1/364. Schwannoma in patients with isolated unilateral trochlear nerve palsy.PURPOSE: To describe the clinical features of patients with isolated unilateral trochlear nerve palsy secondary to imaging-defined schwannoma of the trochlear nerve. methods: A chart review of all patients seen at the Neuro-ophthalmology Unit at Emory University since 1989. Of 221 patients with trochlear nerve palsy, six had a lesion consistent with a trochlear nerve schwannoma. RESULTS: The six patients had isolated unilateral trochlear nerve palsy. Duration of diplopia before diagnosis averaged 6 months. magnetic resonance imaging demonstrated circumscribed, enhancing lesions along the cisternal course of the trochlear nerve, all measuring less than 5 mm in greatest dimension. Five of the patients were seen in follow-up, over periods ranging from 11 to 26 months from initial presentation (mean, 15.6 months; standard deviation, 6.0 months). All of these patients remained stable except one, who was slightly worse at 15 months by clinical measurements and magnetic resonance imaging. None of these patients have developed additional symptoms or signs of cranial nerve or central nervous system involvement. CONCLUSIONS: The differential diagnosis of an isolated unilateral fourth cranial nerve palsy should include an intrinsic neoplasm of the trochlear nerve. magnetic resonance imaging is useful, both for diagnosis and follow-up. These patients can remain stable and may not require neurosurgical intervention.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/364. Ancient schwannoma of the orbit.The ancient schwannoma is a rare variant of a neurilemoma with a course typical of a slow-growing benign neoplasm. Histologically, it can be confused with a malignant mesenchymal tumor because of increased cellularity, nuclear pleomorphism, and hyperchromatism. Despite the degree of nuclear atypia, mitotic figures are absent. We describe the clinical and histopathologic features of an ancient schwannoma of the orbit.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/364. Surgical management of lesions affecting the anterior optic pathways.Although benign neoplasms are the most common lesions of the anterior visual pathways that lend themselves to a combined neurosurgical and ophthalmic surgical treatment, malignant neoplasms, infections (especially fungal), and vascular lesions are also sometimes treated via a combined approach. Recent advances in the field of skull base surgery have made it possible to treat complicated lesions in precarious locations with increasing margins of safety and decreasing morbidity. The role of the neurosurgeon in managing selected patients with lesions of the anterior a visual pathway should not be underestimated.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
4/364. Microsurgical removal of a vestibular schwannoma after stereotactic radiosurgery: surgical and pathologic findings.OBJECTIVE: The objective of this study was to provide objective evidence of the enhanced difficulty of preserving the facial nerve in patients who need microsurgery after failed stereotactic radiosurgery (SRS) of vestibular schwannoma. STUDY DESIGN: This study was a retrospective case review. SETTING: A tertiary care referral center was the setting for the study. patients: The authors present a case of a young woman with a vestibular schwannoma that enlarged 2 years after treatment with SRS. INTERVENTION: microsurgery via the translabyrinthine approach was used. RESULTS: At surgery, extensive scarring between the facial nerve and tumor capsule was seen, and the nerve could not be identified at all beyond several millimeters proximal to the porus acusticus. Adhesions of the tumor to the ninth and tenth cranial nerves, the brain stem, and the anterior inferior cerebellar artery were also markedly increased. Histologic examination confirmed fibrotic adhesions surrounding the facial nerve. CONCLUSIONS: The unusual degree of fibrosis, scarring, and adhesions of the tumor to the surrounding structures after SRS made microsurgical removal of the tumor difficult and preservation of the facial nerve impossible.- - - - - - - - - - ranking = 0.0082622522034595keywords = brain (Clic here for more details about this article) |
5/364. Primary pulmonary neurilemoma. Report of a case with ultrastructural examination.The electron microscopic features of a primary neurilemoma of the lung, a very rare neoplasm, were studied. Characteristic schwann cells were present, with cytoplasm and elongated cytoplasmic processes coated with a basal lamina. The highly characteristic Luse bodies were also seen. We add electron microscopic corroboration to the previous tissue culture confirmation of this unusual benign pulmonary neoplasm.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
