Recurrent Schowannoma With Extensive Xanthomatous Changes: A Case Report
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Abstract
Schwannoma is one of the most common benign intracranial tumors, which originates from the Schwann cells of neural structures in the upper part of the vestibular branch of the eighth cranial nerve. This report describes a 64-year-old woman with headache and vertigo who had a past surgical history of acoustic schwannoma about 10 years ago. The patient underwent excisional surgery. Histological examinations revealed schwannoma with extensive xanthomatous changes. Immunohistochemistry staining confirmed the diagnosis. Base on the diagnosis, the patient received no more treatment. After 6 months of close follow-up examinations, no recurrence and complication were observed. Schwannoma could be seen with a vast variety of histologic changes. Recurrence of Schownnoma is uncommon in patients without neurofibromatosis, but it should be considered in a proper clinical context.
[1] Naghibzadeh M, Faraji Rad M, Kamandi SK. Hypoglossal schowannoma: A case report and review of literature. Iranian Journal of Otorhinolaryngology. 2011; 23(1):45-50. [DOI:10.18502/crcp. v4i3.1713]
[2] Goh BK, Tan YM, Chung YF, Chow PK, Ooi LL, Wong WK. Retroperitoneal schwannoma. The American Journal of Surgery. 2006; 192(1):14-8. [DOI:10.1016/j.amjsurg.2005.12.010] [PMID]
[3] Nazar E, Saffar H. Schowannoma in an uncommon site, upper lip: A case report. Case Reports in Clinical Practce. 2019; 4(3):78-80. [DOI:10.18502/crcp.v4i3.1713]
[4] Kim SH, Youm JY, Song SH, Kim Y, Song KS. Vestbular schwannoma with repeated intratumoral hemorrhage. Clinical Neurology and Neurosurgery. 1998; 100(1):68-74. [DOI:10.1016/S0303- 8467(98)00002-X] [PMID]
[5] Liegl B, Bennet MW, Fletcher CD. Microcystc/retcular schwannoma: A distnct variant with predilecton for visceral locatons. The American Journal of Surgical Pathology. 2008; 32(7):1080-7. [DOI:10.1097/PAS.0b013e318160cfda] [PMID]
[6] Subramanian N, Rambhata S, Mahesh L, Menon SV, Krishnakumar S, Biswas J, et al. Cystc schwannoma of the orbit-a case series. Orbit. 2005; 24(2):125-9. [DOI:10.1080/01676830590922020] [PMID]
[7] Wilkinson J, Reid H, Armstrong G. Malignant transformaton of a recurrent vestbular schwannoma. Journal of Clinical Pathology. 2004; 57(1):109-10. [DOI:10.1136/jcp.57.1.109] [PMID] [PMCID]
[8] Taubenslag KJ, Nickols HH, Chelnis JG, Mawn LA. Hybrid Neurofbroma/Schwannoma of the supraorbital nerve:Clinicopathologic correlaton of a rare tumor. Ophthalmic Plastc and Reconstructve Surgery. 2017; 33(3S Suppl 1):S104-6. [DOI:10.1097/ IOP.0000000000000597] [PMID]
[9] Mrak RE, Flanigan S, Collins CL. Malignant acoustc schwannoma. Archives of Pathology & Laboratory Medicine. 1994; 118(5):557-61. [PMID]
[10] Manolidis L, Baloyannis SJ. Pathology of acoustc nerve schwannoma in vivo and in vitro. Acta Oto-Laryngologica. 1985; 99(3-4):280-4. [DOI:10.3109/00016488509108909] [PMID]
[11] Smirniotopoulos JG, Yue NC, Rushing EJ. Cerebellopontne angle masses: Radiologic-pathologic correlaton. RadioGraphics. 1993; 13(5):1131-47. [DOI:10.1148/radiographics.13.5.8210595] [PMID]
