Nerve Schwannoma Research Articles

Schwannoma causing greater occipital nerve neuralgia: Case report

Schwannomas are benign tumors that originate from the Schwann cells of the nerve sheath. They can arise from any myelinated nerve. The pre-operative diagnosis of schwannoma is difficult and should be suggested by clinical features and supported by investigations based on techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging, and fine-needle aspiration cytology. Schawannomas can present with very subtle symptoms or morbid sequel. A 19-year-old male patient presented with 6 months history of swelling in the upper left side part of the neck. Local examination showed a 5 cm × 3 cm single globular mass in the left suboccipital region. The contrast enhanced CT scan showed a 44 mm × 46 mm × 39 mm well defined heterogeneous mildly enhancing mass on the left side of the upper three cervical vertebras abutting them. The mass was excised under general anesthesia by transcervical approach. After extensive search of English literature we came across only three case reports where schwannoma of greater occipital nerve presented with neuralgia.

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

Schwannomas of the 6th nerve are extremely rare.Only 22 cases of intracranial schwannomas of the 6th cranial nerve pathologically confirmed have been reported. Here, we report a case of a 14-year-old girl who presented with isolated progressive 6th nerve palsy. A cisternal type of schwannomawas found from neuro-imaging. Subtotal removal of the tumor was performed by a routine left subtemporal craniotomy with an petrosectomy. The attachment to the 6th nerve was found. After surgery, the patient’s 6th nerve palsy remained. Histological images revealed a cellular schwannoma. Then the classification, clinical presentation, diagnosis, operation, stereotactic radiosurgery are reviewed. The location and the attachment to the 6th nerve is the key for diagnosis. Most cases are treated surgically. It looks like it is not easy to completely remove for CA type because of invasion of the cavernous sinus or firm adherence to the nerves. The 6th nerve function seldom completely recovered postoperatively. The direction of further research is to improve the diagnosis and therapy to have better nerve recovery.

Electrodiagnosis and Magnetic Resonance Imaging in Schwannoma of the Median Nerve of the Forearm - A Case Report -

Electrodiagnosis and Magnetic Resonance Imaging in Schwannoma of the Median Nerve of the Forearm - A Case Report -

Benign solitary schwannoma of right ulnar nerve – A case report

Introduction: Benign peripheral nerve schwannomas are uncommon tumours. Extra cranial schwannomas have also been reported from uncommon and unusual sites including breast, pancreas, and gastrointestinal system. Peripheral nerve schwannomas may pose a problem in clinical diagnosis, however an appropriate diagnostic work-up including thorough history and clinical examination, Ultrasonography, magnetic resonance imaging, fine needle aspiration cytology, nerve conduction velocity and electromyography study may all help reaching the correct preoperative diagnosis. The important clinical differential diagnoses include traumatic neuroma, neurfibromas, lipoma, cold abscess and muscle hernia. The definitive treatment of benign peripheral nerve schwannoma is complete enucleation of the tumour mass without damaging the intact nerve fascicles followed by confirmatory histopathological examination. When there is a doubt on histopathology, a positive Immunohistochemical staining with S100 is helpful in confirming a diagnosis of schwannoma. Case presentation: We had 40 years female who had a slow growing swelling over the inner aspect of her right elbow for the last one year; this was followed by pain, tingling and numbness over inner one and half fingers of her right hand for six months. Tinnels sign was positive over the swelling. Her subsequent clinical examination and investigations including a magnetic resonance imaging was suggestive of a benign growth in her right ulnar nerve in the elbow region. Complete enucleation of the swelling was done from the right ulnar nerve in the elbow region and subsequent histopathological examination confirmed it to be a benign cellular schwannoma. Patient recovered successfully after the surgery and paresthesia in the distribution of her right ulnar nerve also improved six weeks after surgery. At her last follow-up six months after surgery, the patient was completely asymptomatic and highly satisfied with the results of surgery. Conclusion: A correct preoperative diagnosis of peripheral nerve schwannomas is possible, and it can be successfully managed with complete enucleation of tumour mass with satisfactory patient outcomes.

