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Sample records for schwannoma detected incidentally

  1. Incidentally detected emphysematous pyelonephritis.

    PubMed

    Swami, Yogesh Kumar; Singh, Dharam Vir; Gupta, Sanjay Kumar; Pradhan, Aditya; Rana, Yajvender P S; Harkar, Sandeep; Wani, M Shafi

    2012-01-01

    Emphysematous pyelonephritis (EP) is a rare, severe gas forming infection of renal parenchyma and its surrounding areas and potentially life threatening condition that requires prompt evaluation and treatment. Although it commonly present with a fulminant clinical picture of sepsis, relatively mild symptoms can also be encountered. To our knowledge, incidentally detected emphysematous pyelonephritis has not been reported so far. We report a case of EP that was incidentally detected during evaluation for diabetes. PMID:24578929

  2. Salmonella meningitis in an adult with type B viral hepatitis and an incidental schwannoma

    PubMed Central

    Al-Aani, Fuad Khalil; Abusalah, Salem; Al-aqeedi, Rafid; Ibrahim, Abdulsalam

    2009-01-01

    Salmonella meningitis is an unusual complication of Salmonella sepsis that occurs almost exclusively in infants and young children. Cases that do occur in adults are associated with a high morbidity and mortality. The present study concerns a rare case of Salmonella meningitis, the first to be reported in Qatar, in a previously healthy young adult man who was admitted with fever, headache and nuchal rigidity. Cerebrospinal fluid (CSF) culture produced Salmonella paratyphi A, although cultures of blood were negative. The patient was admitted to the medical intensive care unit (MICU) and assisted with mechanical ventilation for 1 week, then transferred to the medical ward where he exhibited progressive improvement on treatment with meropenam for 3 weeks. The patient was found to have an incidental schwannoma causing right-sided hydronephrosis, and hydroureter, treated with double J stent insertion. He was discharged in good condition without any neurological sequelae. PMID:21686413

  3. Retroperitoneal schwannomas

    PubMed Central

    Veliovits, Dousan; Fiska, Aliki; Zorbas, Georgios; Tentes, Antonios-Apostolos K.

    2012-01-01

    Summary Background: Retroperitoneal schwannomas are very rare and are usually found incidentally. Cases Report: Two rare cases of retroperitoneal schwannomas are reported. Both were incidentally found during US scans for non-specific epigastric pain and were initially diagnosed as non-secreting retroperitoneal tumors. The diagnosis was confirmed by CT scan. In both patients the tumors were resected. The definitive diagnosis was possible by histopathology. Conclusions: Although the preoperative assessment of a retroperitoneal tumor may be indicative of a retroperitoneal schwannoma, the definitive diagnosis is possible only by histopathology after surgical removal of the tumor. PMID:23569539

  4. Adrenal Schwannomas: Rare Tumor of the Retroperitoneum.

    PubMed

    Grasso, Emanuele; Simone, Michele

    2015-01-01

    Schwannoma is a benign neurogenic tumor originating from Schwann cells. These produce the myelin sheath that covers peripheral nerves that are often affected. This latter localization is extremely rare, and only a few case reports can be found in the medical literature. Studies have shown that approximately 0.5% to 5% of schwannomas are retroperitoneal, constituting 0.2% of adrenal incidental tumors. These usually present as incidental findings, nonsecreting adrenal masses in asymptomatic patients. Diagnosis of a schwannoma is based on detection of spindle cells with Antoni A and Antoni B regions in histological sections and positive staining for S-100 protein by immunohistochemical analysis. We report a case of an incidentally identified during an abdominal ultrasound examination with schwannoma localized in the left adrenal gland. PMID:26101687

  5. Incidentally Detected Lymphatic Filariasis in a Renal Allograft Recipient

    PubMed Central

    Vanikar, A. V.; Suthar, K. S.; Kute, V. B.; Rizvi, S. J.; Trivedi, H. L.

    2013-01-01

    Post-transplntation lymphocele is a well known complication, and lymphatic filariasis (LF) has occasionally been found to present as post-transplantation lymphocele. However, incidentally detected LF during transplantation surgery has not been reported. We present an incidentally detected LF presenting as enlarged lymph node in the right iliac fossa of a recipient during transplantation of donor kidney. He was subsequently treated after transplantation and had stable graft function without any complications after 8 months of follow-up. PMID:25013664

  6. Gastric Schwannoma: A Benign Tumor Often Misdiagnosed as Gastrointestinal Stromal Tumor

    PubMed Central

    Rathi, Pravin M.; Somani, Vaibhav S.; Mulani, Astha M.

    2015-01-01

    Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma. PMID:26664714

  7. Gastric Schwannoma: A Benign Tumor Often Misdiagnosed as Gastrointestinal Stromal Tumor.

    PubMed

    Shah, Apurva S; Rathi, Pravin M; Somani, Vaibhav S; Mulani, Astha M

    2015-09-28

    Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma. PMID:26664714

  8. Incidentally Detected Blue Nevus of Endocervix: a Case Report

    PubMed Central

    Bhat, Shaila Talengala; Shivamurthy, Archana; Kini Rao, Anuradha Calicut

    2015-01-01

    Blue nevi are uncommon, asymptomatic lesions of the uterine cervix. These lesions are not often detected clinically or on colposcopy. Careful histopathological examination is required. The nevus cells are said to originate from the immature melanoblasts of the neural crest. These lesions need to be differentiated from malignant melanoma and melanosis of the cervix. We present here a case report of incidentally detected cervical blue nevus in a 52 year old lady. PMID:26351493

  9. Detection of Spontaneous Schwannomas by MRI in a Transgenic Murine Model of Neurofibromatosis Type 21

    PubMed Central

    Messerli, SM; Tang, Y; Giovannini, M; Bronsonx, R; Weissleder, R; Breakefield, XO

    2002-01-01

    Abstract Spontaneous schwannomas were detected by magnetic resonance imaging (MRI) in a transgenic murine model of neurofibromatosis type 2 (NF2) expressing a dominant mutant form of merlin under the Schwann cell-specific P0 promoter. Approximately 85% of the investigated mice showed putative tumors by 24 months of age. Specifically, 21% of the mice showed tumors in the intercostal muscles, 14% in the limb muscles, 7% in the spinal cord and spinal ganglia, 7% in the external ear, 14% in the muscle of the abdominal region, and 7% in the intestine; 66% of the female mice had uterine tumors. Multiple tumors were detected by MRI in 21% of mice. The tumors were isointense with muscle by T1-weighted MRI, showed strong enhancement following administration of gadolinium-DTPA, and were markedly hyperintense by T2-weighted MRI, all hallmarks of the clinical manifestation. Hematoxylin and eosin staining and immunohistochemistry indicated that the tumors consisted of schwannomas and Schwann cell hyperplasias. The lesions stained positively for S-100 protein and a marker antigen for the mutated transgenic NF2 protein, confirming that the imaged tumors and areas of hyperplasia were of Schwann cell origin and expressed the mutated NF2 protein. Tumors were highly infectable with a recombinant herpes simplex virus type 1 vector, hrR3, which contains the reporter gene, lacZ. The ability to develop schwannoma growth with a noninvasive imaging technique will allow assessment of therapeutic interventions. PMID:12407444

  10. Breast Sparganosis Incidentally Detected by FDG PET/CT.

    PubMed

    Ha, Seunggyun; Oh, So Won; Kim, Yu Kyeong; Yi, Ann; Ahn, Young Joon

    2013-06-01

    Sparganosis is a rare, parasitic infection that is caused by the plercercoid tapeworm larvae of the genus Spirometra. Sparganosis is transmitted by ingestion of larvae-containing water or intermediate hosts, such as raw amphibians, and usually presented with a subcutaneous nodule in the abdominal wall, extremities, and genital organs. Among the various involved organs, the breast is a seldom encountered site for sparganosis. However, breast sparganosis has clinical importance, since it is generally presented with an indolent palpable mass that mimics malignancy, even without evidence of inflammation. Herein, we report a case of breast sparganosis that was detected incidentally by FDG PET/CT during staging work ups in a patient with gall bladder cancer. PMID:24900094

  11. Incidental Bladder Cancer Detected on Multiparametric Magnetic Resonance Imaging of the Prostate Gland

    PubMed Central

    Sardari, Al; Thomas, John V.; Nix, Jeffrey W.; Pietryga, Jason A.; Sanyal, Rupan; Gordetsky, Jennifer B.; Rais-Bahrami, Soroush

    2015-01-01

    The increased use of axial imaging in various fields of medicine has led to an increased frequency of incidental findings, specifically incidental cancer lesions. Hence, as the use of multiparametric magnetic resonance imaging (MP-MRI) for prostate cancer detection, staging, and management becomes more widespread, the potential for additional incidental findings in the pelvis increases. Herein, we report the case of a man on active surveillance for low-grade, early-staged prostate cancer who underwent MP-MRI and was incidentally found to have a high-grade bladder cancer lesion. PMID:26783492

  12. Spatial resolution and chest nodule detection: an interesting incidental finding

    NASA Astrophysics Data System (ADS)

    Toomey, R. J.; McEntee, M. F.; Ryan, J. T.; Evanoff, M. G.; Hayes, A.; Brennan, P. C.

    2010-02-01

    This study reports an incidental finding from a larger work. It examines the relationship between spatial resolution and nodule detection for chest radiographs. Twelve examining radiologists with the American Board of Radiology read thirty chest radiographs in two conditions - full (1500 × 1500 pixel) resolution, and 300 × 300 pixel resolution linearly interpolated to 1500 × 1500 pixels. All images were surrounded by a 10-pixel sharp grey border to aid in focussing the observer's eye when viewing the comparatively unsharp interpolated images. Fifteen of the images contained a single simulated pulmonary nodule. Observers were asked to rate their confidence that a nodule was present on each radiograph on a scale of 1 (least confidence, certain no lesion is present) to 6 (most confidence, certain a lesion was present). All other abnormalities were to be ignored. No windowing, levelling or magnification of the images was permitted and viewing distance was constrained to approximately 70cm. Images were displayed on a 3 megapixel greyscale monitor. Receiver operating characteristic (ROC) analysis was applied to the results of the readings using the Dorfman-Berbaum-Metz multiplereader, multiple-case method. No statistically significant differences were found with either readers and cases treated as random or with cases treated as fixed. Low spatial frequency information appears to be sufficient for the detection of chest lesion of the type used in this study.

  13. Incidentally Detected Mediastinal Vascular Anatomical Variants on PET-CT: A Pictorial Essay

    PubMed Central

    Paidipati, Kathyayini Gopalkrishna Murthy; Kashyap, Raghava; Tadimeti, Hima; Peyyeti, Mahidhar

    2015-01-01

    Positron emission tomography with computed tomography (PET–CT) is an integral part of oncology practice in the current-day scenario. The hybrid anatomical and metabolic imaging information in this imaging modality provides access to a wealth of incidental findings which can have implications in the management of the patient, especially when surgical options are being considered. In this pictorial essay, we present incidentally detected mediastinal vascular anomalies on PET–CT, along with a review of associated literature. PMID:25883859

  14. Laryngeal schwannoma: excision via a laryngofissure approach

    PubMed Central

    Tse, Antonia; Anwar, Bilal

    2015-01-01

    Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma. PMID:26034238

  15. H. Pylori in a gastric schwannoma: a case report.

    PubMed

    Lavy, Daniel S; Paulin, Ethan T; Parker, Mitchell I; Zhang, Bin; Parker, Glenn S; Schwartz, Mark R

    2016-04-01

    Schwannomas are benign, often asymptomatic, slow-growing tumors that originate from Schwann cells of the neural sheath. Although H. Pylori has been associated with gastric adenocarcinoma, there has never been a recorded association with schwannoma formation. We present a 64-year-old woman who underwent a laparoscopic partial wedge gastrectomy for an incidentally discovered gastric mass. Histologic examination was consistent with schwannoma; however, chronic inflammation with microorganisms morphologically consistent with H. Pylori was also present. This case suggests the first recorded case of H. Pylori in an immunohistochemically confirmed gastric schwannoma. PMID:27162787

  16. H. Pylori in a gastric schwannoma: a case report

    PubMed Central

    Paulin, Ethan T.; Parker, Mitchell I.; Zhang, Bin; Parker, Glenn S.; Schwartz, Mark R.

