Tan T C, Lam P W Y
Department of Neurosurgery, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China.
Singapore Med J. 2004 Aug;45(8):393-6.
Epithelioid schwannomas are rarely encountered intracranially, with only four cases involving the eighth nerve reported in the literature. Histological behaviour ranging from benign to aggressive has been described. We report a 45-year-old woman who presented with right-sided tinnitus and hearing impairment. Magnetic resonance imaging revealed a tumour in the right cerebellopontine angle with intracanalicular extension. The patient underwent retromastoid craniectomy with near-total tumour excision. Microscopical examination confirmed the diagnosis of epithelioid schwannoma of the vestibular nerve. Intraoperative findings of sharp circumscription, bland histological appearance, low proliferative activity, coupled with the indolent clinical course, point to the quiescent nature of the lesion in this case.
上皮样神经鞘瘤在颅内很少见,文献中仅报道了4例累及第八神经的病例。其组织学行为从良性到侵袭性均有描述。我们报告一名45岁女性,表现为右侧耳鸣和听力障碍。磁共振成像显示右侧桥小脑角有一肿瘤并向管内延伸。患者接受了乳突后颅骨切除术,肿瘤几乎完全切除。显微镜检查证实为前庭神经上皮样神经鞘瘤。术中发现肿瘤边界清晰、组织学表现温和、增殖活性低,再加上临床病程进展缓慢,表明该病例中病变具有静止性。