Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, U.S.A.
Department of Radiology, NYU Langone Health, New York, New York, U.S.A.
Laryngoscope. 2021 May;131(5):E1647-E1652. doi: 10.1002/lary.29201. Epub 2020 Oct 26.
To characterize a series of patients with MRI evidence of spontaneous vestibular schwannoma (VS) regression.
Retrospective case series.
Retrospective review between 2012 and 2020 from a single, tertiary-care center of all patients with an untreated, sporadic VS and spontaneous regression in volumetric tumor size over the course of observation. The main outcome measures included VS size and location, presenting symptoms, medication use, changes in pure-tone averages and word recognition scores.
The 13 treatment-naïve patients (62% female, mean age 67.1 years) with spontaneous VS regression represented 3.9% of all patients undergoing observation with serial imaging during the study period. Median tumor size from initial MRI was 529.0 mm (range: 108 mm -13,180 mm ). The mean interval between MRI measurements was 5.5 years (SD 4.4 years). The average percent decrease in tumor size was 36.1% (SD 21.9%) and the average rate of volume decrease was 15.8 mm /yr (SD 25.4 mm /yr). Five patients were classified as having major regression, defined by a relative decrease in volume of >40%, while eight patients had minor regression (<40% relative volume reduction). No significant differences in initial tumor size, rate of regression, or audiometric changes were observed between the major and minor regression cohorts.
Patients with evidence of a spontaneously shrinking VS have a heterogeneous presentation. Due to the scarcity of this phenomenon, predicting which tumors will eventually undergo regression remains unclear. Employing volumetric measurements to compare serial MRI scans may improve the accuracy of detecting shrinking tumors.
4 Laryngoscope, 131:E1647-E1652, 2021.
对一组有 MRI 自发性听神经鞘瘤（VS）消退证据的患者进行特征分析。
回顾性病例系列研究。
回顾性分析 2012 年至 2020 年期间，在一家三级医疗中心，所有未经治疗的散发性 VS 患者的病例资料，这些患者在观察过程中出现了肿瘤体积的自发消退。主要的结局测量包括 VS 大小和位置、首发症状、药物使用、纯音平均听阈和言语识别率的变化。
13 例未经治疗的 VS 自发消退患者（62%为女性，平均年龄 67.1 岁）占研究期间接受连续影像学观察的所有患者的 3.9%。初始 MRI 时肿瘤的中位大小为 529.0mm（范围：108mm-13180mm）。MRI 测量的平均间隔为 5.5 年（SD 4.4 年）。肿瘤大小的平均消退百分比为 36.1%（SD 21.9%），体积平均消退率为 15.8mm/yr（SD 25.4mm/yr）。5 例患者被归类为有明显的肿瘤缩小，即体积相对减少>40%，而 8 例患者有较小的肿瘤缩小（<40%的相对体积减少）。在主要和次要肿瘤缩小组之间，初始肿瘤大小、缩小率或听力变化均无显著差异。
有自发缩小 VS 证据的患者表现出异质性。由于这种现象的罕见性，预测哪些肿瘤最终会发生消退仍然不清楚。使用体积测量来比较连续的 MRI 扫描可能会提高检测缩小肿瘤的准确性。
4 级。喉镜，131：E1647-E1652，2021 年。