    2016-01-01

    Schwannomas are benign, often asymptomatic, slow-growing tumors that originate from Schwann cells of the neural sheath. Although H. Pylori has been associated with gastric adenocarcinoma, there has never been a recorded association with schwannoma formation. We present a 64-year-old woman who underwent a laparoscopic partial wedge gastrectomy for an incidentally discovered gastric mass. Histologic examination was consistent with schwannoma; however, chronic inflammation with microorganisms morphologically consistent with H. Pylori was also present. This case suggests the first recorded case of H. Pylori in an immunohistochemically confirmed gastric schwannoma. PMID:27162787

  17. Incidental Memory Encoding Assessed with Signal Detection Theory and Functional Magnetic Resonance Imaging (fMRI)

    PubMed Central

    Clemens, Benjamin; Regenbogen, Christina; Koch, Kathrin; Backes, Volker; Romanczuk-Seiferth, Nina; Pauly, Katharina; Shah, N. Jon; Schneider, Frank; Habel, Ute; Kellermann, Thilo

    2015-01-01

    In functional magnetic resonance imaging (fMRI) studies that apply a “subsequent memory” approach, successful encoding is indicated by increased fMRI activity during the encoding phase for hits vs. misses, in areas underlying memory encoding such as the hippocampal formation. Signal-detection theory (SDT) can be used to analyze memory-related fMRI activity as a function of the participant’s memory trace strength (d′). The goal of the present study was to use SDT to examine the relationship between fMRI activity during incidental encoding and participants’ recognition performance. To implement a new approach, post-experimental group assignment into High- or Low Performers (HP or LP) was based on 29 healthy participants’ recognition performance, assessed with SDT. The analyses focused on the interaction between the factors group (HP vs. LP) and recognition performance (hits vs. misses). A whole-brain analysis revealed increased activation for HP vs. LP during incidental encoding for remembered vs. forgotten items (hits > misses) in the insula/temporo-parietal junction (TPJ) and the fusiform gyrus (FFG). Parameter estimates in these regions exhibited a significant positive correlation with d′. As these brain regions are highly relevant for salience detection (insula), stimulus-driven attention (TPJ), and content-specific processing of mnemonic stimuli (FFG), we suggest that HPs’ elevated memory performance was associated with enhanced attentional and content-specific sensory processing during the encoding phase. We provide first correlative evidence that encoding-related activity in content-specific sensory areas and content-independent attention and salience detection areas influences memory performance in a task with incidental encoding of facial stimuli. Based on our findings, we discuss whether the aforementioned group differences in brain activity during incidental encoding might constitute the basis of general differences in memory performance

  18. Pancreatic Schwannoma - A Rare Case Report

    PubMed Central

    R, Sathyalakshmi; K, Chandramouleeswari; Devi, Nalli R. Sumitra

    2014-01-01

    Pancreatic schwannomas are rare neoplasms. Only 47 cases have been reported in literature as of date. Age group that is commonly involved varies between the range of 20-87 years, with an almost equal sex ratio. Tumour size ranges from 1-20 cm. Locations where schwannomas can be encountered in the pancreas are in the vast majority, the head and body, the incidence being: head-40 %, junction of head and body-6 %, body-21 %, body and tail-15 %, tail-4 % and uncinate process-13 %, 60 % of the tumours are cystic, the rest being solid tumours. We hereby report a case where in total gastrectomy with distal pancreatectomy and splenectomy was done for carcinoma stomach involving the stomach bed and pancreatic schwannoma was an incidental finding in this case. PMID:25177575

  19. Incidentally Detected Lithopedion in an 87-Year-Old Lady: An Autopsy Case Report.

    PubMed

    Gürler, Ahmet Selçuk; Daş, Taner; Gitmiş, Gökhan; Apaydin, Nedim; Kara, Erdoğan; Özdemirel, Rifat Özgür; Çelik, Safa; Özdeş, Emel; Sezer, Yiğit

    2016-09-01

    A lithopedion is a rare complication of pregnancy that occurs when a fetus in an intraabdominal location dies, and it is too large to be reabsorbed by the body. The case was an 87-year-old woman, and she was transferred to the morgue department in April 2014 to determine the cause of death. During autopsy, an intraabdominally located calcified dead fetus and a 12-cm diameter calcified cyst in the right ovary were incidentally detected. It was aged 25 to 29 weeks (according to femur and humerus measurements) with a size of 12.5 × 8 × 5 cm and a weight of 227 g. According to investigation reports, her husband died in 1990, and she had 3 deliveries, the most recent of which was in 1946. Because the menopause age of the case was not exactly known, the retention time of the lithopedion was supposed to be 24 to 68 years according to the date of the most recent pregnancy and the date of her spouse's death. It is the first case that has been incidentally detected and identified during an autopsy in Turkey and also one of the oldest cases in the literature. PMID:27389692

  20. Clinical significance of incidental FDG uptake in the prostate gland detected by PET/CT

    PubMed Central

    Sahin, Ertan; Elboga, Umut; Kalender, Ebuzer; Basıbuyuk, Mustafa; Demir, Hasan Deniz; Celen, Yusuf Zeki

    2015-01-01

    The value of FDG-positron emission tomography/computed tomography (PET/CT) for detecting prostate cancer is unknown. We aimed to investigate the clinical value of incidental prostate FDG uptake on PET/CT scans. We reviewed 6128 male patients who underwent FDG-PET/CT scans and selected cases that reported hypermetabolic lesion in the prostate. The patients who have prior history of prostate carcinoma or prostate surgery were excluded from the study. We have analyzed the correlation between PET/CT findings and serum prostate-specific antigen (PSA) levels, imaging (USG), urological examinations and biopsy. Incidental 18F-FDG uptake of the prostate gland was observed in 79 patients (1.3%). While sixteen of them were excluded due to inadequate clinical data, the remaining 63 patients were included for further analysis. The patients were divided into two groups; 8 patients (12.7%) in the malignant group and 55 patients (87.3%) in the benign group. The SUVmax values were not significantly different between the two groups. In 6 (75%) patients with prostate cancer, FDG uptake was observed focally in the peripheral zone of the prostate glands. There was no significant correlation between the SUVmax and the PSA levels. Incidental 18F-FDG uptake in the prostate gland is a rare condition, but a substantial portion of it is associated with the cancer. Benign and malignant lesions of the prostate gland in FDG-PET/CT imaging could not be reliably distinguished. The peripheral focally FDG uptake of prostate glands should be further examined with the clinical and labaratory evaluations. PMID:26379847

  1. A rare cause of dilated bile duct incidentally detected on imaging

    PubMed Central

    Loh, Kah Poh; Nautsch, Deborah; Desilets, David; Mehendiratta, Vaibhav

    2014-01-01

    Adenomas involving the extrahepatic bile ducts are rare benign tumours of the biliary tract. Given the asymptomatic nature of these tumours and the natural progression of biliary adenoma to carcinoma including cholangiocarcinoma, early detection is challenging. We present a case of an octogenarian woman with a remote history of gallstones who initially presented to the gastroenterology office for an incidental finding of biliary dilation, and whose subsequent imagings and biopsy suggested common bile adenoma. However, the patient was deemed a poor surgical candidate for pancreaticoduodenectomy, and unfortunately represented 5 months later with findings suggesting cholangiocarcinoma. This case provides a unique opportunity to study the natural progression of biliary adenoma to cholangiocarcinoma. PMID:24859557

  2. A Solitary Metastasis for a Malignant Schwannoma in the Gallbladder Detected by 18F-FDG PET/CT.

    PubMed

    Evangelista, Laura; Burei, Marta; Basso, Umberto

    2016-08-01

    A 63-year-old woman with a history of malignant schwannoma in the left shoulder (pT1aNxMx) was treated with surgical resection in 2012. During follow-up, patient developed a metastasis in the right lung treated by further surgical intervention. For a suspicion on persistent disease in the lung, patient was sent to FDG PET/CT examination, which showed a focal uptake in the gallbladder. The patient underwent cholecystectomy, and a solitary metastasis from schwannoma was diagnosed by pathology. This case highlights that, in patients with a malignant schwannoma, a careful differential diagnosis should be made in case of a significant FDG uptake in the gallbladder. PMID:27280905

  3. Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients

    SciTech Connect

    Nakamura, Naoki; Tsunoda, Hiroko; Takahashi, Osamu; Kikuchi, Mari; Honda, Satoshi; Shikama, Naoto; Akahane, Keiko; Sekiguchi, Kenji

    2012-11-01

    Purpose: To determine the frequency and clinical significance of previously undetected incidental findings found on computed tomography (CT) simulation images for breast cancer patients. Methods and Materials: All CT simulation images were first interpreted prospectively by radiation oncologists and then double-checked by diagnostic radiologists. The official reports of CT simulation images for 881 consecutive postoperative breast cancer patients from 2009 to 2010 were retrospectively reviewed. Potentially important incidental findings (PIIFs) were defined as any previously undetected benign or malignancy-related findings requiring further medical follow-up or investigation. For all patients in whom a PIIF was detected, we reviewed the clinical records to determine the clinical significance of the PIIF. If the findings from the additional studies prompted by a PIIF required a change in management, the PIIF was also recorded as a clinically important incidental finding (CIIF). Results: There were a total of 57 (6%) PIIFs. The 57 patients in whom a PIIF was detected were followed for a median of 17 months (range, 3-26). Six cases of CIIFs (0.7% of total) were detected. Of the six CIIFs, three (50%) cases had not been noted by the radiation oncologist until the diagnostic radiologist detected the finding. On multivariate analysis, previous CT examination was an independent predictor for PIIF (p = 0.04). Patients who had not previously received chest CT examinations within 1 year had a statistically significantly higher risk of PIIF than those who had received CT examinations within 6 months (odds ratio, 3.54; 95% confidence interval, 1.32-9.50; p = 0.01). Conclusions: The rate of incidental findings prompting a change in management was low. However, radiation oncologists appear to have some difficulty in detecting incidental findings that require a change in management. Considering cost, it may be reasonable that routine interpretations are given to those who have not

  4. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    MedlinePlus

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis On this page: ... more information about vestibular schwannomas? What is a vestibular schwannoma (acoustic neuroma)? Inner ear with vestibular schwannoma ( ...