[12] Jo VY, Fletcher CDM. SMARCB1/INI1 loss in epithelioid schwannoma: A clinicopathologic and immunohistochemical study of 65 cases. The American Journal of Surgical Pathology. 2017; 41(8):1013-22. [DOI:10.1097/PAS.0000000000000849] [PMID]
[13] McLean CA, Laidlaw JD, Brownbill DS, Gonzales MF. Recurrence of acoustc neurilemoma as a malignant spindle-cell neoplasm. Case report. Journal of Neurosurgery. 1990; 73(6):946-50. [DOI:10.3171/ jns.1990.73.6.0946] [PMID]
[14] Carlson ML, Van Abel KM, Driscoll CL, Neff BA, Beaty CW, Lane JI, et al. Magnetc resonance imaging surveillance following vestbular schwannoma resecton. The Laryngoscope. 2012; 122(2):378-88. [DOI:10.1002/lary.22411] [PMID]
[15] Moshref M, Tomarian L, Behnia H, Mashhadi Abbas A, Zafar Asoodeh M. Schowannoma, review of the literature and report of a case. 2001; 19(3):318-22. htps://www.sid.ir/en/journal/ViewPaper. aspx?ID=32454
[16] Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: Radiologic-pathologic correlaton. RadioGraphics. 2004; 24(5):1477-81. [DOI:10.1148/rg.245045001] [PMID]
[17] Mohiuddin Y, Gilliland MG. Adrenal schwannoma: A rare type of adrenal incidentaloma. Archives of Pathology and Laboratory Medicine. 2013; 137(7):1009-14. [DOI:10.5858/arpa.2012-0291-RS] [PMID]
[18] Pfeifle R, Baur DA, Paulino A, Helman J. Schwannoma of the tongue: Report of 2 cases. Journal of Oral and Maxillofacial Surgery. 2001; 59(7):802-4. [DOI:10.1053/joms.2001.24298] [PMID]
[19] Kashyap S, Pushker N, Meel R, Sen S, Bajaj MS, Khuriajam N, et al. Orbital schwannoma with cystc degeneraton. Clinical & Experimental Ophthalmology. 2009; 37(3):293-8. [DOI:10.1111/j.1442- 9071.2009.02029.x] [PMID]
[20] Subhashraj K, Balanand S, Pajaniammalle S. Ancient schwannoma arising from mental nerve. A case report and review. Medicina Oral, Patología Oral y Cirugía Bucal. 2009; 14(1):E12-4. [PMID]
[21] Tan G, Vitellas K, Morrison C, Frankel WL. Cystc schwannoma of the pancreas. Annals of Diagnostc Pathology. 2003; 7(5):285-91. [DOI:10.1016/S1092-9134(03)00082-0]
[22] Narasimha A, Kumar MH, Kalyani R, Madan M. Retroperitoneal cystc schwannoma: A case report with review of literature. Journal of Cytology. 2010; 27(4):136-9. [DOI:10.4103/0970-9371.73299] [PMID] [PMCID]
[23] Andonian S, Karakiewicz PI, Herr HW. Presacral cystc schwannoma in a man. Urology. 2003; 62(3):551. [DOI:10.1016/S0090- 4295(03)00481-3] [PMID]
[24] Gelal F, Rezanko T, Uyaroglu MA, Tunakan M, Bezircioglu H. Islets of meningioma in an acoustc schwannoma in a patent with neurofbromatosis-2: Pathology and magnetc resonance imaging fndings. Acta Radiologica. 2005; 46(5):519-22. [DOI:10.1080/02841850510021382] [PMID]
[25] Ammoun S, Provenzano L, Zhou L, Barczyk M, Evans K, Hilton DA, et al. Axl/Gas6/NFκB signalling in schwannoma pathological proliferaton, adhesion and survival. Oncogene. 2014; 33(3):336-46. [DOI:10.1038/onc.2012.587] [PMID]
[26] Eldridge R, Parry D. Vestbular schwannoma (acoustc neuroma). Consensus development conference. Neurosurgery. 1992; 30(6):962-4. [PMID]
[27] Muzumdar DP, Goel A. Pathological laughter as a presentng symptom of acoustc schwannoma: Report of two cases. Journal of Clinical Neuroscience. 2003; 10(3):384-6. [DOI:10.1016/S0967- 5868(03)00027-4]
