Large Vestibular Schwannoma Presenting in Pregnancy: A Case Report
Vestibular Schwannoma (VS) is a brain tumor arising from the internal auditory canal, growing towards the cerebellopontine angle. Diagnosis and management of these tumors during pregnancy may present a therapeutic challenge. Herein, we report a case, of a huge VS presented in pregnancy by nonspecific symptoms. Thus, despite increased intracranial pressure and its possibly dangerous sequela, the patient delivered full-term vaginally. Finally, three months after delivery, VS underwent retrosigmoid microsurgical removal. The postoperative period was uneventful, with total hearing loss in her left ear and, transient paralysis of the left seventh cranial nerve. Gynecologists and Obstetricians should consider brain tumors in the differential diagnosis of CNS symptoms in the prenatal period, if there are no pregnancyrelated etiologies to explain.
Arthurs BJ, Fairbanks RK, Demakas JJ, Lamoreaux WT, Giddings NA, Mackay AR, et al. A review of treatment modalities for vestibular schwannoma. Neurosurgical review 2011;34(3):265-279.
Lemée JM, Delahaye C, Laccourreye L, Mercier P, Fournier HD. Post-surgical vestibular schwannoma remnant tumors: What to do? Neurochirurgie 2014;60(5):2215-05.
Swensson RC, Swensson RP, Pizzini FE, Boldorini PR, Jorge Júnior JJ. An uncommon presentation of an VIII nerve tumor. Revista Brasileira de Otorrinolaringologia 2008;74(4):628-631.
Simon RH. Brain tumors in pregnancy. InSeminars in neurology. © 1988 by Thieme Medical Publishers, Inc.
Haas JF, Jänisch W, Staneczek W. Newly diagnosed primary intracranial neoplasms in pregnant women: a population-based assessment. Journal of Neurology, Neurosurgery & Psychiatry 1986;49(8):874-880.
Tewari KS, Cappuccini F, Asrat T, Flamm BL, Carpenter SE, Disaia PJ, et al. Obstetric emergencies precipitated by malignant brain tumors. American journal of obstetrics and gynecology 2000;182(5):1215-1221.
Allen J, Eldridge R, Koerber T. Acoustic neuroma in the last months of pregnancy. American journal of obstetrics and gynecology 1974;119(4):516-520.
Bakkouri WE, Kania RE, Guichard JP, Lot G, Herman P, Huy PT. Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. Journal of neurosurgery 2009;110(4):662-669.
Beni-Adani L, Pomeranz S, Flores I, Shoshan Y, Ginosar Y, Ben-Shachar I. Huge acoustic neurinomas presenting in the late stage of pregnancy. Acta obstetricia et gynecologica Scandinavica 2001;80(2):179-184.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 24th ed. Brasil, McGraw Hill, 2014.
Pinna MH, Bento RF, Neto RV. Vestibular schwannoma: 825 cases from a 25-year experience. International archives of otorhinolaryngology 2012;16(04):466-475.