  5. Intraosseous schwannoma in schwannomatosis.

    PubMed

    Kashima, T G; Gibbons, M R J P; Whitwell, D; Gibbons, C L M H; Bradley, K M; Ostlere, S J; Athanasou, N A

    2013-12-01

    This study investigates the clinical, radiological, and pathological features of two cases of intraosseous schwannoma that arose in patients with multiple soft tissue schwannomas. In both cases, the patients were adult females and the tibial bone was affected. Vestibular schwannomas were not identified, indicating that these were not cases of neurofibromatosis 2 (NF2). Radiographs showed a well-defined lytic lesion in the proximal tibia; in one case, this was associated with a pathological fracture. Histologically, both cases showed typical features of benign schwannoma. Molecular analysis of one of the excised tumors showed different alterations in the NF2 gene in keeping with a diagnosis of schwannomatosis. Our findings show for the first time that intraosseous schwannomas can occur in schwannomatosis. PMID:23995262

  6. Oncologic aspects of long-term followed incidental prostate cancer detected by cystoprostatectomy in Korean patients

    PubMed Central

    Cho, In-Chang; Kim, Jeong Eun; Kim, Sung Han; Joung, Jae Young; Seo, Ho Kyung; Chung, Jinsoo; Park, Weon Seo; Lee, Kang Hyun

    2015-01-01

    Purpose To determine the incidence and clinical features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy (CPT) for bladder cancer. Methods Ninety-six consecutive patients scheduled to undergo CPT were prospectively enrolled. The prostates were excised completely during CPT. The CPT specimens were examined, and the clinicopathologic characteristics of incidental prostate cancer studied. Complete transverse sections of the prostate were taken from the apex to the base at 4-mm intervals and all prostates were examined by a single pathologist. Results The mean patient age and prostate-specific antigen level were 66.1 ± 10.0 years and 2.8 ± 5.0 ng/mL, respectively. Of the 96 patients, 35 (36.5%) had prostate cancer (PCa). Of these incidental PCas, 57.1% (20.8% of all patients undergoing CPT) were clinically significant. None of the patients who were age ≤50 years had incidental PCa. However, the incidences of PCa in the 51–60 years, 61–70 years, and ≥71 years age groups were 27.8% (5/18), 48.7% (19/39), and 35.5% (15/31), respectively, and the difference according to the age subgroup was significant (P = 0.048). During the median follow-up of 49 months, 29.2% (28/96) of patients died. There were no PCa-specific deaths, and two patients (2.1%) showed biochemical recurrences. Conclusion Incidental PCas were diagnosed in ∼40% of CPT specimens, and ∼50% of incidental PCas were clinically significant. During radical CPT in patients aged ≥60 years, the possibility of the presence of PCa and the potential oncologic risk of partial prostatectomy during CPT should be remembered. PMID:26157769

  7. Incidental diffuse low-grade gliomas: from early detection to preventive neuro-oncological surgery.

    PubMed

    Lima, Guilherme Lucas de Oliveira; Zanello, Marc; Mandonnet, Emmanuel; Taillandier, Luc; Pallud, Johan; Duffau, Hugues

    2016-07-01

    Although a large amount of data supports early surgical resection for symptomatic diffuse low-grade glioma, the therapeutic strategy is still a matter of debate regarding incidentally discovered diffuse low-grade glioma. Indeed, early and "preventive" surgery has recently been proposed in asymptomatic patients with silent diffuse low-grade glioma with better outcomes. The present review discusses the importance of an early diagnosis and of a preventive surgical treatment to improve the outcomes of incidental diffuse low-grade glioma and suggests the possible relevance of a tailored screening policy. PMID:26610909

  8. Schwannomas and their pathogenesis.

    PubMed

    Hilton, David A; Hanemann, Clemens Oliver

    2014-04-01

    Schwannomas may occur spontaneously, or in the context of a familial tumor syndrome such as neurofibromatosis type 2 (NF2), schwannomatosis and Carney's complex. Schwannomas have a variety of morphological appearances, but they behave as World Health Organization (WHO) grade I tumors, and only very rarely undergo malignant transformation. Central to the pathogenesis of these tumors is loss of function of merlin, either by direct genetic change involving the NF2 gene on chromosome 22 or secondarily to merlin inactivation. The genetic pathways and morphological features of schwannomas associated with different genetic syndromes will be discussed. Merlin has multiple functions, including within the nucleus and at the cell membrane, and this review summarizes our current understanding of the mechanisms by which merlin loss is involved in schwannoma pathogenesis, highlighting potential areas for therapeutic intervention. PMID:24450866

  9. Hybrid Neurofibroma-Schwannoma

    PubMed Central

    Specht, Charles S; Frauenhoffer, Elizabeth; Glantz, Michael; Harbaugh, Kimberly

    2016-01-01

    Neurofibromas and schwannomas are common lesions that may be idiopathic or may occur in association with neural crest genetic syndromes such as neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. A hybrid tumor that contains pathological characteristics of both neurofibroma and schwannoma has been described as a rare entity. We present the clinical, radiographic, and pathological findings of such a case. PMID:27158577

  10. Hybrid Neurofibroma-Schwannoma.

    PubMed

    Hussain, Namath S; Specht, Charles S; Frauenhoffer, Elizabeth; Glantz, Michael; Harbaugh, Kimberly

    2016-01-01

    Neurofibromas and schwannomas are common lesions that may be idiopathic or may occur in association with neural crest genetic syndromes such as neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. A hybrid tumor that contains pathological characteristics of both neurofibroma and schwannoma has been described as a rare entity. We present the clinical, radiographic, and pathological findings of such a case. PMID:27158577

  11. Sandstorm Appearance of Pulmonary Alveolar Microlithiasis Incidentally Detected in a Young, Asymptomatic Male

    PubMed Central

    Bux, Shaik Ismail; Liam, Chong Kin; Rahman, Nazarina Abdul; Ho, Choon Yan

    2013-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical "sandstorm" appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM. PMID:24043987

  12. Sandstorm appearance of pulmonary alveolar microlithiasis incidentally detected in a young, asymptomatic male.

    PubMed

    Ch'ng, Li Shyan; Bux, Shaik Ismail; Liam, Chong Kin; Rahman, Nazarina Abdul; Ho, Choon Yan

    2013-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical "sandstorm" appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM. PMID:24043987

  13. Development of a Phenotypic Method for Detection of Fecal Carriage of OXA-48-Producing Enterobacteriaceae after Incidental Detection from Clinical Specimen▿

    PubMed Central

    Ruppé, Etienne; Armand-Lefèvre, Laurence; Lolom, Isabelle; El Mniai, Assiya; Muller-Serieys, Claudette; Ruimy, Raymond; Woerther, Paul-Louis; Bilariki, Kalliopi; Marre, Michel; Massin, Philippe; Andremont, Antoine; Lucet, Jean-Christophe

    2011-01-01

    We report incidental isolation of an OXA-48-producing Escherichia coli strain in urine of a 62-year-old woman recently returning from a 2-month vacation in Morocco. Commercially available extended-spectrum beta-lactamase (ESBL)-targeting medium failed to detect it in the patient's stools, although a locally developed and easy-to-implement method using ertapenem-supplemented brain heart infusion (BHI) broths could. PMID:21562103

  14. Incidental midgut malrotation detected during second laparotomy: Case report and literature review

    PubMed Central

    Vural, Veli; Türkoğlu, Mehmet Akif; Karatas, Gulnur

    2014-01-01

    Introduction Intestinal malrotation is defined as intestinal nonrotation or incomplete rotation around superior mesenteric artery (SMA), involving anomalies of intestinal fixation as well. The patients may be recognized incidentally during other surgical procedures or at autopsy. Here in, we present a case of midgut malrotation which was diagnosed incidentally during hepaticojejunostomy procedure for benign biliary stricture. Presentation of case A 46 years old male patient was referred to our clinic with failed surgery for biliary stricture due to extensive adhesions. Prior to our surgery, intestinal malrotation was not reported and noticed by the diagnostic tools. When the patient underwent relaparotomy, midgut malrotation was observed. Discussion Distruption in the normal embryological development of bowel is the cause of intestinal malrotation. Various anatomic configurations and anomalies resulting from rotation anomalies of midgut. Adult patients are usually asymptomatic and the anomaly is discovered only at autopsy or incidentally at surgery. The role of additional surgery especially in patients with asymptomatic disease related to malrotation is debated. Conclusion Performing loop hepaticojejunostomy with Braun enteroenterostomy is feasible and acceptable option rather than Roux-N-Y hepaticojejunostomy in case of intestinal malrotation. PMID:25533325

  15. Distress and Patient-Centered Communication among Veterans with Incidental (Not Screen-Detected) Pulmonary Nodules. A Cohort Study

    PubMed Central

    Golden, Sara E.; Ganzini, Linda; Wiener, Renda Soylemez; Au, David H.

    2015-01-01

    Rationale: Incidental pulmonary nodule detection is postulated to cause distress, but the frequency and magnitude of that distress have not been reported. The quality of patient–clinician communication and the perceived risk of lung cancer may influence distress Objectives: To evaluate the association of communication processes with distress and the perceived risk of lung cancer using validated instruments. Methods: We conducted a prospective cohort study of patients with incidentally detected nodules who received care at one Department of Veterans Affairs Medical Center. We measured distress with the Impact of Event Scale and patient-centered communication with the Consultation Care Measure, both validated instruments. Risk of lung cancer was self-reported by participants. We used multivariable adjusted logistic regression to measure the association of communication quality with distress. Measurements and Main Results: Among 122 Veterans with incidental nodules, 23%, 12%, and 4% reported experiencing mild, moderate, and severe distress, respectively, at the time they were informed of the pulmonary nodule. Participant-reported risk of lung cancer was not associated with distress. In the adjusted model, high-quality communication was associated with decreased distress (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.08–1.00, P = 0.05). Among participants who reported a risk of malignancy of 30% or less, high-quality communication was associated with decreased distress (OR = 0.15, 95% CI = 0.02–0.92, P = 0.04), but was not associated with distress for those who reported a risk greater than 30% (OR = 0.12 (95% CI = 0.00–3.97, P = 0.24), although the P value for interaction was not significant. Conclusions: Veterans with incidental pulmonary nodules frequently reported inadequate information exchange regarding their nodule. Many patients experience distress after they are informed that they have a pulmonary nodule

  16. Incidental Detection of Oxyphilic Papillary Thyroid Carcinoma by 18F-Fluorocholine PET/CT.

    PubMed

    Lalire, Paul; Zalzali, Mohamed; Garbar, Christian; Bruna-Muraille, Claire; Morland, David

    2016-06-01

    A 70-year-old man with prostate cancer and increased prostate-specific antigen level of 55 ng/mL underwent staging F-fluorocholine PET/CT, which demonstrated the primary prostate tumor and a focal area corresponding to a 2-cm hypodense nodule in the left thyroid lobe. Fine-needle aspiration and subsequent total thyroidectomy with central lymph node dissection showed an oxyphilic papillary thyroid carcinoma and a medullary microcarcinoma. Oxyphilic tumors represent a significant proportion of the few case reports of incidental focal thyroid fluorocholine thyroid uptake. PMID:26914574

  17. Avoiding incidental predation by mammalian herbivores: accurate detection and efficient response in aphids

    NASA Astrophysics Data System (ADS)

    Gish, Moshe; Dafni, Amots; Inbar, Moshe

    2011-09-01

    Mammalian herbivores eat plants that may also provide food and shelter for insects. The direct trophic effect of the browsing and grazing of mammalian herbivory on insects, which is probably prevalent in terrestrial ecosystems, has been mostly neglected by ecologists. We examined how the aphid Uroleucon sonchi L. deals with the danger of incidental predation by mammalian herbivores. We found that most (76%) of the aphids in a colony survive the ingestion of the plant by a feeding herbivore. They do so by sensing the combination of heat and humidity in the herbivore's breath and immediately dropping off the plant in large numbers. Their ability to sense the herbivore's breath or their tendency to drop off the plant weakens as ambient temperature rises. This could indicate a limitation of the aphids' sensory system or an adaptation that enables them to avoid the hostile conditions on a hot ground. Once on the ground, U. sonchi is highly mobile and capable of locating a new host plant by advancing in a pattern that differs significantly from random movement. The accurate and efficient defense mechanism of U. sonchi emphasizes the significance of incidental predation as a danger to plant-dwelling invertebrates.

  18. Incidental Auditory Category Learning

    PubMed Central

    Gabay, Yafit; Dick, Frederic K.; Zevin, Jason D.; Holt, Lori L.

