Cystic intraventricular schwannoma: case report and review of the literature

doi:10.1016/S1130-1473(01)70719-1

Neurocirugía

Volume 12, Issue 1, 2001, Pages 56-60

https://doi.org/10.1016/S1130-1473(01)70719-1 Get rights and content

Summary

Intraventricular schwannoma is an exceedingly rare tumour with only 6 cases described in the literature.

One case of a cystic intraventricular schwannoma operated on at our Institution is analized and the other cases reported in the literature are reviewed.

Complete removal was achieved and no reccurrence was noted after a follow-up period of 10 years.

Intraventricular schwannomas are rare tumours that are amenable to complete surgical removal, having a good prognosis without the need of adjuvant therapy.

Resumen

El schwanoma intraventricular es un tumor extremadamente raro del que se han descrito tan solo seis casos en la literatura.

Se describe un caso de schwanoma intraventricular operado en nuestro servicio y se analizan los casos reportados en la literatura.

En nuestro paciente conseguimos una extirpación total y no hemos observado recidiva después de 10 años de seguimiento.

Los schwanomas intraventriculares son tumores raros cuya extirpación total se asocia a buen pronóstico sin necesidad de terapias coadyuvantes.

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Cited by (25)

Intraventricular schwannomas: A case report and literature review
2022, Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
Citation Excerpt :
The literature review has identified 40 articles [26,11,14,37,32,31,34,40,19,3,17,13,12,28,25,4,30,38,27,16,20,24,18,2,5,41,22,15,9,35,1,21,33,29,42,7,36,39,6,23] for a total of 42 cases of intraventricular schwannoma. Among them, forty were benign (group A) [11,14,37,32,31,34,40,3,17,13,12,28,25,4,30,38,27,16,20,24,18,2,5,41,22,15,9,35,1,21,33,29,42,7,36,39,6,23] and only two were malignant (group B) [26,19] . The data of 43 cases, included our own, are described and summarized in Tables 1–3.
Intraventricular schwannomas are a very rare pathological entity with few reported cases in the literature. A medline search up to July 2021 has identified 40 articles for a total of 42 cases. Our personal case has been also added. The patients were divided in two groups in regards of histological features and were separately analyzed and compared: benign intraventricular schwannomas (group A) and malignant intraventricular schwannomas (group B). Intraventricular schwannoma affected patients from the pediatric to the elderly age (range 7–78 years) and mainly the sex male (M,67% vs F,33%). The malignant forms were extremely rare (5%) with only two cases described in literature, but they were associated whit aggressive behavior with tendence to recur (100%). The clinical symptoms were mainly due to obstructive hydrocephalus or mass effect. The lateral ventricles (58%) were the most common involved site, followed by fourth (35%) and finally by the third (7%) ventricle. The hydrocephalus was present in 24% in the preoperative and in 5% of cases in the postoperative period. The surgical procedure performed is microscopic in all except in one of the cases, in which the endoscopic technique was used. There was a need for a ventricular shunting in six (15%) cases in the preoperative and in 7 (17%) in the postoperative course. A complete resection was achieved in 34 out of 43 cases, subtotal in 8 and in one case the tumor was discovered during the autopsy.
Intraventricular schwannomas are mainly benign tumors, without tendence to regrowth or recurrence or malignant transformation after resection. A gross total removal is possible in the most of cases and adjuvant therapies are not necessary. Nevertheless, due to its rarity of occurrence, there are not defined guidelines of treatment. Intraventricular schwannomas should be considered in the differential diagnosis among intraventricular tumors.
Diagnosis of a Rare Intraventricular Schwannoma
2020, World Neurosurgery
Intraventricular schwannoma is extremely rare, with only 35 cases reported to date in the literature. Consequently, its etiology and pathogenesis are still unclear, and therefore require further investigations. Here, we report on and discuss a rare case of intraventricular schwannoma to elucidate on this matter.
