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Intrinsic brainstem schwannoma - A rare clinical entity and a histological enigma.

Sharma AK, Savardekar AR, Nandeesh BN, Arivazhagan A, Rao MB - J Neurosci Rural Pract (2016 Apr-Jun)

Bottom Line: Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now.We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins.We highlight the importance of an intraoperative frozen section diagnosis in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

ABSTRACT
Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma.

No MeSH data available.


Related in: MedlinePlus

(a-d) Preoperative magnetic resonance imaging, (a) T2-weighted axial, (b) precontrast T1-weighted sagittal, (c) postcontrast T1-weighted axial, (d) postcontrast T1-weighted sagittal, showing a well-demarcated, intra-axial, solid-cystic tumor involving pons and medulla. (e and f) Magnetic resonance imaging at 6 months follow-up, postcontrast T1-weighted axial (e), and sagittal (f) images, showing small enhancing residual tumor component at left pontomedullary junction
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Figure 1: (a-d) Preoperative magnetic resonance imaging, (a) T2-weighted axial, (b) precontrast T1-weighted sagittal, (c) postcontrast T1-weighted axial, (d) postcontrast T1-weighted sagittal, showing a well-demarcated, intra-axial, solid-cystic tumor involving pons and medulla. (e and f) Magnetic resonance imaging at 6 months follow-up, postcontrast T1-weighted axial (e), and sagittal (f) images, showing small enhancing residual tumor component at left pontomedullary junction

Mentions: Magnetic resonance imaging (MRI) of the brain showed an intra-axial, solid-cystic lesion involving the pons and medulla, extending up to cervicomedullary junction. The solid portion was hypointense on T1-weighted images, hyperintense on T2-weighted images and showed enhancement on contrast administration. Cystic components were cerebrospinal fluid isointense. The fourth ventricle was compressed and displaced posteriorly by the lesion [Figure 1a–d].


Intrinsic brainstem schwannoma - A rare clinical entity and a histological enigma.

Sharma AK, Savardekar AR, Nandeesh BN, Arivazhagan A, Rao MB - J Neurosci Rural Pract (2016 Apr-Jun)

(a-d) Preoperative magnetic resonance imaging, (a) T2-weighted axial, (b) precontrast T1-weighted sagittal, (c) postcontrast T1-weighted axial, (d) postcontrast T1-weighted sagittal, showing a well-demarcated, intra-axial, solid-cystic tumor involving pons and medulla. (e and f) Magnetic resonance imaging at 6 months follow-up, postcontrast T1-weighted axial (e), and sagittal (f) images, showing small enhancing residual tumor component at left pontomedullary junction
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4821946&req=5

Figure 1: (a-d) Preoperative magnetic resonance imaging, (a) T2-weighted axial, (b) precontrast T1-weighted sagittal, (c) postcontrast T1-weighted axial, (d) postcontrast T1-weighted sagittal, showing a well-demarcated, intra-axial, solid-cystic tumor involving pons and medulla. (e and f) Magnetic resonance imaging at 6 months follow-up, postcontrast T1-weighted axial (e), and sagittal (f) images, showing small enhancing residual tumor component at left pontomedullary junction
Mentions: Magnetic resonance imaging (MRI) of the brain showed an intra-axial, solid-cystic lesion involving the pons and medulla, extending up to cervicomedullary junction. The solid portion was hypointense on T1-weighted images, hyperintense on T2-weighted images and showed enhancement on contrast administration. Cystic components were cerebrospinal fluid isointense. The fourth ventricle was compressed and displaced posteriorly by the lesion [Figure 1a–d].

Bottom Line: Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now.We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins.We highlight the importance of an intraoperative frozen section diagnosis in such cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

ABSTRACT
Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma.

No MeSH data available.


Related in: MedlinePlus