    2015-01-01

    Very little is known about how auditory categories are learned incidentally, without instructions to search for category-diagnostic dimensions, overt category decisions, or experimenter-provided feedback. This is an important gap because learning in the natural environment does not arise from explicit feedback and there is evidence that the learning systems engaged by traditional tasks are distinct from those recruited by incidental category learning. We examined incidental auditory category learning with a novel paradigm, the Systematic Multimodal Associations Reaction Time (SMART) task, in which participants rapidly detect and report the appearance of a visual target in one of four possible screen locations. Although the overt task is rapid visual detection, a brief sequence of sounds precedes each visual target. These sounds are drawn from one of four distinct sound categories that predict the location of the upcoming visual target. These many-to-one auditory-to-visuomotor correspondences support incidental auditory category learning. Participants incidentally learn categories of complex acoustic exemplars and generalize this learning to novel exemplars and tasks. Further, learning is facilitated when category exemplar variability is more tightly coupled to the visuomotor associations than when the same stimulus variability is experienced across trials. We relate these findings to phonetic category learning. PMID:26010588

  19. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    PubMed Central

    Cınar, Alev; Sadıc, Murat; Demırel, Koray; Korkmaz, Meliha

    2013-01-01

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of distribution of this radiotracer in order to recognize the abnormal uptake. Here in, we present a large diaphragmatic hernia, seemed as a mirror vision of myocardium that was determined incidentally during the MPI with 99mTc MIBI. PMID:24379540

  20. Surgical methods and efficacies for cervicothoracolumbar spinal schwannoma

    PubMed Central

    DENG, QIANG; TIAN, ZHENG; SHENG, WEIBIN; GUO, HAILONG; DAN, MAI ER

    2015-01-01

    The aim of this study was to investigate the surgical methods and efficacies for cervicothoracolumbar spinal schwannoma (CSS). A total of 52 patients who had undergone treatment for schwannoma were retrospectively analyzed. Two methods were employed for the surgical resection of the thoracic and lumbar schwannomas: Type I (posterior midline approach semi-laminectomy with tumor resection and internal fixation with pedicle screws) was used in 24 cases, and type II (posterior midline approach laminectomy with tumor resection and internal fixation with pedicle screws) was used in 26 cases. Two cases of giant cervical schwannoma were treated via anterior-posterior combined surgery. Histopathological examination confirmed the diagnosis of schwannoma in all cases (n=52). The clinical status of the patients was evaluated pre- and postoperatively using the visual analog scale, Oswestry Disability Index and Japanese Orthopedic Association scale, and the scores associated with the two types of surgical method were compared. Within the follow-up period, which lasted between 6 months and 3 years, no recurrence was detected, and such preoperative symptoms as radicular pain and spinal dysfunction were improved significantly. The numbness and hyperesthesia were relieved to different extents. In conclusion, methods of exposing and surgically treating CSS should be selected according to the growth site of the schwannoma in order to reduce the blood loss and surgery duration and to improve the surgical safety. PMID:26668590

  1. Schwannoma of Extraocular Nerves

    PubMed Central

    Niazi, Wasim; Boggan, James E.

    1994-01-01

    An unusual case of schwannoma arising from the third cranial nerve in a thirteen year old male is reported. The patient presented with paresis of the right oculomotor nerve and ipsilateral hemiparesis. The clinical features of this case are discussed and the pertinent medical literature reviewed. ImagesFigure 1p220-bFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:17171175

  2. Radiation-induced schwannomas

    SciTech Connect

    Rubinstein, A.B.; Reichenthal, E.; Borohov, H.

    1989-06-01

    The histopathology and clinical course of three patients with schwannomas of the brain and high cervical cord after therapeutic irradiation for intracranial malignancy and for ringworm of the scalp are described. Earlier reports in the literature indicated that radiation of the scalp may induce tumors in the head and neck. It is therefore suggested that therapeutic irradiation in these instances was a causative factor in the genesis of these tumors.

  3. An Incidental Detection of Popliteal Vein Aneurysm during Labeled Leukocyte Scintigraphy

    PubMed Central

    Hassan, H. Abu.; Nazri, M.; Azman, R. R.

    2012-01-01

    Technetium (99mTc) exametazime (hexamethylpropyleneamine oxime, HMPAO) labeled leukocyte scintigraphy is mainly used to exclude occult infection in our institution. On review of previously published article, no case of popliteal venous aneurysm was ever diagnosed and detected on labeled leukocyte scintigraphy. We present a rare case of popliteal venous aneurysm which was detected on labeled leukocyte scintigraphy and was further confirmed with single-photon emission computed tomography and computed tomography fusion. PMID:23372443

  4. Incidence of malignancy and outcomes for dogs undergoing splenectomy for incidentally detected nonruptured splenic nodules or masses: 105 cases (2009-2013).

    PubMed

    Cleveland, Matthew J; Casale, Sue

    2016-06-01

    OBJECTIVE To determine the frequency of malignancy and survival rates of dogs that underwent splenectomy for incidentally detected nonruptured splenic masses or nodules. DESIGN Retrospective case series. ANIMALS 105 client-owned dogs. PROCEDURES Medical records of dogs that underwent splenectomy at a veterinary teaching hospital between 2009 and 2013 were examined to identify patients with incidentally detected nonruptured splenic masses or nodules without associated hemoperitoneum. Only dogs with histologically confirmed diagnoses were included. Information regarding signalment, preoperative diagnostic tests, perioperative blood product transfusions, splenic mass diameter, histologic findings, adjunctive treatments, and survival time was collected and analyzed. RESULTS 74 of 105 (70.5%) patients had benign splenic lesions and 31 (29.5%) had malignant neoplasia, most commonly hemangiosarcoma (18/31 [58%]). The hazard of death decreased as preoperative PCV increased; histopathologic diagnosis of malignant neoplasia was significantly associated with an increased hazard of death. Median life expectancy of dogs with benign and malignant lesions was 436 and 110 days, respectively; 41 of 74 patients with benign lesions and 3 of 31 patients with malignant neoplasia were still alive at study conclusion. Median life expectancy of dogs with hemangiosarcoma was 132 days; only 7 of these 18 dogs received any adjunctive chemotherapeutic treatments. CONCLUSIONS AND CLINICAL RELEVANCE Incidentally found, nonruptured splenic masses or nodules without associated hemoperitoneum were most commonly benign. Results suggested that life expectancy for these dogs with incidentally detected benign or malignant splenic lesions that received prompt intervention was better than has previously been reported for other studied populations. PMID:27172343

  5. Acute brainstem compression by intratumoral hemorrhages in an intracranial hypoglossal schwannoma.

    PubMed

    Inoue, Hiromasa; Nakagawa, Yasuhisa; Ikemura, Mayumi; Usugi, Eri; Kiyofuji, Yuma; Nata, Masayuki

    2013-09-01

    A 77-year-old female in the hospital was found tachycardic and hypothermic by a nurse, and the patient's respiration subsequently ceased. Forensic autopsy revealed an intracranial cystic tumor that would have compressed the brainstem. On microscopic examination, the tumor was diagnosed as an Antoni A schwannoma growth, and recent multiple intratumoral hemorrhages in the intracranial schwannoma were observed, suggesting the sudden enlargement of the intracranial schwannoma due to intratumoral hemorrhaging. Accordingly, we diagnosed the cause of death as brainstem compression induced by the intratumoral hemorrhaging in the intracranial schwannoma. Meanwhile, a rhinopharyngeal tumor was also detected by the autopsy, which was compatible with an antemortem diagnosis of a dumbbell-shaped hypoglossal schwannoma. PMID:23541888

  6. Gynaecological Perspective of Schwannoma: A Rare Pelvic Tumour.

    PubMed

    Padmanaban, Neranjana; Chandrabose, Priya Subash; Esakki, Muthuvel; Kirubamani, Hephzibah; Srinivasan, Chitra

    2016-04-01

    Schwannomas are benign tumours that arise from Schwann cells of nerve fibres. They commonly occur in the head, neck, mediastinum and extremities but pelvic occurrence is rare. We report a rare case of retroperitoneal tumour with Gynaec presentation. A 26-year-old parous woman was admitted with abdominal mass, pain abdomen, painful menstruation and painful coitus for one year. Abdominal examination revealed firm mass filling the lower abdomen with restricted mobility. On bimanual examination cervix was hitched against pubic symphysis. Mass felt through anterior and left adnexa not tender, uterus felt close to the mass about 8-10 weeks size, right adnexa free. USG revealed broad ligament fibroid with cystic right ovary. Hence myomectomy was planned, but intraoperatively it was found that the mass was filling the pelvis close to bulky uterus with cystic right ovary. After informed consent while proceeding with hysterectomy, necrotic, yellow colour material came out from the capsule like structure of the mass which was close to lower part of posterior wall of uterus. Mass was removed except which was adherent to deeper structure left behind. Histopathological examination revealed Schwannoma undergoing cystic degeneration. Since Schwannoma was mostly diagnosed incidentally, high degree suspicion is necessary for diagnosis. PMID:27190900

  7. Gynaecological Perspective of Schwannoma: A Rare Pelvic Tumour

    PubMed Central

    Padmanaban, Neranjana; Chandrabose, Priya Subash; Esakki, Muthuvel; Srinivasan, Chitra

    2016-01-01

    Schwannomas are benign tumours that arise from Schwann cells of nerve fibres. They commonly occur in the head, neck, mediastinum and extremities but pelvic occurrence is rare. We report a rare case of retroperitoneal tumour with Gynaec presentation. A 26-year-old parous woman was admitted with abdominal mass, pain abdomen, painful menstruation and painful coitus for one year. Abdominal examination revealed firm mass filling the lower abdomen with restricted mobility. On bimanual examination cervix was hitched against pubic symphysis. Mass felt through anterior and left adnexa not tender, uterus felt close to the mass about 8-10 weeks size, right adnexa free. USG revealed broad ligament fibroid with cystic right ovary. Hence myomectomy was planned, but intraoperatively it was found that the mass was filling the pelvis close to bulky uterus with cystic right ovary. After informed consent while proceeding with hysterectomy, necrotic, yellow colour material came out from the capsule like structure of the mass which was close to lower part of posterior wall of uterus. Mass was removed except which was adherent to deeper structure left behind. Histopathological examination revealed Schwannoma undergoing cystic degeneration. Since Schwannoma was mostly diagnosed incidentally, high degree suspicion is necessary for diagnosis. PMID:27190900

  8. Bowel mesentery (meso-appendix) microcystic/reticular schwannoma: Case report and literature review

    PubMed Central

    Tang, Shao-Xian; Sun, Yi-Hua; Zhou, Xian-Rong; Wang, Jian

    2014-01-01

    Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract. Due to overlapping features with other tumors, unawareness of this tumor type may lead to diagnostic and therapeutic pitfalls. We here report a case of microcystic/reticular schwannoma arising in the meso-appendix of a 43-year-old woman. The tumor was incidentally discovered by computed tomography scan for unrelated reasons. A laparoscopic operation was performed shortly after admission. Histological examination revealed a circumscribed tumor with a striking microcystic and cribriform architecture. Immunohistochemically, the tumor cells were diffusely positive for S100 protein, glial fibrillary acid protein and protein gene product 9.5, which were consistent with a peripheral nerve sheath tumor. The patient remains well with no signs of recurrence at a 10-mo follow-up. To our knowledge, this is the first case of microcystic/reticular schwannoma arising in the meso-appendix. Albeit very rare, microcystic/reticular schwannoma should be included in the differential diagnosis of appendiceal tumors. PMID:24574814

  9. Laparoscopic Excision of Retroperitoneal Schwannoma

    PubMed Central

    Rajkumar, J S; Anirudh, J R; Akbar, S; Kishore, C M

    2015-01-01

    Schwannomas are tumours that arise from the myelin sheath of the nerves. A very unusual location for schwannoma is the retro peritoneal areas (less than 2%). We present herewith a patient who had a 4x5cm Schwannoma arising from the nerve root of L2 on the right side, which presented as a lump in the psoas major muscle. This was treated by total laparoscopic excision after splitting open the psoas major. In the published english medical literature we could find only 16 cases of laparoscopic resection of retroperitoneal schwannoma and we believe ours to be the first case that was done through a psoas muscle split technique. Technical and histopathological details are discussed elaborately in this article. PMID:26676094