A 26-year-old man was admitted to our institution with a 1-month history of headaches and left hemianopsia. At diagnosis, magnetic resonance imaging of the brain revealed a well-demarcated mass with surrounding edema in the right lateral ventricle. Total resection of the tumor was performed by a transsulcal approach through the right parietal lobe. In surgery, it was observed that the tumor was attached to the choroid plexus without invading the wall of the right lateral ventricle. The respective histologic examination confirmed the diagnosis of intraventricular schwannoma. Six months after the surgery, there was no recurrence. Additionally, during this follow-up period, the patient did not develop any neurologic deficit, including visual field narrowing or parietal symptoms, such as acalculia and right-left, finger, and space agnosias.
Although intraventricular schwannomas are rare, 35 cases have already been reported to date. We emphasize the importance of diagnosing such cases correctly to increase knowledge on the origin and pathogenesis of intraventricular tumors, which would facilitate disease management.
Schwannoma of the Fourth Ventricle: Report of Two Cases and Review of Literature
2018, World Neurosurgery
Schwannomas have been reported in several unusual intracranial locations. Here we report 2 cases of extremely rare schwannomas originating in the fourth ventricle, without attachment to the surrounding structures. The clinical course, radiologic and pathological features, treatment, and follow-up are described.
Case 1 was a 49-year-old man who presented with symptoms of paroxysmal dizziness and vomiting. Magnetic resonance imaging (MRI) showed a mixed solid-cystic mass occupying the inferior half of the fourth ventricle. Complete excision of the tumor was performed via midline suboccipital craniectomy. The histological diagnosis was intraventricular schwannoma. Case 2 was an 18-year-old man with chronic vertigo and progressive gait unsteadiness. MRI revealed a heterogeneously enhancing lesion completely filling the fourth ventricle. An Ommaya tube was placed in the ventricle to relieve symptoms of hydrocephalus, followed by tumor resection performed via a suboccipital craniotomy. Histopathological examination confirmed the diagnosis of schwannoma.
Fourth ventricular schwannomas are rare but should be considered in the differential diagnosis of contrast-enhancing intraventricular tumors in both children and adults. Although their etiopathological origin may differ from that of extra-axial schwannomas, their imaging, histology, and clinical course appear to be identical, and these tumors should be managed similarly.
Intraventricular schwannoma: Case report and review of literature
2018, Neurochirurgie
Citation Excerpt :
Most of the reported cases have been histologically benign. Surgical resection was considered curative except in two cases where a malignant tumor of the nerve sheaths was found [3–33] (Table 1). These schwannomas are more frequent in the lateral ventricle and generally posterior to the foramen of Monro.
We report here a case of intraventricular schwannoma. This location is rare. Our patient was a 68-year-old female with a large intraventricular lesion of the body of the lateral ventricle on the right side. Brain magnetic resonance imaging (MRI) revealed this lesion. After a right parietotemporal craniotomy, microsurgical excision using neuronavigation was performed to completely remove the tumor. Histological and immunohistochemical examination confirmed the diagnosis of intraventricular schwannoma devoid of atypical features. Postoperative MRI showed macroscopically complete tumor removal with no recurrence after 12 months of follow-up. A review of the literature identified 32 such cases published to date.
Nous rapportons un cas de schwannome intraventriculaire. Cette localisation est exceptionnelle. Une revue de la littérature retrouve 32 cas publiés à ce jour. Il s’agit d’une femme de 68 ans avec une volumineuse lésion intraventriculaire intéressant le carrefour ventriculaire droit. L’imagerie par résonance magnétique (IRM) cérébrale a révélé cette lésion. Une exérèse microchirurgicale sous neuronavigation après une craniotomie pariéto-temporale droite a permis une résection complète de la tumeur. L’examen histologique et immunohistochimique a confirmé le diagnostic de schwannome intraventriculaire dépourvu de caractère atypique. L’IRM de contrôle post-opératoire a montré une exérèse tumorale macroscopiquement complète et absence de récidive après 12 mois de suivi.
Schwannoma of the Fourth Ventricle: The Eighth Case Report
2015, World Neurosurgery
Citation Excerpt :
Most (95%) are extra-axial, but they can also be found within the brain and spinal cord parenchyma or ventricular system (4, 16). The intraventricular location is the least common, with no more than 20 cases reported since 1950 (18), comprising 1 case in the third ventricle (17), 12 in the lateral ventricles (2, 4-8, 11-13, 19, 20, 25, 28), and 7 cases in the fourth ventricle (10, 14, 16, 18, 22, 29). The first fourth ventricle schwannoma ever reported (in 1957) was malignant and diagnosed postmortem (14).
