Intraparenchymal schwannomas: Report of two new cases studied with MRI and review of the literature

Abstract Intraparenchymal schwannomas are very rare tumours. We present two young adult patients operated for this type of lesion who show no signs of recurrence 2 years after surgery. These tumours have a bimodal peak of presentation: most occur in young patients under 25 years, and the rest presen...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2012-01, Vol.114 (1), p.42-46
Main Authors: Paredes, I, Jimenez Roldán, L, Ramos, A, Lobato, R.D, Ricoy, J.R
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers, Tumor
Brain
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Cancer
Cell adhesion & migration
Cysts
Epilepsy, Complex Partial - etiology
Epilepsy, Complex Partial - pathology
Headache - etiology
Humans
Image Processing, Computer-Assisted
Intracranial tumour
Lipids
Magnetic Resonance Imaging
Male
Medical sciences
Microscopy, Electron
Neurilemmoma - pathology
Neurilemmoma - surgery
Neurologic Examination
Neurology
Neurosurgery
Neurosurgical Procedures
Occipital Lobe - pathology
Perfusion MRI
Recovery of Function
Schwannoma
Spectroscopy
Spectrum analysis
Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
Young Adult
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Summary:Abstract Intraparenchymal schwannomas are very rare tumours. We present two young adult patients operated for this type of lesion who show no signs of recurrence 2 years after surgery. These tumours have a bimodal peak of presentation: most occur in young patients under 25 years, and the rest present in the elderly. Characteristically they show both Antoni A and Antoni B areas, intense inmunoreactivity to S-100 and Vimentin protein, and none to EMA or CD34. Electron microscopy is diagnostic when basal membrane is found around the cytoplasmatic processes. MRI spectroscopy depicts increased myoinositol, choline and lipids, and perfusion MR demonstrates high rCBV with a characteristic curve due to the total absence of blood brain barrier. An origin in the Schwann cells of the perivascular nervous plexus in the subarachnoid space is the most accepted theory for the histogenesis of these tumours. We propose to perform the characterization of a series of markers such as SOX-10 in every new case in order to prove that theory.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2011.07.003