A Case of Schwannoma of Vagus Nerve with Hypoglossal Nerve Paralysis

A Case of Schwannoma of Vagus Nerve with Hypoglossal Nerve Paralysis

Ancient schwannoma of the cervical vagus nerve: a rare benign neurogenic tumor

Schwannomas are benign, slow-growing encapsulated tumors that originate from Schwann cells of the nerve sheaths. Schwannoma originating from the cervical vagus nerve is an extremely rare neoplasm that usually occurs in men between the 3rd and 6th decades of life. Ancient schwannoma is a rare variant that was first described by Ackerman and Taylor in 1951 as a long standing degenerative schwannoma that presented with wide areas of hyalinized matrix. A case of ancient Schwannoma of the cervical vagus nerve in a 56-year-old male who presented to our department with history of a firm and painless mass lesion on right side of the neck is being reported here.

Diagnosing features of Jacobson’s nerve schwannoma

Jacobson's nerve schwannoma is a rare middle ear tumour presenting as a mass along the cochlear promontory. It can be differentiated from other masses along the promontory based on clinical findings, and computed tomography and magnetic resonance imaging features. For small-sized masses, it is possible to differentiate the various middle ear schwannomas from one another. We present the case of a 40-year-old woman with a ten-year history of left hearing loss who was diagnosed with Jacobson's nerve schwannoma.

Exploring Therapeutic Targets in Schwannoma Through Integrative Analysis

Vestibular schwannomas (VS) are common benign tumors of the vestibular nerve and spinal schwannomas (SS) arise form nerves within the spinal canal. SS are the most common intradural extramedullary spinal tumors, representing 30% of such lesions and both VS and SS both cause significant morbidity. The current treatment strategies for VS and SS include surgery or radiation with each treatment option having associated complications and side effects. The transcriptional landscape of schwannoma remains largely unknown. We first performed gene expression profiling of 49 VS schwannomas and seven normal control vestibular nerves to identify tumor-specific gene expression patterns. We identified over 2000 differentially expressed genes between control and schwannoma with network analysis uncovering proliferation and anti-apoptotic pathways previously not implicated in VS. Furthermore, using several distinct clustering technologies, we could not reproducibly identify distinct VS subtypes or significant differences between sporadic and germline NF2 associated schwannomas suggesting that VS comprises of a highly similar entity. We next performed a transcript analysis comparing VS to SS. Surprisingly; we identified few differential transcripts demonstrating that schwannoma in general is a homogenous entity. Current studies are focused on copy number, DNA methylation profiling and genome wide sequencing analysis. Preliminary data suggests that NF2 is the major driver of schwannoma as previously implicated. Interestingly, we identified several novel and recurrent point mutations of NF2 in exon 1 of both VS and SS, which may lead to loss of function. Our most recurrent activated pathway in schwannoma was overexpression of PI3K/AKT/mTOR signaling pathway, which is directly druggable and evaluated this pathway for therapeutic targeting. Testing compounds BEZ235 and PKI-587, both novel dual inhibitors of PI3K and mTOR, attenuated tumor growth in a pre-clinical cell line model of schwannoma (HEI-293). Our In vitro findings demonstrated that pharmacological inhibition of the PI3K/AKT/mTOR pathway with next generation compounds lead to decreased cell viability, and increased cell death in VS, SS but not normal schwann cells. Future work is testing these compounds in vivo using relevant cell lines and primary cultures of VS/SS. Our findings implicate aberrant activation of the PI3K/AKT/mTOR pathway as a molecular mechanism of pathogenesis in VS and suggest inhibition of this pathway as a potential treatment strategy.

Schwannoma of the Superficial Peroneal Nerve in 12-Year-Old Female Child: A Case Report

We present a case of Schwannoma of superficial peroneal nerve that presents as single enlarging mass in anterolateral aspect of right leg. After clinical diagnosis work-up is done with ultrasound, MRI and excision biopsy.