[28] Chuang WY, Yeh CJ, Jung SM, Hsueh S. Plexiform schwannoma of the clitoris. APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica. 2007; 115(7):889-90. [DOI:10.1111/j.1600-0463.2007.apm_734.x] [PMID]
[29] Moradi TH, Razmpa E, Abd Elahi R. Head and neck nerve sheath tumors: A 10-year evaluaton in Iran. Iranian Journal of Pathology . 2009; 4(3):118-22. htps://www.sid.ir/en/Journal/ViewPaper. aspx?ID=144570
[30] Casadei GP, Komori T, Scheithauer BW, Miller GM, Parisi JE, Kelly PJ. Intracranial parenchymal schwannoma: A clinicopathological and neuroimaging study of nine cases. Journal of Neurosurgery. 1993; 79(2):217-22. [DOI:10.3171/jns.1993.79.2.0217] [PMID]
[31] Louw D, Sutherland G, Halliday W, Kaufmann J. Meningiomas mimicking cerebral schwannoma. Journal of Neurosurgery. 1990; 73(5):715-9. [DOI:10.3171/jns.1990.73.5.0715] [PMID]
[32] Isobe K, Shimizu T, Akahane T, Kato H. Imaging of ancient schwannoma. American Journal of Roentgenology. 2004; 183(2):331-6. [DOI:10.2214/ajr.183.2.1830331] [PMID]
[33] Freeman SRM, Ramsden RT, Saeed SR, Alzoubi FQ, Simo R, Rutherford SA, et al. Revision surgery for residual or recurrent ves tbular schwannoma. Otology & Neurotology. 2007; 28(8):1076-82. [DOI:10.1097/MAO.0b013e318159e76a] [PMID]
[34] Ahmad RA, Sivalingam S, Topsakal V, Russo A, Taibah A, Sanna M. Rate of recurrent vestbular schwannoma afer total removal via different surgical approaches. Annals of Otology, Rhinology & Laryngology. 2012; 121(3):156-61. [DOI:10.1177/00034894121210 0303] [PMID]
[35] Sordillo PP, Helson L, Hajdu SI, Magill GB, Kosloff C, Golbey RB, et al. Malignant schwannoma-clinical characteristcs, survival, and response to therapy. Cancer. 1981; 47(10):2503-9. [DOI:10.1002/1097-0142(19810515)47:103.0.CO;2-3] [PMID]
[36] Song JY, Kim SY, Park EG, Kim CJ, Kim DG, Lee HK, et al. Schwannoma in the retroperitoneum. The Journal of Obstetrics and Gynaecology Research. 2007; 33(3):371-5. [DOI:10.1111/j.1447- 0756.2007.00539.x] [PMID]
[2] Goh BK, Tan YM, Chung YF, Chow PK, Ooi LL, Wong WK. Retroperitoneal schwannoma. The American Journal of Surgery. 2006; 192(1):14-8. [DOI:10.1016/j.amjsurg.2005.12.010] [PMID]
[3] Nazar E, Saffar H. Schowannoma in an uncommon site, upper lip: A case report. Case Reports in Clinical Practce. 2019; 4(3):78-80. [DOI:10.18502/crcp.v4i3.1713]
[4] Kim SH, Youm JY, Song SH, Kim Y, Song KS. Vestbular schwannoma with repeated intratumoral hemorrhage. Clinical Neurology and Neurosurgery. 1998; 100(1):68-74. [DOI:10.1016/S0303- 8467(98)00002-X] [PMID]
[5] Liegl B, Bennet MW, Fletcher CD. Microcystc/retcular schwannoma: A distnct variant with predilecton for visceral locatons. The American Journal of Surgical Pathology. 2008; 32(7):1080-7. [DOI:10.1097/PAS.0b013e318160cfda] [PMID]
[6] Subramanian N, Rambhata S, Mahesh L, Menon SV, Krishnakumar S, Biswas J, et al. Cystc schwannoma of the orbit-a case series. Orbit. 2005; 24(2):125-9. [DOI:10.1080/01676830590922020] [PMID]
[7] Wilkinson J, Reid H, Armstrong G. Malignant transformaton of a recurrent vestbular schwannoma. Journal of Clinical Pathology. 2004; 57(1):109-10. [DOI:10.1136/jcp.57.1.109] [PMID] [PMCID]
