Naslov
Large subfrontal schwannoma

Autori
Žarković, Kamelija ; Jurić, Gordana ; Papa, J. ; Paladino, J.

Izvornik
Brain Pathology 10 (1015-6305) 10 (2000);

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, kongresno priopcenje, stručni

Sažetak
Introduction. Meningioma is common subfrontal, extracerebral tumour that develops usually without clinical symptoms for the long time thus achieving reach a considerably huge dimensions before becoming manifest. Schwannoma in this region could originated from olfactory groove or dural nerves. There were only ten cases of tumours of the olfactory groove reported so far presented by hyposmia, progressive visual field loss, papilloedma, memory disturbance, generalised convulsion, and/or co-expression of vestibular schwannoma. Clinical details. A 30-year-old female had generalized convulsion for the first time only teen days before surgery. At admission she had no neurological deficit. Phisical examination and family history did not indicated neurofibromatosis. CT scan delineated a large, 10 cm in diameter, isodense mass with small cystic components and faint homogeneous enhancement. Tumor was bifrontal, but predominantly on the left side and was surrounded with perilesional oedema. The tumor tissue predented as isointense on T1-weighted magnetic resonance images (MRI) and displayed high intensity on T2-weighted MRI. Postcontrast MRI showed hetrogeneous enhancement. A bifrontal craniotomy, with total excison of the tumor, was performed. Tumor tissue was firm, with irregular lobules and fixed to cribriform plate but not with falx. Neuropathology findings. The initial biopsy contained several small pieces of tumour tissue, together ranging 7 cm in diameter. On the cut the tissue was predominantly solid and firm. Microscopic appearance of the tumour showed fascicles of fusiform cells with elongated nuclei and indistinct cytoplasmic border. Compact bundles of fusiform cells with nuclear palisading (Verocay bodies) characteristic for Antoni A pattern. Hyalinizated blood vessels and stroma were common, while atypical nuclei (hyper-chromatic and enlarged) were only occasional. Antoni B pattern was not detected, but some wavy areas as in neurofibroma were present. Tumor tissue was diffusely immunopositive for S-100 and vimentin, but not for EMA and neuronal associated proteins. Conclusion Solitary, large tumor of subrontal region raised from cribriform plate could seldom be schwannoma. This tumor might originate from olfactory grooves or from dural nerves of this region and is usually not associated with neurofibromatosis. The schwannoma in our case had in some parts hystological appearance of neurofibroma. Neurofibromas are extremely rare inside of cranium, in contrast to schwanomas. Hence, our report presents a rare site of development of nerve sheath tumour exerting morphology of both tumour types.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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