Isolated intraneural schwannoma of the median nerve

Isolated intraneural schwannoma of the median nerve

Eyelid and Eye Movements Following Fourth to Third Nerve Anastomosis

A 34-year-old woman presented with brainstem compression from a large third nerve schwannoma although third nerve function was intact. At surgery, preservation of the proximal third nerve was not possible. Because of preexisting amblyopia of the contralateral eye, an attempt was made to surgically reinnervate the affected third nerve. The fourth nerve was divided at its entry into the tentorium and anastomosed to the distal stump of the third nerve. Partial recovery of third function occurred over several months and is still present 6 years later. Successful long-term reinnervation of the third nerve by direct anastomosis with the fourth nerve may be useful when third repair is not possible.

A Case of Jacobson's Nerve Schwannoma Extending into the External Auditory Canal

Received September 19, 2012 Revised January 8, 2013 Accepted January 8, 2013 Address for correspondence Sung Il Cho, MD, PhD Department of OtolaryngologyHead and Neck Surgery, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea Tel +82-62-220-3207 Fax +82-62-225-2702 E-mail chosi@chosun.ac.kr Schwannomas are slow-growing, benign neurogenic tumors arising from schwann cells. Their localization in the external auditory canal and the middle ear has rarely been reported. The authors experienced a very rare case of Jacobson’s nerve schwannoma that extended into the external auditory canal in a 55-year-old woman. The tumor eroded the wall of the cochlear promontory and exposed the membranous labyrinth. The jugular foramen and the wall of the ear canal were preserved without destruction. This report represents the first documented case of a Jacobson’s nerve schwannoma, which involved the external auditory canal. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:373-6 Key WordsZZEar canal ᆞJacobson’s nerve ᆞMiddle ear ᆞSchwannoma.

Unusually large quiescent ancient schwannoma of hypoglossal nerve

Ancient schwannoma is considered as a variant of schwannoma, comprising about 10% of all schwanommas. Schwannoma is a benign neoplasm derived from the nerve sheath of peripheral motor, sensory and sympathetic nerves and from the cranial nerve pairs. It usually presents as a solitary soft-tissue lesion which is slow growing, encapsulated and is often associated with nerve attached peripherally. Diagnosis is often confirmed with the microscopic examination. The long standing schwannoma attributes to degenerative changes and is termed "ancient" schwannoma. Present case is of a 68-year-old female patient who reported with an asymptomatic large swelling below mandible on the left side since last 23 years. The lesion was surgically excised under general anesthesia.

Synchrones Schwannom des N. vagus und des zervikalen sympathischen Grenzstrangs

Schwannomas are rare neural sheath tumors which are generally benign. Up to 45% of all schwannomas originate in the head and neck region. In the parapharyngeal space (PPS) they may arise from any of the lower cranial nerves IX, X, XI and XII or from the cervical sympathetic chain. We report a unique case of a synchronous schwannoma of the vagal nerve and the cervical sympathetic chain in a patient without neurofibromatosis.

Pelvic Schwannoma

Schwannoma is a rare benign tumor of peripheral nerves arising from Schwann cells of the ubiquitous nerve sheath. To describe the operative steps and technical aspects of robotic laparoscopic resection of pelvic schwannoma. We describe 2 patients with pelvic schwannoma: a 34-year-old woman with schwannoma of the right lumbosacral trunk and a 58-year-old woman with schwannoma of a left S1 nerve. Pain was the main symptom in both patients. The diagnosis was confirmed by magnetic resonance imaging and nerve biopsies. Both patients were operated on by robotic laparoscopy. Lesions were totally enucleated after incising the epineurium. After dissection of the schwannoma, the vascular pedicle and nerve fascicles involved were identified, coagulated, and then sectioned. The remaining fascicles of the nerve were preserved. The postoperative course was uneventful in both patients. With follow-up of 9 and 13 months, both patients obtained complete pain relief with no neurological sequelae. Robotic laparoscopic resection of pelvic nerve tumors such as schwannomas is technically feasible.

