Timmer F C A, Graamans K
Donders Institute for Brain, Cognition and Behaviour, Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
B-ENT. 2011;7(4):305-7.
Treatment strategies for vestibular schwannoma include microsurgery, stereotactic radiotherapy and conservative management (wait and scan). To avoid neurological complications or even death, surgery is the preferred treatment for large tumours with an extrameatal diameter > 3.0 cm.
OBJECTIVE/METHODS: We present the case history of a man with a large vestibular schwannoma who had refused treatment and was seen again eighteen years later.
This patient had not developed symptoms other than the initial hearing loss. Repeated imaging showed that the tumour had not grown and the brainstem compression had not progressed.
This case history illustrates the unpredictable growth pattern of vestibular schwannomas. Apparently, even large tumours in close proximity to the brainstem may remain stable for many years. However, there still are no valid arguments to refrain from therapy in patients with a large vestibular schwannoma, since reliable growth predictors are not available.
前庭神经鞘瘤的治疗策略包括显微手术、立体定向放射治疗和保守治疗（观察等待）。为避免神经并发症甚至死亡，对于外耳道直径>3.0 cm的大型肿瘤，手术是首选治疗方法。
目的/方法：我们介绍了一名患有大型前庭神经鞘瘤的男性患者的病史，该患者拒绝治疗，18年后再次就诊。
除了最初的听力损失外，该患者没有出现其他症状。重复成像显示肿瘤没有生长，脑干压迫也没有进展。
该病史说明了前庭神经鞘瘤不可预测的生长模式。显然，即使是靠近脑干的大型肿瘤也可能多年保持稳定。然而，对于患有大型前庭神经鞘瘤的患者，仍然没有有效的理由不进行治疗，因为目前尚无可靠的生长预测指标。