  10. Schwannoma arising from intramasseteric region.

    PubMed

    He, Yue; Fu, Hong Hai; He, Jie; Zhu, Han Guang; Zhang, Zhi Yuan

    2010-11-01

    Schwannoma in the head and neck is usually arising in the parapharyngeal space, but intramasseteric schwannoma is very rare. We report a schwannoma arising from masseter muscle in a middle-aged woman, who presented with a history of a painless right cheek mass for 3 years. Computed tomography scan suggested that the mass was located within the masseter muscle. Fine-needle aspiration was performed and showed spindle neoplastic cells, which were suspected to be of mesenchymal tissue origin. The mass was completely resected under general anesthesia. It was a well-circumscribed and lobulated mass, 4 × 3 × 2 cm in size. Histological examination gave the diagnosis of schwannoma, which was also confirmed by immunohistochemical stainings for S-100 and vimentin. Neurologic sequelae and recurrence were not found at 2 years after surgery. PMID:21119484

  11. Schwannoma of the sigmoid colon.

    PubMed

    Çakır, Tuğrul; Aslaner, Arif; Yaz, Müjgan; Gündüz, Umut rıza

    2015-01-01

    Colonic schwannomas are very rare gastrointestinal tumours originating from Schwann cells, which form the neural sheath. Primary schwannomas of the lower gastrointestinal tract are very rare and usually benign in nature. However, if they are not surgically removed, malign degeneration can occur. We report a case of a 79-year-old woman who presented to our clinic with rectal bleeding and constipation. She underwent a lower gastrointestinal tract endoscopy. A mass subtotally obstructing the lumen of the sigmoid colon was seen and biopsies were taken. Histopathological examination indicated a suspicion of gastrointestinal tumour and the patient underwent sigmoid colon resection after preoperative evaluation by laboratory analysis, abdominal ultrasonography and CT. Her postoperative course was uneventful and she was discharged on the fifth day for outpatient control. The histopathology report revealed schwannoma of the sigmoid colon. This was a case of schwannoma of the sigmoid colon that was successfully treated with total resection. PMID:25976197

  12. Schwannoma of the hard palate

    PubMed Central

    Sahoo, Pradyumna Kumar; Mandal, Palash Kumar; Ghosh, Saradindu

    2014-01-01

    Schwannomas are benign encapsulated perineural tumors. The head and neck region is the most common site. Intraoral origin is seen in only 1% of cases, tongue being the most common site; its location in the palate is rare. We report a case of hard-palate schwannoma with bony erosion which was immunohistochemically confirmed. The tumor was excised completely intraorally. After two months of follow-up, the defect was found to be completely covered with palatal mucosa. PMID:25298716

  13. Incidental Meningiomas: Management in the Neuroimaging Era.

    PubMed

    Spasic, Marko; Pelargos, Panayiotis E; Barnette, Natalie; Bhatt, Nikhilesh S; Lee, Seung James; Ung, Nolan; Gopen, Quinton; Yang, Isaac

    2016-04-01

    The number of patient imaging studies has increased because of precautious physicians ordering scans when a vague symptom is presented; subsequently, the number of incidental meningiomas detected has increased as well. These brain tumors do not present with related symptoms and are usually small. MRI and computed tomographic scans most frequently capture incidental meningiomas. Incidental meningiomas are managed with observation, radiation, and surgical resection. Ultimately, a conservative approach is recommended, such as observing an incidental meningioma and then only radiating if the tumor displays growth, whereas a surgical approach is to be used only when proven necessary. PMID:27012387

  14. FDG PET/CT of Intercostal Schwannoma.

    PubMed

    Wang, Si-Yun; Luo, Dong-Lan; Chen, Gang; Liu, En-Tao; Wang, Shu-Xia

    2016-06-01

    Intercostal schwannoma is rare. We report FDG PET/CT findings of intercostal schwannoma in a 66-year-old woman. The tumor contains both solid and cystic components with intense FDG activity in the solid component. Postsurgical pathology diagnosis revealed schwannoma. PMID:26859215

  15. Schwannoma of the larynx

    PubMed Central

    Ebmeyer, Jörg; Reineke, Ulf; Gehl, Hans-Björn; Hamberger, Ulrich; Mlynski, Robert; Essing, Matthias; Upile, Tahwinder; Sudhoff, Holger

    2009-01-01

    Objectives Neurogenic tumors of the larynx are extremely rare. The goal of this report is to advert to this rare disease, to review and discuss diagnostics, differential diagnoses and treatment options. Study Design: Retrospective case report and review of the literature. Methods: Case report of a schwannoma of the supraglottic larynx and review of the English- and German-language literature regarding neurogenic tumors of the larynx. Results: Neurogenic laryngeal tumors typically involve the supraglottic larynx, rarely the glottis. They can course globus sensation, dysphagia, dysphonia and upper airway obstruction. Imaging does not yield a definite diagnosis. The only curative treatment option is complete surgical resection. Conclusions: A definite diagnosis can only be made histologically. Endoscopic (laser-) resection for smaller lesions and external approaches for larger lesions are recommended treatment options. PMID:19586539

  16. Erector Spinal Muscular Schwannoma of the Dorsal Ramus Nerve: A Case Report

    PubMed Central

    Kim, Jeong Hoon; Kim, Chang Hyun; Moon, Jae Gon; Lee, Ho Kook

    2015-01-01

    We present a rare case of intramuscular schwannoma originating from the dorsal ramus nerve in a 62-year-old woman. The mass grew slowly, with pain developing upon touch five years prior. No neurological deficit was detected. The mass was observed in the erector spinae muscles in magnetic resonance imaging (MRI), and surgical excision was performed. The mass was well encapsulated with clear margin. The lesion appeared to originate from the cranial side. We completely removed the mass including the origin. Histopathology confirmed a schwannoma diagnosis. This is the first report, to our knowledge, of a dorsal ramus-nerve schwannoma within the erector spinae muscles. PMID:26512285

  17. Evaluation of focal thyroid lesions incidentally detected in fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography images.

    PubMed

    Yaylali, O; Kirac, F S; Yuksel, D; Marangoz, E

    2014-01-01

    Background and Purpose: Increased uptake in the thyroid gland (TG) is often identified as an incidental finding on the whole body fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in non-thyroid cancer patients. Currently, there is no consensus on the appropriate approach for the management of these cases. Thyroid ultrasound, scintigraphy and fine-needle aspiration biopsy (FNAB) are suggested to exclude malignant thyroid lesions. Our aim is to determine the importance of increased F-18-FDG uptake in the TG on positron emission tomography/computed tomography (PET/CT) scans in patients who are being screened for various forms of non-thyroid cancer. Materials and Methods: We evaluated 2000 cases undergoing whole body PET/CT scanning between April 2011 and October 2012. The age, sex, type of primary cancer, maximum standardized uptake value (SUV max ), size of the thyroid nodules and cervical lymph nodes (CLNs) on 18 F-FDG PET/CT images and if available, the biopsy results were evaluated. Results: In total, 57 patients (23 men, 34 women, mean age ± standard deviation (SD), 60.89 ± 14 years) showed an increased fluorine-18-fluorodeoxyglucose ( 18 F-FDG) uptake by the TG (average SUV max : 4.07 ± 3.7). The CLNs were detected in 19/57 patients (33%). Only 20 cases (35%) received FNAB. The final histopathological diagnosis was papillary thyroid carcinoma in seven patients (mean SUV max ± SD: 6.0 ± 5.43) and benign thyroid disease in seven patients (mean SUV max ± SD: 2.36 ± 0.63). The FNAB results were undetermined for six patients. Conclusion: Focal high 18 F-FDG uptake in the TG may be associated with an increased risk of malignancy, but the clinical significance is unclear. More data are needed to elucidate the role of the SUV in the differentiation of benign and malign thyroid lesions. If a focal increase in 18 F-FDG uptake in the TG on PET/CT is present, a prompt histopathological evaluation should be suggested

  18. Orbital extension of trigeminal schwannoma.

    PubMed

    Ghosh, Shantanu; Das, Debabrata; Varshney, Rahul; Nandy, Sumit

    2015-01-01

    Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35-year-old female presenting with an axial proptosis of right eyeball with right-sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right-sided heterogeneous, extra-axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post-operative period was uneventful. PMID:25552864

  19. Orbital extension of trigeminal schwannoma

    PubMed Central

    Ghosh, Shantanu; Das, Debabrata; Varshney, Rahul; Nandy, Sumit

    2015-01-01

    Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35-year-old female presenting with an axial proptosis of right eyeball with right-sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right-sided heterogeneous, extra-axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post-operative period was uneventful. PMID:25552864

  20. Plexiform Schwannoma of Lumbar Region

    PubMed Central

    Parihar, Asmita; Verma, Sarika; Suri, Tarun; Agarwal, Anil; Bansal, Kalpana

    2015-01-01

    Plexiform schwannoma is an unusual peripheral nerve sheath tumor. It can mimic plexiform neurofibroma. A five-year-old girl presented with painful swelling in left lumbar region. Radiologic investigations showed a multinodular tumor in the subcutaneous plane of lumbosacral region. A complete excision and histopathologic examination revealed a plexiform tumor composed of hypocellular and hypercellular areas with verocay bodies. The tumor cells showed strong positivity for S-100 protein, rendering a final diagnosis of plexiform schwannoma. The child has been free of recurrence in 12-month follow-up. PMID:26064806

  1. Incidental Detection of a Hodgkin Lymphoma on 18F-Choline PET/CT and Comparison With 18F-FDG in a Patient With Prostate Cancer.

    PubMed

    Goineau, Aurore; Colombié, Mathilde; Rousseau, Caroline; Sadot-Lebouvier, Sophie; Supiot, Stéphane

    2015-08-01

    Combined PET/CT scanning with (18)F-FDG is in current use in Hodgkin lymphoma. New tracers have been developed, such as (18)F-choline in prostate cancer. Its use is under investigation in other solid tumors (eg, brain, liver, lung). We report a case of Hodgkin lymphoma incidentally detected on (18)F-choline PET/CT in a prostate cancer patient and show a comparison with (18)F-FDG PET/CT. (18)F-choline PET/CT detected more lymph node lesions than the (18)F-FDG PET/CT for this patient. Comparative studies of the 2 tracers might help fine-tune treatments and, in particular, delineate target zones in radiation therapy. PMID:26018683

  2. Intracranial Schwannoma in a Cow

    PubMed Central

    Mitcham, S. A.; Kasari, T. R.; Parent, J. M.; Naylor, J. M.

