pneumonia is very important. Nasotracheal intubation is much more tolerated than orotracheal intubation for postoperative patient management. WHO grade 2 was found in four cases (18.2 %) and grade 3 in one. During the average time of follow-up in 83.2 months, only one (grade 3) died of tumor regrowth 20 months after surgery and radiosurgery. Five of 17 patients of grade 1 developed tumor regrowth. Radiosurgery provides a good tumor control for tumor regrowth in grade 1, or postoperative grade 2 tumor. In conclusion, JFMs has a favorable long-term overall survival; however, neurological preservation is still challenging, especially low cranial nerves.

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confidence: 99%

“…Among intracranial meningiomas, 5%-10% are located in the anatomic region of cerebellopontine angle (CPA) 8,9 . Although involvement and enlargement of internal auditory canal (IAC) is a common sign of schwannomas of the CPA, meningiomal extension into the IAC can be seen 8 . Extension into the IAC is rare and should be treated like a separate disease entity because preoperative diagnostic identifi cation permits alterations in surgical strategy planning that allow for the more complete resection of the tumour and better clinical outcome.…”

mentioning

confidence: 99%

“…Extension into the IAC is rare and should be treated like a separate disease entity because preoperative diagnostic identifi cation permits alterations in surgical strategy planning that allow for the more complete resection of the tumour and better clinical outcome. Due to this exceedingly rare occurrence, only few cases have been reported in world literature [2][3][4][5][6][7][8][9][10][11][12] . Our patient, harbouring a CPA meningioma extending into IAC, pose a diagnostic and therapeutic challenge on account of anatomic location and site of dural attachment, diverse intimate relationships to important neurovascular structures and a variable constellation of presenting clinical symptoms and signs like unilateral headache, hearing loss and abnormal facial motor function 9,10 .…”

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confidence: 99%

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Cerebellopontine angle meningioma extending into internal auditory canal presenting with unilateral facial weakness and sensorineural hearing loss: Case presentation with review of literature

Kumar

Jaiswal²,

Bhargava

et al. 2017

J. Kathmandu Med. Coll.

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Tumour types other than schwannomas are uncommonly encountered in the cerebellopontine angle, and unusual lesions extending into the internal auditory canal are even rarer. We herein present a case of a 50-year-old woman with a right cerebellopontine angle meningioma (measuring 34mm x 35mm x 36mm), arising from the posterior surface of the petrous bone or the petrotentorial junction, secondarily involving the internal auditory canal. Contrast enhanced MRI showed typical appearance of a meningioma, with calcifi ed fl at surface against the petrous bone, a hemispheric or ice-cream-cone shape sign, adjacent hyperostosis, and 'dural tail' extending from the tumour. Initial clinical evaluation revealed continued presence of a stable neurological defi cit such as unilateral headache, hearing loss, reduced taste sensation, positive corneal and conjunctival refl ex along with right facial weakness (House-Brackmann grade III) signalling towards the involvement of V, VII and VIII cranial nerve. The variation in the anatomy of the faciocochlear nerve bundle in relation to the tumour has to be kept in mind, and preservation of these vital neural structures should be the goal in every case. Tumour resection was performed through a suboccipital-retrosigmoidal approach with a good outcome. Ours is an unusual case report analysing the diagnostic and therapeutic issues, surgical management strategies and treatment outcomes related to this rare disease entity.

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Usefulness of PRESTO Magnetic Resonance Imaging for the Differentiation of Schwannoma and Meningioma in the Cerebellopontine Angle

Cited by 25 publications

References 16 publications

Vestibular Schwannomas: Diagnosis and Surgical Treatment

Vestibular Schwannomas: Diagnosis and Surgical Treatment

Microsurgical management of primary jugular foramen meningiomas: a series of 22 cases and review of the literature

Cerebellopontine angle meningioma extending into internal auditory canal presenting with unilateral facial weakness and sensorineural hearing loss: Case presentation with review of literature

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