[8] Taubenslag KJ, Nickols HH, Chelnis JG, Mawn LA. Hybrid Neurofbroma/Schwannoma of the supraorbital nerve:Clinicopathologic correlaton of a rare tumor. Ophthalmic Plastc and Reconstructve Surgery. 2017; 33(3S Suppl 1):S104-6. [DOI:10.1097/ IOP.0000000000000597] [PMID]
[9] Mrak RE, Flanigan S, Collins CL. Malignant acoustc schwannoma. Archives of Pathology & Laboratory Medicine. 1994; 118(5):557-61. [PMID]
[10] Manolidis L, Baloyannis SJ. Pathology of acoustc nerve schwannoma in vivo and in vitro. Acta Oto-Laryngologica. 1985; 99(3-4):280-4. [DOI:10.3109/00016488509108909] [PMID]
[11] Smirniotopoulos JG, Yue NC, Rushing EJ. Cerebellopontne angle masses: Radiologic-pathologic correlaton. RadioGraphics. 1993; 13(5):1131-47. [DOI:10.1148/radiographics.13.5.8210595] [PMID]
[12] Jo VY, Fletcher CDM. SMARCB1/INI1 loss in epithelioid schwannoma: A clinicopathologic and immunohistochemical study of 65 cases. The American Journal of Surgical Pathology. 2017; 41(8):1013-22. [DOI:10.1097/PAS.0000000000000849] [PMID]
[13] McLean CA, Laidlaw JD, Brownbill DS, Gonzales MF. Recurrence of acoustc neurilemoma as a malignant spindle-cell neoplasm. Case report. Journal of Neurosurgery. 1990; 73(6):946-50. [DOI:10.3171/ jns.1990.73.6.0946] [PMID]
[14] Carlson ML, Van Abel KM, Driscoll CL, Neff BA, Beaty CW, Lane JI, et al. Magnetc resonance imaging surveillance following vestbular schwannoma resecton. The Laryngoscope. 2012; 122(2):378-88. [DOI:10.1002/lary.22411] [PMID]
[15] Moshref M, Tomarian L, Behnia H, Mashhadi Abbas A, Zafar Asoodeh M. Schowannoma, review of the literature and report of a case. 2001; 19(3):318-22. htps://www.sid.ir/en/journal/ViewPaper. aspx?ID=32454
[16] Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: Radiologic-pathologic correlaton. RadioGraphics. 2004; 24(5):1477-81. [DOI:10.1148/rg.245045001] [PMID]
[17] Mohiuddin Y, Gilliland MG. Adrenal schwannoma: A rare type of adrenal incidentaloma. Archives of Pathology and Laboratory Medicine. 2013; 137(7):1009-14. [DOI:10.5858/arpa.2012-0291-RS] [PMID]
[18] Pfeifle R, Baur DA, Paulino A, Helman J. Schwannoma of the tongue: Report of 2 cases. Journal of Oral and Maxillofacial Surgery. 2001; 59(7):802-4. [DOI:10.1053/joms.2001.24298] [PMID]
[19] Kashyap S, Pushker N, Meel R, Sen S, Bajaj MS, Khuriajam N, et al. Orbital schwannoma with cystc degeneraton. Clinical & Experimental Ophthalmology. 2009; 37(3):293-8. [DOI:10.1111/j.1442- 9071.2009.02029.x] [PMID]
[20] Subhashraj K, Balanand S, Pajaniammalle S. Ancient schwannoma arising from mental nerve. A case report and review. Medicina Oral, Patología Oral y Cirugía Bucal. 2009; 14(1):E12-4. [PMID]
[21] Tan G, Vitellas K, Morrison C, Frankel WL. Cystc schwannoma of the pancreas. Annals of Diagnostc Pathology. 2003; 7(5):285-91. [DOI:10.1016/S1092-9134(03)00082-0]
[22] Narasimha A, Kumar MH, Kalyani R, Madan M. Retroperitoneal cystc schwannoma: A case report with review of literature. Journal of Cytology. 2010; 27(4):136-9. [DOI:10.4103/0970-9371.73299] [PMID] [PMCID]
[23] Andonian S, Karakiewicz PI, Herr HW. Presacral cystc schwannoma in a man. Urology. 2003; 62(3):551. [DOI:10.1016/S0090- 4295(03)00481-3] [PMID]