6/364. Pleomorphic hyalinized angiectatic tumor of soft parts.Pleomorphic hyalinized angiectatic tumor of soft parts is a recently described neoplasm that most commonly affects the lower extremities. It is locally aggressive but has not been known to metastasize. This article presents a case of a softball-sized tumor on the dorsum of the foot that was identified as pleomorphic hyalinized angiectatic tumor of soft parts. Previously, it would have been misdiagnosed and treated as either a neurilemoma or a malignant fibrous histiocytoma.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/364. Midline cerebellar cystic schwannoma : a case report.An extremely unusual case of a cystic schwannoma in the region of the inferior vermis and posterior to the fourth ventricle in a fifteen year old boy is reported. The cystic tumour caused partial obstruction to the outflow of cerebrospinal fluid from fourth ventricle and resulted in development of supratentorial hydrocephalus. On investigations, the schwannoma simulated a Dandy-Walker cyst. The boy presented with symptoms of increased intracranial pressure. On surgery, the lesion was not arising from any cranial nerve, nor was it attached to brain parenchyma, blood vessel or to the dura. The possible histogenesis of the cystic schwannoma in a rare location is discussed.- - - - - - - - - - ranking = 0.019522486453556keywords = brain, ventricle (Clic here for more details about this article) |
8/364. Diffuse schwannoma involving the entire large bowel with huge extramural development: report of a case.Schwannoma of the large bowel is a rare clinical entity, which has reportedly been recognized to arise from one place with a submucosal tumor morphology. We present herein the unique case of a 25-year-old woman who suffered from a schwannoma diffusely involving the entire large intestine. The patient complained of abdominal distension and imaging studies revealed a giant tumor occupying the whole abdomen, but no confirmed preoperative diagnosis could be made. A laparotomy proved the huge tumor detected preoperatively to be the markedly wall-thickened entire large bowel itself due to the diffuse extramural development of a neoplasm, but no other organs were involved. biopsy specimens from the tumor were histologically diagnosed as benign schwannoma. However, because of the possibility of malignancy, we later performed a total proctocolectomy followed by an ileal J-pouch-anal canal anastomosis. The final pathological diagnosis was also that of a benign schwannoma originating from the large intestine. The patient remains well without recurrence 15 months after surgery. To the best of our knowledge, no such case of a schwannoma in the entire large bowel has yet been reported in the literature, and the pathogenesis of its occurrence remains unknown.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/364. ciliary body schwannoma.PURPOSE: Intraocular schwannomas are very rare, benign, peripheral nerve neoplasms. The authors report a case of ciliary body schwannoma. METHOD: A 39-year-old Korean woman presented with slowly decreasing visual acuity and proptosis of the right eye for 4 years. At the time of her visit, the eyeball protruded and deviated laterally. She could not sense light with her right eye. We enucleated the eyeball. The enucleated eyeball with tumor was examined histopathologically, immunohistochemically, and under electron microscope. RESULTS: Microscopic examination revealed spindle cells and characteristic Antoni type A and B areas with Verocay bodies. Immunohistochemical study showed tumor cell expressions of S-100 and vimentin, but other immunohistochemical studies were negative. Electron microscopic examination demonstrated Luse body. CONCLUSIONS: We diagnosed the tumor as a schwannoma arising from the ciliary body on the basis of the above mentioned results. Schwannomas are very rare intraocular neoplasms, but they are benign so we should differentiate from other intraocular neoplasms.- - - - - - - - - - ranking = 3keywords = neoplasm (Clic here for more details about this article) |
10/364. neurilemmoma of the mandible.Intraosseous neurilemmoma is rare, representing less than 1% of benign primary bone tumors. The site most commonly involved is the mandible. We report on a neurilemmoma of the mandible in a 30-year-old woman. A panoramic radiograph of the mandible showed a well-defined unilocular osteolytic lesion with a thin uniform sclerotic margin located in the body of the mandible. The CT scan confirmed a well-defined osteolytic lesion with thinning of the cortex of the body of the left side of the mandible. Histologically, the lesion was a moderately cellular neoplasm with distinct palisading and numerous Verocay bodies. Ultrastructurally, the cytoplasmic membranes were distinct and coated by amorphous bands of basal lamina. Complete excision was achieved by removing the tumor from the inferior alveolar nerve.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
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