Multiple plexiform schwannoma of a finger

ejd.2011.1609 Auteur(s) : Jiong Zhou, Xiao-Yong Man, Min Zheng, Sui-Qing Cai cai.suiqing@gmail.com Department of Dermatology, Second Affiliated Hospital, Hangzhou 310009, China Schwannomas are benign neurogenic tumors, first described by Verocay in 1908 [1]. There are 7 subtypes: classical (Verocay), cranial nerve, cellular, plexiform, degenerated (ancient), melanotic, and granular cell schwannoma [2]. Plexiform schwannoma is a rare subtype, accounting for approximately 5% of schwannomas [2]. Sometimes, [...]

Schwannoma of the Posterior Tibial Nerve: An Unusual Finding during Arterial Ultrasound Examination of the Lower Extremities

Introduction Ultrasound examination of the lower extremity, regardless of the motive, can yield a considerable amount of data essential to the diagnosis of various diseases. Case Report We reported a clinical case of a woman, 50 years of age, who was sent to our vascular laboratory for arterial ultrasound examination of the lower extremities. She complained of coldness of the left foot associated with paresthesia and hypersensitivity of the middle third of the left lower leg for the past 3 years. During physical examination, there was a diminished, but palpable, posterior tibial artery pulse. The ultrasound performed revealed a tumor of the posterior tibial nerve, with 4 cm in longitudinal dimension and 2.7 cm of maximum diameter, typical of a neurofibroma or a schwannoma, with anterior deviation of the vascular structures. She was referred to a plastic surgeon and submitted to surgical resection of the nerve sheath tumor, with preservation of artery and venous flow. Histological analysis revealed a capsulated mass with fusiform cells, without atypical cells, compatible with a schwannoma. Patient completed 1 year of follow-up, maintaining a slight, nondisabling, local hypersensitivity. Discussion This clinical case shows an interesting imaging finding, with major repercussions in the treatment of this patient.

Preoperative prediction of vestibular schwannoma's nerve of origin with posturography and electronystagmography

Conclusion: Chances of hearing preservation are better in patients with vestibular schwannoma (VS) from the superior vestibular nerve (SVN) than from the inferior vestibular nerve (IVN). Pathologic posturography and electronystagmography (ENG) findings are more common in schwannomas from the SVN compared with tumors from the IVN. In this way, computerized dynamic platform posturography (CDPP) and ENG contribute to predict the nerve of origin of VS and can be used indirectly as a prognostic factor for hearing preservation. Objectives: To test whether preoperative CDPP or ENG results contribute to predict the nerve of origin in VS and also to evaluate the influence of the nerve of origin on hearing preservation. Methods: Eighty-nine patients with VS originating from the IVN and 22 patients with VS from the SVN were included. Hearing loss due to surgery was calculated on postoperative and preoperative audiograms. Caloric response was measured by ENG and condition 5 and 6 score were recorded by CDPP before surgery. Results: Hearing loss due to surgery was significantly lower in patients with tumors from the SVN than from the IVN (p = 0.011). Pathologic results in preoperative ENG (p < 0.0001) and CDPP (p = 0.025) were significantly more frequent in subjects with SVN than with IVN schwannomas.

A rare case of Schwannoma of the intrathoracic phrenic nerve

A rare case of Schwannoma of the intrathoracic phrenic nerve

Vagus Nerve Schwannoma in the Middle Mediastinum

Intrathoracic neurogenic tumors are generally located in the posterior mediastinum. They usually arise from an intercostal nerve or a sympathetic chain. Tumors originating from the vagus nerve in the middle mediastinum are extremely rare. This report describes a patient with a huge intrathoracic schwannoma of the vagus nerve in the middle mediastinum and reviews the literature.