[24] Gelal F, Rezanko T, Uyaroglu MA, Tunakan M, Bezircioglu H. Islets of meningioma in an acoustc schwannoma in a patent with neurofbromatosis-2: Pathology and magnetc resonance imaging fndings. Acta Radiologica. 2005; 46(5):519-22. [DOI:10.1080/02841850510021382] [PMID]
[25] Ammoun S, Provenzano L, Zhou L, Barczyk M, Evans K, Hilton DA, et al. Axl/Gas6/NFκB signalling in schwannoma pathological proliferaton, adhesion and survival. Oncogene. 2014; 33(3):336-46. [DOI:10.1038/onc.2012.587] [PMID]
[26] Eldridge R, Parry D. Vestbular schwannoma (acoustc neuroma). Consensus development conference. Neurosurgery. 1992; 30(6):962-4. [PMID]
[27] Muzumdar DP, Goel A. Pathological laughter as a presentng symptom of acoustc schwannoma: Report of two cases. Journal of Clinical Neuroscience. 2003; 10(3):384-6. [DOI:10.1016/S0967- 5868(03)00027-4]
[28] Chuang WY, Yeh CJ, Jung SM, Hsueh S. Plexiform schwannoma of the clitoris. APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica. 2007; 115(7):889-90. [DOI:10.1111/j.1600-0463.2007.apm_734.x] [PMID]
[29] Moradi TH, Razmpa E, Abd Elahi R. Head and neck nerve sheath tumors: A 10-year evaluaton in Iran. Iranian Journal of Pathology . 2009; 4(3):118-22. htps://www.sid.ir/en/Journal/ViewPaper. aspx?ID=144570
[30] Casadei GP, Komori T, Scheithauer BW, Miller GM, Parisi JE, Kelly PJ. Intracranial parenchymal schwannoma: A clinicopathological and neuroimaging study of nine cases. Journal of Neurosurgery. 1993; 79(2):217-22. [DOI:10.3171/jns.1993.79.2.0217] [PMID]
[31] Louw D, Sutherland G, Halliday W, Kaufmann J. Meningiomas mimicking cerebral schwannoma. Journal of Neurosurgery. 1990; 73(5):715-9. [DOI:10.3171/jns.1990.73.5.0715] [PMID]
[32] Isobe K, Shimizu T, Akahane T, Kato H. Imaging of ancient schwannoma. American Journal of Roentgenology. 2004; 183(2):331-6. [DOI:10.2214/ajr.183.2.1830331] [PMID]
[33] Freeman SRM, Ramsden RT, Saeed SR, Alzoubi FQ, Simo R, Rutherford SA, et al. Revision surgery for residual or recurrent ves tbular schwannoma. Otology & Neurotology. 2007; 28(8):1076-82. [DOI:10.1097/MAO.0b013e318159e76a] [PMID]
[34] Ahmad RA, Sivalingam S, Topsakal V, Russo A, Taibah A, Sanna M. Rate of recurrent vestbular schwannoma afer total removal via different surgical approaches. Annals of Otology, Rhinology & Laryngology. 2012; 121(3):156-61. [DOI:10.1177/00034894121210 0303] [PMID]
[35] Sordillo PP, Helson L, Hajdu SI, Magill GB, Kosloff C, Golbey RB, et al. Malignant schwannoma-clinical characteristcs, survival, and response to therapy. Cancer. 1981; 47(10):2503-9. [DOI:10.1002/1097-0142(19810515)47:103.0.CO;2-3] [PMID]
[36] Song JY, Kim SY, Park EG, Kim CJ, Kim DG, Lee HK, et al. Schwannoma in the retroperitoneum. The Journal of Obstetrics and Gynaecology Research. 2007; 33(3):371-5. [DOI:10.1111/j.1447- 0756.2007.00539.x] [PMID]
| Files | ||
| Issue | Vol 6 No 3 (2021): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v6i3.7125 | |
| Keywords | ||
| Schwannoma Recurrence Neurofbromatosis | ||
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How to Cite
1.
Moradi Tabriz H, nazar elham, Efekhar Javadi A, Bakhshi N. Recurrent Schowannoma With Extensive Xanthomatous Changes: A Case Report. CRCP. 2021;6(3):99-104.