    1984-01-01

    A nine year old Hereford crossbred cow with a history of progressive neurological signs was referred to the Western College of Veterinary Medicine, Saskatoon. A large intracranial mass, histologically identified as a schwannoma, was found to be compressing the left brain stem and appeared to have arisen from the left fifth cranial nerve. ImagesFigure 1.Figure 2.Figure 3. PMID:17422375

  3. Pancreatic schwannoma: A rare case and a brief literature review

    PubMed Central

    Ercan, Metin; Aziret, Mehmet; Bal, Ali; Şentürk, Adem; Karaman, Kerem; Kahyaoğlu, Zeynep; Koçer, Havva Belma; Bostancı, Birol; Akoğlu, Musa

    2016-01-01

    Introduction Pancreatic schwannoma (PS) is an extremly rare benign tumor. Less than 50 cases of pancreatic schwannoma have been described in the English literature over the past thirty years. Presentation of case report A 63-year-old female underwent left modified radical mastectomy 2 years ago due to breast cancer. During her routine check-up, a 65 × 63 × 55 mm measured calcified, well-demarcated, cystic-mass having septations and calcifications that localized to the pancreatic head was detected by abdominal computerized tomography. She was asymptomatic and her tumor markers were in normal ranges. A standard Whipple procedure was performed, and the histo-pathological diagnosis of the resected specimen was reported as ancient schwannoma with clear surgical margins. Patient’s postoperative course was eventful. She had a biliary leakage after surgery which was managed conservatively. She is under follow-up. Discussion Pancreatic schwannoma also known as neurilemoma or neuroma is a slowly growing, encapsulated, mostly benign tumor with smooth well-delineated margins that originates from myelin producing schwann cells located on the nerve sheath of the peripheral epineurium of either the sympathetic or parasympathetic autonomic fibers. PS’s are extremly rare. The head of pancreas being involved in the vast majority of cases (40%), followed by its body (20%). Management of pancreatic schwannomas remains largely controversial. Both enucleation and radical surgical resections have revealed great therapeutic efficiency. with a well prognosis without recurrences. Conclusion Although rare, PS’s should be considered in the differential diagnosis of the other solid or cystic masses of the pancreas. PMID:27084984

  4. Laryngeal schwannoma as an acute airway presentation.

    PubMed

    Markou, Konstantinos; Dova, Stamatia; Poulios, Christos; Karkos, Petros

    2016-01-01

    A schwannoma is a neurogenic tumour arising from nerve sheaths. Between 25% and 45% of schwannomas occur in the head and neck region. Schwannomas of the larynx are extremely rare. They usually occur in women during the fourth and fifth decades of life. We present a case of a laryngeal schwannoma in a 76-year-old patient with acute stridor, hoarseness and dysphagia. Laryngeal conservation surgery was performed without the need for a tracheostomy. One year later, the patient remains symptom-free with no evidence of recurrence. Clinical presentation, diagnosis and management are discussed and the literature is reviewed. PMID:26969364

  5. Stereotactic Radiotherapy for Intracranial Nonacoustic Schwannomas Including Facial Nerve Schwannoma

    SciTech Connect

    Nishioka, Kentaro; Abo, Daisuke; Aoyama, Hidefumi; Furuta, Yasushi; Onimaru, Rikiya; Onodera, Shunsuke; Sawamura, Yutaka; Ishikawa, Masayori; Fukuda, Satoshi; Shirato, Hiroki

    2009-12-01

    Purpose: Although the effectiveness of stereotactic radiosurgery for nonacoustic schwannomas is currently being assessed, there have been few studies on the efficacy of stereotactic radiotherapy (SRT) for these tumors. We investigated the long-term outcome of SRT for nonacoustic intracranial nerve schwannomas. Methods and Materials: Seventeen patients were treated between July 1994 and December 2006. Of these patients, 7 had schwannomas located in the jugular foramen, 5 in the trigeminal nerve, 4 in the facial nerve, and 1 in the oculomotor nerve. Radiotherapy was used as an initial treatment without surgery in 10 patients (59%) and after initial subtotal resection in the remaining patients. The tumor volume ranged from 0.3 to 31.3 mL (mean, 8.2 mL). The treatment dose was 40 to 54 Gy in 20 to 26 fractions. The median follow-up period was 59.5 months (range, 7.4-122.6 months). Local control was defined as stable or decreased tumor size on follow-up magnetic resonance imaging. Results: Tumor size was decreased in 3 patients, stable in 13, and increased in 1 after SRT. Regarding neurologic symptoms, 8 patients (47%) had improvement and 9 patients were unchanged. One patient had an increase in tumor size and received microsurgical resection at 32 months after irradiation. No patient had worsening of pre-existing neurologic symptoms or development of new cranial nerve deficits at the last follow-up. Conclusions: SRT is an effective alternative to surgical resection for patients with nonacoustic intracranial nerve schwannomas with respect to not only long-term local tumor control but also neuro-functional preservation.

  6. Hybrid Epithelioid Schwannoma/Perineurioma.

    PubMed

    Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

    2016-07-01

    We report a case of a 58-year-old who woman presented with a solitary slowly growing subcutaneous nodule covered by normally appearing skin on her left groin. Microscopically, the lesion was well circumscribed but unencapsulated, and showed biphasic cellular differentiation. One cell population was presented by small rounded (epithelioid) cells arranged singly, in small aggregates or short cords, whereas the second one was composed of cells with slender nuclei and delicate elongated bipolar cytoplasmic processes. On immunohistochemistry, the epithelioid component showed positive reaction for S-100 protein and negative for epithelial membrane antigen (EMA), thus compatible with schwannian differentiation and resembling epithelioid schwannoma. The other component showed a reverse immunophenotype being S-100 protein negative and EMA positive, thus corresponding to perineuriomatous differentiation. The clinicopathologic and immunohistochemical features of the lesion were compatible with hybrid epithelioid schwannoma/perineurioma, a rare morphological variant of peripheral nerve sheath tumors. PMID:26863063

  7. Schwannoma Located in Nasopharyngeal Region.

    PubMed

    Aksoy, Fadlullah; Yenigun, Alper; Senturk, Erol; Ozturan, Orhan

    2016-01-01

    Schwannoma is a tumor which has neuroectoderm origins, is hard, well-circumscribed, encapsulated, and slow growing benign cranial tumor, and may autonomously grow out of the nerve sheath of peripheral nerves. It is mostly seen in the head and neck region. In the paranasal sinus and nose areas, it is seen at a rate of 4%. The diagnosis is mostly made after histopathological examination. In this paper, a Schwannoma case observed in the nasopharyngeal region was presented in a 20-year-old female who had complaints of sleeping with open mouth, snoring, foreign body feeling in throat, and swallowing difficulties. The tumor was extracted via transoral approach. No recurrence was observed during follow-up over the next year. This case presentation is presented for the first time in the literature in English. PMID:27293938

  8. Schwannoma Located in Nasopharyngeal Region

    PubMed Central

    Aksoy, Fadlullah; Senturk, Erol; Ozturan, Orhan

    2016-01-01

    Schwannoma is a tumor which has neuroectoderm origins, is hard, well-circumscribed, encapsulated, and slow growing benign cranial tumor, and may autonomously grow out of the nerve sheath of peripheral nerves. It is mostly seen in the head and neck region. In the paranasal sinus and nose areas, it is seen at a rate of 4%. The diagnosis is mostly made after histopathological examination. In this paper, a Schwannoma case observed in the nasopharyngeal region was presented in a 20-year-old female who had complaints of sleeping with open mouth, snoring, foreign body feeling in throat, and swallowing difficulties. The tumor was extracted via transoral approach. No recurrence was observed during follow-up over the next year. This case presentation is presented for the first time in the literature in English. PMID:27293938

  9. Multimodality Management of Trigeminal Schwannomas.

    PubMed

    Niranjan, Ajay; Barnett, Samuel; Anand, Vijay; Agazzi, Siviero

    2016-08-01

    Patients presenting with trigeminal schwannomas require multimodality management by a skull base surgical team that can offer expertise in both transcranial and transnasal approaches as well as radiosurgical and microsurgical strategies. Improvement in neurologic symptoms, preservation of cranial nerve function, and control of mass effect are the primary goals of management for trigeminal schwannomas. Complete surgical resection is the treatment of choice but may not be possible in all cases. Radiosurgery is an option as primary management for small- to moderate-sized tumors and can be used for postoperative residuals or recurrences. Planned surgical resection followed by SRS for residual tumor is an effective option for larger trigeminal schwannomas. The endoscopic resection is an excellent approach for patients with an extradural tumor or tumors isolated to the Meckel cave. A detailed analysis of a tumor and its surroundings based on high-quality imaging can help better estimate the expected outcome from each treatment. An expert skull base team should be able to provide precise counseling for each patient's situation for selecting the best option. PMID:27441164

  10. Isolated Primary Schwannoma of Urinary Bladder

    PubMed Central

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  11. Intrascrotal extratesticular schwannoma: A first pediatric case.

    PubMed

    Bergeron, Michelle; Bolduc, Stéphane; Labonté, Sébastien; Moore, Katherine

    2014-03-01

    Scrotal nerve sheath tumours unassociated with neurofibromatosis or schwannomatosis are extremely rare. Very few cases of benign intrascrotal and extratesticular schwannomas have been reported, but none of them occurred in childhood. This current report describes for the first time a case of benign intrascrotal extratesticular solitary schwannoma in a 16-year-old male. PMID:24839501

  12. Intrascrotal extratesticular schwannoma: A first pediatric case

    PubMed Central

    Bergeron, Michelle; Bolduc, Stéphane; Labonté, Sébastien; Moore, Katherine

    2014-01-01

    Scrotal nerve sheath tumours unassociated with neurofibromatosis or schwannomatosis are extremely rare. Very few cases of benign intrascrotal and extratesticular schwannomas have been reported, but none of them occurred in childhood. This current report describes for the first time a case of benign intrascrotal extratesticular solitary schwannoma in a 16-year-old male. PMID:24839501

  13. P07.04PROMOTER METHYLATION OF THE LATS1 AND LATS2 GENES IN SCHWANNOMAS

    PubMed Central

    Ohta, T.; Oh, J.; Mittelbronn, M.; Paulus, W.; Ohgaki, H.

    2014-01-01

    Schwannoma is a benign nerve sheath tumor that is typically encapsulated and composed of well-differentiated Schwann cellswhich comprises 5-10% of all intracranial tumors in adults. Approximately 90% of schwannomas are solitary and sporadic, whereas ∼4% are considered to arise in the setting of neurofibromatosis type 2 (NF2) syndrome by NF2 germline mutations. The molecular basis of sporadic schwannomas is not fully understood, other than frequent NF2 mutations (∼60%). LATS1 and the related LATS2 are downstream molecules of NF2 and negative regulators of the YAP oncogene in the Salvador/Warts/Hippo (SWH) signaling pathway. Expression of these genes is reduced due to promoter methylation in a variety of neoplasms including gliomas. In the present study, methylation-specific PCR revealed promoter methylation of the LATS1 and LATS2 in 15 of 91 (16%) and 32 of 91 (35%) schwannomas, respectively. These alterations were significantly more frequent in spinal than in peripheral schwannomas (23% vs 3% for LATS1, P = 0.0171; 42% vs 21% for LATS2, P = 0.0386). LATS1 methylation was also detected in 3 of 4 schwannomatosis cases. Furthermore, neurofibroma / schwannoma hybrid tumors showed promoter methylation in LATS1 (3/14; 21%) and LATS2 (8/14; 57%). LATS1 and LATS2 promoter methylation were largely mutually exclusive, and there was a significant negative correlation (P = 0.003); only 10 cases had methylation in both genes. These results suggest that LATS1 and LATS2 promoter methylation may be additional molecular mechanisms resulting in an abnormal SWH pathway in schwannomas and related tumors.

