D'Urso Pietro Ivo, Marino Michele, Di Blasi Arturo, Muccio Carmine Franco, De Cillis Pompilio, Catapano Giuseppe
Neurosurgery Operative Unit, Department of Neuroscience, 'G Rummo' Hospital, Benevento, Italy.
J Med Case Rep. 2011 Dec 28;5:597. doi: 10.1186/1752-1947-5-597.
Intracranial schwannomas unrelated to the cranial nerves are uncommon. We report a new case of tentorial schwannoma unrelated to the cranial nerves, with extension into the pons. A literature review with discussion of the most relevant pathogenetic aspects is also performed.
A 42-year-old Caucasian man was admitted with right-sided paresthesias and weakness of his upper and lower extremities. The neurological examination revealed right hemiparesis and hemi-hypoesthesia. A brain magnetic resonance imaging scan revealed a cerebellopontine lesion, arising from the left free edge of the tentorium, and extending into his pons. A piecemeal removal was performed through a retrosigmoid approach. The lesion was not found to be associated with any cranial nerves. The histological examination revealed a schwannoma Antoni type A. His postoperative course was uneventful. At one year follow-up, the patient was neurologically intact and the magnetic resonance imaging of his brain performed at that time showed complete removal without signs of recurrence.
Tentorial schwannomas are rare clinical entities. Knowledge of their clinical, radiological and anatomical characteristics is very important for the correct diagnosis and management.
与颅神经无关的颅内神经鞘瘤并不常见。我们报告一例与颅神经无关的小脑幕神经鞘瘤，肿瘤延伸至脑桥。同时进行文献回顾并讨论最相关的发病机制方面。
一名42岁的白种男性因右侧感觉异常及上下肢无力入院。神经系统检查发现右侧偏瘫和偏身感觉减退。脑部磁共振成像扫描显示一个小脑桥脑病变，起源于小脑幕左侧游离缘，并延伸至脑桥。通过乙状窦后入路进行了分块切除。未发现该病变与任何颅神经相关。组织学检查显示为Antoni A型神经鞘瘤。他的术后过程平稳。在一年的随访中，患者神经系统完好，当时进行的脑部磁共振成像显示肿瘤完全切除，无复发迹象。
小脑幕神经鞘瘤是罕见的临床实体。了解其临床、放射学和解剖学特征对于正确诊断和治疗非常重要。
