Subfrontal schwannoma

Summary Subfrontal schwannoma is a rare disease, which can be mis-diagnosed as an olfactory meningioma or a neuroblastoma, because of similar clinical symptoms and signs and neuroradiological features. Especially for young subjects, olfactory neuroblastoma should be carefully differentiated, since the management strategies for those lesions are significantly different. The craniofacial approach is often needed for the resection of a neuroblastoma. We report a case of 14-year old boy in which olfactory neuroblastoma was suspected prior to surgery, but turned out to be a schwannoma histologically. Molecular genetic examination revealed neither NF2 gene mutation nor loss of heterozygosity of chromosome 22q, unlike common schwannomas.     

Intracerebellar schwannoma

Only some rare examples of schwannomas localized in the medullary parenchyma are cited in the literature. The first was described by Kernohan in 1933; 9 cases were rapported in the thirty following years. For Brain a few observations about one case were cited by David (1965), Gibson (1966), New (1972) and Ghatak (1975). The authors relate one case of isolated schwannoma in superior vermis. That was a 15 years old young man who had a low evoluting I.C.P. syndrome. The pre-operating neurological investigation revealed a small cerebellar syndrome. The neuroradiological record allowed to localize an expansive median affection in the posterior fossa on a level with the Sylvius aqueduct. The neurosurgical operation allowed to carry off a tumor from the superior vermis; schwannoma tissue was the conclusion of the histological study. The evolution has been good and no cranial nerves were involved. Different theoris about the localisation of Schwann cells in this region are described.     

Olfactory schwannoma

Summary We report a case of olfactory schwannoma with calcification. Intraoperative findings indicated that the tumour originated from the olfactory groove. Intraoperative findings of previous studies have not indicated a clear relationship between subfrontal schwannoma and the olfactory nerve, which seems strange, given the association between tumours and cranial nerves at other sites. We suggest this observation has not been reported because the growing olfactory schwannoma changes the local morphology, affecting the appearance of the olfactory nerve.     

Penile schwannoma

Schwannoma of the penis is extremely rare. A 65-year-old man presented with a subcutaneous tumor of penile shaft without any other symptoms. Histopathologic examination of the excised tumor revealed benign schwannoma. No recurrence has been observed over the 6 months since the surgery.     

胃神经鞘瘤

目的 总结胃神经鞘瘤的临床特点及治疗方法。方法 收集经我院诊治的10例胃神经鞘瘤患的资料,对其诊断及治疗作分析总结。结果 胃神经鞘瘤主要表现为腹痛、腹部肿块、黑便、上消化道出血亲休克。可通过胃镜、X线、B超等辅助检查协助诊断,确诊靠病理检查。治疗以手术为主。结论 胃神经鞘瘤无特殊临床表现,诊断困难,术前确诊率低,误诊率高。     

Vestibular schwannoma

The state of the art of vestibular schwannoma management is reviewed with discussion of pertinent literature to bring out the current results and controversies in this field. Microsurgery results from four major series are discussed along with data from those using gamma knife or linear accelerators to treat these tumors.     

Esophageal schwannoma

A rare case of esophageal schwannoma is presented. A 63-year-old woman was admitted to our hospital with a 5-year history of dysphagia. The barium esophagogram showed a protrusive smooth tumor in the upper thoracic esophagus. The tumor was removed through right thoracotomy. There was no anatomical relationship between the tumor and vagal nerve trunk. From pathologic findings and positive immunohistochemical staining for S-100 protein, the diagnosis of esophageal schwannoma was made.     

Retroperitoneal schwannoma

A case of retroperitoneal benign schwannoma is presented; in addition, 133 cases of retroperitoneal schwannoma reported in Japanese literature are studied. In our series 66 per cent of the cases were found to be cystic. Therefore, the cystic change may be one of the preoperative features of schwannomas, because other types of retroperitoneal tumor do not frequently form cysts. Furthermore, the necessity of postoperative electron microscopy for accurate histologic diagnosis is discussed.     

Nasal schwannoma

A 36-year-old man with a nasal septal mass is presented. The diagnosis of a benign neoplasm arising from peripheral nerve Schwann cells was made by excisional biopsy. A benign nerve sheath tumor may be either a schwannoma or neurofibroma. Schwannomas may be distinguished from neurofibroma by clinical and histologic criteria. Malignant degeneration and intracranial extension may complicate the course of a nasal schwannoma. Complete excision is the preferred therapy.