We report an uncommon case of a surgical resection of a fourth ventricle tumor in an adult that proved to be a schwannoma.
A 53-year-old man presented with a 1.5-year history of gait unsteadiness and vertigo and a few-week history of headache, emesis, and neurogenic dysphagia. A brain magnetic resonance imaging revealed a large, heterogeneously contrast enhancing mass located within the fourth ventricle, compressing the brainstem and causing supratentorial ventricle enlargement. A suboccipital craniotomy and a telovelar approach were performed to resect the tumor. The ventricular system was repermeabilized at the end of the operation.
A postoperative magnetic resonance imaging confirmed complete tumor removal. There was an initial worsening of the preoperative deficits, which progressively improved. The tumor was classified as a fourth ventricle schwannoma. There has been no evidence of tumor recurrence during the 6 years of follow-up. At present, the patient is ambulatory and reports an intermittent diplopia on conjugated gaze.
This case report intends to reveal the eighth case of a fourth ventricle schwannoma since 1957. Schwannomas of the fourth ventricle are infrequent but should be accounted in the differential diagnosis of space-occupying lesions in this location. Gross total resection might be the definite treatment of these tumors if deemed possible.
Intraventricular schwannoma of the choroid plexus. Case report and review of the literature
2013, Neurocirugia
Los tumores intraventriculares representan alrededor del 10% de los tumores del sistema nervioso central. Los schwannomas intraventriculares son infrecuentes y solo existen 15 casos descritos en la literatura.
Paciente de 41 años de edad, con antecedentes de migrañas de 17 años de evolución, que consultó por cefaleas y náuseas. La tomografía y resonancia magnética de cerebro evidenciaron una lesión nodular sólida a nivel del asta occipital derecha con realce homogéneo con contraste. Se realizó una exéresis completa a través de una craneotomía parietal y un abordaje transcortical. La evolución postoperatoria fue favorable. La anatomía patológica informó: schwannoma. La resonancia de control a los 18 meses no mostró recidiva.
Los schwannomas intraventriculares son lesiones muy infrecuentes. El tratamiento quirúrgico de elección es la resección completa. Es un diagnóstico a tener en cuenta en tumores intraventriculares.
Intraventricular tumors account for approximately 10% of central nervous system tumors. The intraventricular schwannomas are rare because there are only 15 cases reported in the international literature.
A forty-one years old female, with a history of migraines during 17 years, consulted for headaches and nausea. Brain computed tomography and magnetic resonance imaging evidenced solid nodular lesion at the right occipital horn with homogeneous contrast enhancement. Complete excision was performed through a right parietal craneotomy and a transcortical approach. The postoperative evolution was favorable. The pathology report: schwannoma. The magnetic resonance imaging 18 months after resection showed no recurrence of tumors.
Intraventricular schwannomas are very rare tumors. Surgery is treatment of choice for total resection. This is a diagnosis to consider in intraventricular tumors.

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^☆: Barbosa M.D.; Rebelo, O.; Barbosa, R; Goncalves J.; Fernandes, R.: Cystic intraventricular schwannoma: case report and review of the literature. Neurocirugía 2001; 12: 56–60.

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Cystic intraventricular schwannoma: case report and review of the literatureSchwanoma quístico intraventricular☆

Summary

Resumen

Exp Neurol

Tumors of the Cen tral Nervous System

Atlas of Tumor Pathology, Third Series Fascicle

Intracranial parenchymal schwannoma. A clinicopathological andneuroimaging study ofnine cases

J Neurosurg

Tumeur schwannoide du ventricule lateral

Neurochirurgie

Ultrastructural and biochemical evidence for a sympathetic neural influence on the choroíd plexus

Exp Neurol

Intracerebral Schwannoma

Surg Neurol

Intracerebral Schwannoma. Report of a case

J Neurosurg

Supratentorial Intracerebral Schwannomas

Surg Neurol

Unilateral Proptosis and Intracranial Schwannoma

Surg Neurol

Malignant intraventricular schwannoma

Case report. J Neurosurg

Histological Typing of Tumours of the Central Nervous System