  14. Extensive cytogenetic heterogeneity in a benign retroperitoneal schwannoma.

    PubMed

    Gorunova, L; Dawiskiba, S; Andrén-Sandberg, A; Höglund, M; Johansson, B

    2001-06-01

    A benign retroperitoneal schwannoma from a patient without prior exposure to radiotherapy or chemotherapy was analyzed by chromosome banding after short-term culture. An extensive intratumor heterogeneity in the form of 29 karyotypically related as well as unrelated clones was found. The aberrant clones were diploid or near-diploid and displayed both numerical and structural changes. All chromosomes, except 11, 16, and 20, were affected. Numerical changes included trisomies X, 7, 9, 17, and 18, and monosomies 13 and 18. No clonal loss of chromosome 22, the most characteristic abnormality in schwannomas of other locations, was, however, detected. The structural aberrations resulted in a total of 58 chromosomal breakpoints, with chromosomes 18, 1, and 15 participating in rearrangements most frequently, followed by chromosomes 14, 2, and 22. A striking finding was the clonal involvement of 18p11 in eight rearrangements affecting different chromosomes, suggesting alteration of telomeric function. The molecular mechanisms underlying the observed massive polyclonality in the schwannoma, particularly the presence of cytogenetically unrelated clones, are unknown and probably heterogeneous. PMID:11425455

  15. Intracochlear schwannoma: diagnosis and management.

    PubMed

    Bittencourt, Aline Gomes; Alves, Ricardo Dourado; Ikari, Liliane Satomi; Burke, Patrick Rademaker; Gebrim, Eloisa Maria Santiago; Bento, Ricardo Ferreira

    2014-07-01

    Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions. PMID:25992114

  16. Management of sporadic vestibular schwannoma.

    PubMed

    Carlson, Matthew L; Link, Michael J; Wanna, George B; Driscoll, Colin L W

    2015-06-01

    Vestibular schwannomas (VS) comprise 8% of all intracranial tumors and 90% of cerebellopontine angle and internal auditory canal neoplasms. Secondary to the widespread adoption of screening protocols for asymmetrical hearing loss and the increasing use of advanced imaging, the number of VS diagnosed each year continues to rise, while the average size has declined. Microsurgery remains the treatment of choice for large tumors, however the management of small- to medium-sized VS remains highly controversial with options including observation, radiotherapy, or microsurgery. Within this chapter, the authors provide an overview of the contemporary management of VS, reviewing important considerations and common controversies. PMID:25886814

  17. Presacral schwannoma: laparoscopic resection, a viable option

    PubMed Central

    Jatal, Sudhir; Pai, Vishwas D.; Rakhi, Bharat

    2016-01-01

    Schwannomas are benign nerve sheath tumours arising from Schwann cells. Presacral schwannomas are rare with only case report and short case series being reported in literature. Complete surgical resection is the treatment of choice for these rare tumours. Approach to surgical resection depends on the type of the tumour. Type 3 tumours have conventionally been treated with open intra or extra peritoneal approach. With improvement in the laparoscopic surgical skills, more and more complex surgical procedures have been attempted via this approach. We are presenting a case of presacral schwannoma in an overweight lady treated by laparoscopic resection. PMID:27275489

  18. An atypical case of intracerebral schwannoma.

    PubMed

    AlBatly, Abdulrahman Abdullah; Zakzouk, Reem Seraj; Alhaidey, Ali Khalaf

    2014-01-01

    We report a case of intracerebral cystic schwannoma in the temporal fossa manifested as a gradually worsening headache in a 49-years-old woman. Computed Tomography (CT) and magnetic resonance imaging (MRI) showed a left temporal partly cystic, partly solid mass. The preoperative diagnosis was astrocytoma or glioblastoma multiforme (GBM), but microscopic examination of the mass showed the characteristic pattern with cellular Antony A component. Immunohistochemically, the tumor was positive for S-100 protein. These findings are consistent with a schwannoma. Intracerebral schwannomas not related to cranial nerves are rare and most reported cases involved young patients. PMID:25574318

  19. An atypical case of intracerebral schwannoma

    PubMed Central

    AlBatly, Abdulrahman Abdullah; Zakzouk, Reem Seraj; Alhaidey, Ali Khalaf

    2014-01-01

    We report a case of intracerebral cystic schwannoma in the temporal fossa manifested as a gradually worsening headache in a 49-years-old woman. Computed Tomography (CT) and magnetic resonance imaging (MRI) showed a left temporal partly cystic, partly solid mass. The preoperative diagnosis was astrocytoma or glioblastoma multiforme (GBM), but microscopic examination of the mass showed the characteristic pattern with cellular Antony A component. Immunohistochemically, the tumor was positive for S-100 protein. These findings are consistent with a schwannoma. Intracerebral schwannomas not related to cranial nerves are rare and most reported cases involved young patients. PMID:25574318

  20. Presacral schwannoma: laparoscopic resection, a viable option.

    PubMed

    Jatal, Sudhir; Pai, Vishwas D; Rakhi, Bharat; Saklani, Avanish P

    2016-05-01

    Schwannomas are benign nerve sheath tumours arising from Schwann cells. Presacral schwannomas are rare with only case report and short case series being reported in literature. Complete surgical resection is the treatment of choice for these rare tumours. Approach to surgical resection depends on the type of the tumour. Type 3 tumours have conventionally been treated with open intra or extra peritoneal approach. With improvement in the laparoscopic surgical skills, more and more complex surgical procedures have been attempted via this approach. We are presenting a case of presacral schwannoma in an overweight lady treated by laparoscopic resection. PMID:27275489

  1. Benign schwannoma of the maxillary antrum

    PubMed Central

    Hegde, Oshin; Desai, Dinkar; Bhandarkar, Gowri P.; Paul, Tony

    2016-01-01

    Schwannoma also known commonly as neurilemmoma and schwann cell tumor is a benign nerve sheath tumor. About 1/3rd cases of schwannoma arise from the head and neck region but rarely from the nasal and paranasal sinuses. The recurrence rate in these cases has reported to be very rare. We report a rare case of schwannoma in a 60-year-old woman arising from the maxillary sinus further eroding the orbital floor and nasal bone. We have also described the clinical presentation, radiological, histological findings, and management of the case. PMID:27095911

  2. Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis

    PubMed Central

    Lin, Yu-Pang; Hsu, Hsian-He; Ko, Kai-Hsiung; Chu, Chi-Ming; Chou, Yu-Ching; Chang, Wei-Chou; Chang, Tsun-Hou

    2016-01-01

    To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units) to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs). A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU) analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU) to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI) to measure the HU within the most suspicious part of the lesion. PMID:27128524

  3. Incidental finding of meningioma on bone scintigraphy.

    PubMed

    Thakorlal, A; Wong, D C; Anderson, R J

    2005-06-01

    An incidental finding of an intracranial posterior fossa meningioma detected by bone scintigraphy is presented. Most of the published literature on the diagnosis of meningioma is on the use of CT and MRI. There is limited published literature on the detection of meningioma with bone scintigraphy. PMID:15932468

  4. Ventral Schwannoma of the Thoracolumbar Spine

    PubMed Central

    Yamaguchi, Satoshi; Mori, Masanao; Kubo, Fumikatsu; Tokimura, Hiroshi; Arita, Kazunori

    2013-01-01

    We report two patients with ventral schwannoma in the thoracolumbar region manifesting as low back pain with or without paraparesis. In both patients magnetic resonance imaging (MRI) revealed a heterogeneously-enhanced intradural extramedullary mass in the thoracolumbar region. The tumors were successfully removed via the posterior approach. Their histology was consistent with schwannoma. Postoperative MRI showed no evidence of a tumor in either patient. Spinal schwannomas are common benign intradural extramedullary spinal neoplasms; most arise from the dorsal- and very few from the anterior roots. A literature review revealed that ventral schwannomas, including giant tumors as in the one from case 2 in our study, affect mainly the cervical region, and most are surgically addressed via the posterior approach. Careful handling of the spinal cord is mandatory for satisfactory surgical results. PMID:24353852

  5. Intraosseous Schwannoma of the Petrous Apex

    PubMed Central

    Goiney, Christopher; Bhatia, Rita; Auerbach, Kevin; Norenberg, Michael; Morcos, Jacques

    2011-01-01

    Primary neoplasms of the petrous apex are rare and include eosinophilic granuloma, chondroma, chondrosarcoma, chordoma, and schwannoma. We report just the second published case of an intraosseous schwannoma of the petrous apex and are the first to describe the entity using magnetic resonance imaging. By studying the computed tomography and magnetic resonance imaging features of this rare tumor, it is possible to suggest the diagnosis preoperatively. PMID:22470769

  6. Primary Schwannoma of the Petrous Apex

    PubMed Central

    Horn, Karl L.; Hankinson, Hal L.; Nissen, Alan J.; McDaniel, Shawna L.

    1995-01-01

    We present two patients with primary petrous apex schwannoma. These tumors were centered on the petrous carotid artery and are thought to have originated from the deep petrosal nerve. This would account for the paucity of neurologic deficits in these patients. Imaging findings and surgical treatment of primary petrous apex schwannomas are discussed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8 PMID:17170967

  7. [Focal liver lesion, incidental finding].

    PubMed

    Dietrich, C F; Jenssen, C

    2012-10-01

    The differential diagnosis of incidentally found Focal Liver Lesions (FLL) is complex. Screening procedures so far are only defined for patients with liver cirrhosis. Characterization of a FLL begins as soon as it is detected. Taking patients history and thorough clinical examination are essential. An imaging procedure that is used to detect liver masses should also allow the examiner to determine whether the lesion is benign or malignant. Conventional B-mode US and colour Doppler imaging are effective at detecting and characterizing typical liver cysts and calcifications. Laboratory data, computed tomography, magnetic resonance imaging and imaging guided liver biopsy are complementary methods.Contrast Enhanced Ultrasound (CEUS) is a well established diagnostic imaging technique for a variety of indications and applications. One of the most important applications is in the liver where it is frequently a first-line technique for the detection and diagnosis (characterization) of focal liver lesions (FLL). In this setting the accurate differentiation of benign from malignant lesions is critical to ensure the patient undergoes the appropriate therapeutic option. This has been documented in recently published guidelines, in particular in terms of the enhancement patterns of the most common FLL hemangioma, focal nodular hyperplasia hepatocellular adenoma and their differentiation from malignant lesions. In this article the role of CEUS in the characterization of incidentally found FLL is described. PMID:23033169

  8. Intraosseous Schwannoma of the Petrous Apex

    PubMed Central

    Tamura, Ryota; Takahashi, Satoshi; Kohno, Maya; Kameyama, Kaori; Fujiwara, Hirokazu; Yoshida, Kazunari

    2015-01-01

    Background and Importance Intraosseous schwannoma is a relatively rare clinical entity that typically arises in vertebral and mandibular bone. Intraosseous schwannoma located entirely within the petrous bone is exceedingly rare, and only two cases have been reported to date. Clinical Presentation A 47-year-old Asian man was referred to our hospital with a chief complaint of double vision. Neurologic examination revealed left abducens nerve palsy. Radiologic imaging showed a 35-mm osteolytic expansive lesion located in the left petrous apex. We made a preoperative diagnosis of chondrosarcoma and performed surgical resection. Surgery was performed via a left subtemporal epidural approach with anterior petrosectomy. The histopathologic diagnosis of the tumor was schwannoma. Schwannoma arising from cranial nerves was excluded from intraoperative findings in conjunction with the results for cranial nerves, and intraosseous schwannoma was diagnosed. Postoperative course was uneventful, and abducens nerve palsy resolved immediately after surgery. Conclusion The differential diagnosis of intraosseous schwannoma should be considered for an osteolytic mass lesion within the petrous apex. Subcapsular tumor removal was considered ideal in terms of preservation of the cranial nerves and vessels around the tumor. PMID:26251791

  9. Incidental Detection of Subcutaneous Myopericytoma of Trunk on FDG PET/CT and Bone Scintigraphy for Imaging of Colon Cancer.

    PubMed

    Demir, Selin Soyluoglu; Sarikaya, Ali; Aktas, Gul Ege; Oz Puyan, Fulya

    2016-08-01

    Myopericytoma is a rare type of unusual soft tissue tumor with perivascular myoid differentiation. A 53-year-old man with the diagnosis of colon cancer was referred to Tc-MDP bone scan and F-FDG PET/CT for staging. A subcutaneous mass located in right lower back with heterogeneous FDG uptake was detected on PET/CT. There was increased osteoblastic activity on MDP bone scan in the same region. Mass was resected and subsequently confirmed as myopericytoma by histopathology. PMID:27124684

  10. The Effects of Incidentally Learned Temporal and Spatial Predictability on Response Times and Visual Fixations during Target Detection and Discrimination

    PubMed Central

    Beck, Melissa R.; Hong, S. Lee; van Lamsweerde, Amanda E.; Ericson, Justin M.

