Department of Experimental and Clinical Neuropathology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
Folia Neuropathol. 2012;50(2):166-72.
The coexistence of schwannoma and meningioma in the same cerebellopontine angle (CPA) is uncommon. Especially, the presence of a single mixed tumour composed of demarcated or intermingled components of schwannoma and meningioma tissue is extremely rare. Such a phenomenon is mainly reported in a patient with NF2 or with history of previous irradiation. We present two cases of simultaneous occurrence of schwannoma and meningioma in the same cerebellopontine angle in young adult patients with clinical manifestation of NF2. The first patient was a 18-year-old young man who presented with bilateral CPA tumours, spinal mass lesion and multiple, small, schwannoma-like lesions of the cauda equina. Both CPA tumours was initially diagnosed as schwannomas based on preoperative MR imagings, however right CPA tumour appeared to be composed of a well-circumscribed transitional meningioma located inside schwannoma of Antoni A and B type. The second patient, a young 16-year-old boy, presented bilaterall CPA tumours as well as many meningeal tumours supratentorially and infratentorially. Two adjacent tumours in the left CPA proved to be schwannoma and meningioma. In both cases, the different neoplastic components were confirmed by histopathological and immunohistochemical studies. The possible mechanism underlying the occurrence of such coexisting tumors of different histogenesis remains unclear.
神经鞘瘤和脑膜瘤同时发生于同一桥小脑角（CPA）并不常见。尤其，由神经鞘瘤和脑膜瘤组织的界限分明或混合成分组成的单一混合性肿瘤极为罕见。这种现象主要见于 NF2 患者或有既往放疗史的患者。我们报道了两例年轻成人 NF2 临床表现患者的同一桥小脑角同时发生神经鞘瘤和脑膜瘤的病例。第一例患者是一名 18 岁的年轻人，他表现为双侧 CPA 肿瘤、脊髓肿块病变和多发性、小型、马尾神经鞘瘤样病变。根据术前磁共振成像，双侧 CPA 肿瘤最初被诊断为神经鞘瘤，但右侧 CPA 肿瘤似乎由位于 Antoni A 和 B 型神经鞘瘤内的界限分明的过渡型脑膜瘤组成。第二例患者是一名年轻的 16 岁男孩，表现为双侧 CPA 肿瘤以及颅顶和颅底的许多脑膜瘤。左侧 CPA 的两个相邻肿瘤被证实为神经鞘瘤和脑膜瘤。在这两种情况下，不同的肿瘤成分均通过组织病理学和免疫组织化学研究得到证实。不同组织发生的这种共存肿瘤发生的可能机制尚不清楚。