    2014-01-01

    Responses are quicker to predictable stimuli than if the time and place of appearance is uncertain. Studies that manipulate target predictability often involve overt cues to speed up response times. However, less is known about whether individuals will exhibit faster response times when target predictability is embedded within the inter-trial relationships. The current research examined the combined effects of spatial and temporal target predictability on reaction time (RT) and allocation of overt attention in a sustained attention task. Participants responded as quickly as possible to stimuli while their RT and eye movements were measured. Target temporal and spatial predictability were manipulated by altering the number of: 1) different time intervals between a response and the next target; and 2) possible spatial locations of the target. The effects of target predictability on target detection (Experiment 1) and target discrimination (Experiment 2) were tested. For both experiments, shorter RTs as target predictability increased across both space and time were found. In addition, the influences of spatial and temporal target predictability on RT and the overt allocation of attention were task dependent; suggesting that effective orienting of attention relies on both spatial and temporal predictability. These results indicate that stimulus predictability can be increased without overt cues and detected purely through inter-trial relationships over the course of repeated stimulus presentations. PMID:24732965

  11. Silicone Granuloma in the Buttocks Incidentally Detected by 18F-FDG PET/CT 30 Years After Free Liquid Silicone Injections.

    PubMed

    Ohnona, Jessica; Durand, Pauline; Amegnizin, Jean-Louis; Kerrou, Khaldoun

    2016-06-01

    A 59-year-old transexual (male to female) patient presented with a squamous cell carcinoma of the larynx. She underwent an F-FDG PET/CT for initial staging. The examination showed high F-FDG uptake of the primary lesion and a homolateral lymphadenopathy. Incidental heterogeneous uptake of round hyperdense lesions in the gluteal muscles and subcutaneous fat was visualized. The medical history revealed secondly that the patient had had free liquid silicone injections 30 years before the examination. Although the injection of free silicone is not practised since the 1980s, this incidental finding should prompt to check the patient's medical history over several decades. PMID:26975013

  12. Incidental Variants Are Critical for Genomics

    PubMed Central

    Biesecker, Leslie G.

    2013-01-01

    The topic of incidental variants detected through exome and genome sequencing is controversial, both in clinical practice and in research. The arguments for and against the deliberate analysis and return of incidental variants focus on issues of clinical validity, clinical utility, autonomy, clinical and research infrastructure and costs, and, in the research arena, therapeutic misconception. These topics are briefly reviewed and an argument is made that these variants are the future of genomic medicine. As a field, we should take full advantage of all opportunities to study these variants by searching them out, returning them to patients and research participants, and studying their utility for predictive medicine. PMID:23643378

  13. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    PubMed

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. PMID:23891013

  14. Incidental extraspinal findings on magnetic resonance imaging of intervertebral discs

    PubMed Central

    Ayaz, Umit Yasar; Turanlı, Sevim; Saltas, Hakan; Karabacak, Osman Raif; Damar, Cagrı; Hekimoglu, Baki

    2014-01-01

    Introduction We aimed to evaluate pathological extraspinal findings and congenital anomalies/anatomical variations that were incidentally detected on the magnetic resonance imaging (MRI) scans of intervertebral discs, to find the frequencies of these incidental findings, and to emphasise the clinical importance of them. Material and methods A retrospective study including 1031 consecutive patients (730 females and 301 males, with a median age of 46 years) was conducted by evaluating a total of 1106 MRI examinations of intervertebral discs. Examinations were performed with a 1.5 T MRI unit. Incidental findings were classified as pathological findings and congenital anomalies/anatomical variations. Results The percentages of incidental extraspinal pathological findings and congenital anomalies/anatomical variations were 16.6% (95% confidence interval (CI): 14.4–18.8) and 3.7% (95% CI: 2.6–4.3), respectively. The percentage of incidental extraspinal pathological findings on cervical spinal MRI was 25.7% (95% CI: 20.1–31.7), thyroid nodules being the most common incidental findings. On thoracic spinal MRI (n = 19), inferior pole thyroid nodules were demonstrated as incidental extraspinal pathological findings, with a percentage of 10.5% (95% CI: 9.6–11.5). On lumbar spinal MRI, incidental pathological findings were detected with a percentage of 14.2% (95% CI: 11.9–16.6), while the percentage of congenital anomalies/anatomical variations was 4.8% (95% CI: 3.4–6.3). Eventually, 6.5% (95% CI: 2.6–9.4) of all cases with incidental extraspinal pathological findings underwent surgery. Conclusions On MRI examination of intervertebral discs, paying attention to incidentally detected pathological extraspinal findings and congenital anomalies/anatomical variations is very important due to the fact that they can alter the treatment of the patient or affect the patient's life. PMID:25276162

  15. Diagnosis and management of retroperitoneal ancient schwannomas

    PubMed Central

    Choudry, Haroon A; Nikfarjam, Mehrdad; Liang, John J; Kimchi, Eric T; Conter, Robert; Gusani, Niraj J; Staveley-O'Carroll, Kevin F

    2009-01-01

    Background Ancient schwannomas are degenerate peripheral nerve sheath tumors that very rarely occur in the retroperitoneum. They generally reach large proportions before producing symptoms due to mass effect. We describe three cases of retroperitoneal ancient schwannomas and discuss the diagnosis and management of these tumors. Case presentations Three female patients with retroperitoneal ancient schwannomas were reviewed. One patient presented with several weeks of upper abdominal pain and lower chest discomfort, whereas back pain and leg pain with associated weakness were predominant symptoms in the remaining two. Abdominal imaging findings demonstrated heterogeneous masses in the retroperitoneum with demarcated margins, concerning for malignancy. The patients successfully had radical excision of their tumors. Histological examination showed encapsulated tumors that displayed alternating areas of dense cellularity and areas of myxoid matrix consistent with a diagnosis of ancient schwannoma. Conclusion A diagnosis of ancient schwannoma should be entertained for any heterogeneous, well encapsulated mass in the retroperitoneum. In these cases less radical surgical resection should be considered as malignant transformation of these tumors is extremely rare and recurrence is uncommon following excision. PMID:19187535

  16. Intramammary schwannoma: a palpable breast mass.

    PubMed

    Parikh, Yasha; Sharma, Kush J; Parikh, Samir J; Hall, Diane

    2016-09-01

    Schwannomas are benign tumors arising from the peripheral nerve sheath, commonly occurring in the head, neck, and extensor surfaces of the extremities. They can be associated with neurofibromatosis type II. Our case describes a 48-year-old woman with a 2-week history of a left-sided palpable breast mass. She was referred to radiology, where additional imaging revealed a 1.1-cm mass. A biopsy was performed; histology revealed an intramammary schwannoma. Mammography findings include a well-defined mass without calcification. Ultrasound images have shown hypoechoic, encapsulated, and well-defined lesions without calcification. Histologically, schwannomas reveal alternating Antoni A and Antoni B cellular areas. Schwannomas are also S100-positive on immunohistochemistry. This case is best categorized as a BI-RADS 4A lesions. This case report highlights the importance of both imaging and pathology in the diagnosis of breast neoplasms. Although breast schwannomas are not a common entity, they are an important consideration when evaluating a breast mass. PMID:27594933

  17. Extracranial Head and Neck Schwannomas: Our Experience.

    PubMed

    Shrikrishna, B H; Jyothi, A C; Kulkarni, N H; Mazhar, Md Shafiuddin

    2016-06-01

    Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25 % of the cases, and may be associated with Von Recklinghausen's disease. Schwannomas are always a diagnostic dilemma as they are asymptomatic for long time and histopathology is the gold standard for diagnosis. The present study retrospectively analysed data of 4 patients with schwannomas and reviewed the literature on the subject. Retrospective study at ENT & Head and Neck Surgery Department of Navodaya Medical College, Raichur. Data of 4 patients between 2008 and 2014 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and associated nerve of origin (NOO) were evaluated. The patients' age ranged from 18 to 50 years. None of them had type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial plexus, vagus nerve, sympathetic chain and lingual nerve. The nerve of origin was identified based on intra-operative findings and post-operative neurological deficits. Tumour was removed by debulk operation with the preservation of NOO method. Schwannomas are generally benign, and rarely recur. An accurate preoperative workup with the identification of NOO is very important not only for a correct diagnosis, but also for surgical planning and informing the patient about the possible complications. PMID:27340644

  18. Genome-wide methylation analysis in vestibular schwannomas shows putative mechanisms of gene expression modulation and global hypomethylation at the HOX gene cluster.

    PubMed

    Torres-Martín, Miguel; Lassaletta, Luis; de Campos, Jose M; Isla, Alberto; Pinto, Giovanny R; Burbano, Rommel R; Melendez, Bárbara; Castresana, Javier S; Rey, Juan A

    2015-04-01

    Schwannomas are tumors that develop from Schwann cells in the peripheral nerves and commonly arise from the vestibular nerve. Vestibular schwannomas can present unilaterally and sporadically or bilaterally when the tumor is associated with neurofibromatosis Type 2 (NF2) syndrome. The molecular hallmark of the disease is biallelic inactivation of the NF2 gene. The epigenetic signature of schwannomas remains poorly understood and is mostly limited to DNA methylation of the NF2 gene, whose altered expression due to epigenetic factors in this tumor is controversial. In this study, we tested the genomewide DNA methylation pattern of schwannomas to shed light on this epigenetic alteration in these particular tumors. The methodology used includes Infinium Human Methylation 450K BeadChip microarrays in a series of 36 vestibular schwannomas, 4 nonvestibular schwannomas, and 5 healthy nerves. Our results show a trend toward hypomethylation in schwannomas. Furthermore, homeobox (HOX) genes, located at four clusters in the genome, displayed hypomethylation in several CpG sites in the vestibular schwannomas but not in the nonvestibular schwannomas. Several microRNA (miRNA) and protein-coding genes were also found to be hypomethylated at promoter regions and were confirmed as upregulated by expression analysis; including miRNA-21, Met Proto-Oncogene (MET), and PMEPA1. We also detected methylation patterns that might be involved in alternative transcripts of several genes such as NRXN1 or MBP, which would increase the complexity of the methylation and expression patterns. Overall, our results show specific epigenetic signatures in several coding genes and miRNAs that could potentially be used as therapeutic targets. PMID:25533176

  19. Schwannoma

    MedlinePlus

    ... tumor of the nerve of hearing (the 8th cranial nerve, also known as the acoustic or vestibulocochlear nerve). ... the tumor affects the facial nerve (the 7th cranial nerve, which is located next to the 8th cranial ...

  20. Trochlear Nerve Schwannoma With Repeated Intratumoral Hemorrhage.

    PubMed

    Liu, Pengfei; Bao, Yuhai; Zhang, Wenchuan

    2016-09-01

    Trochlear nerve schwannoma is extremely rare, with only 35 pathologically confirmed patients being reported in the literature. Here, the authors report a patient of trochlear nerve schwannoma in the prepontine cistern manifesting as facial pain and double vision and presenting the image characteristics of repeated intratumoral hemorrhage, which has never been reported in the literature. Total tumor along with a portion of the trochlear nerve was removed by using a retrosigmoid approach. Facial pain disappeared after operation, and the diplopia remained. Follow-up studies have shown no tumor recurrence for 2 years and the simultaneous alleviation of diplopia. Information regarding the clinical presentation, radiological features and surgical outcomes of trochlear nerve schwannoma are discussed and reviewed in the paper. PMID:27607129

  1. Spontaneous shrinkage of vestibular schwannoma

    PubMed Central

    Romani, Rossana; Pollock, Jonathan

    2016-01-01

    Background: “Watch, wait, and rescan” (WWR) has an established place as a successful management option for a significant proportion of vestibular schwannomas (VS) as an alternative to microsurgical removal or stereotactic radiotherapy. VS may grow slowly and continuously, followed by stagnation or even shrinkage. We present two case reports of spontaneous shrinkage of VS along with a review of the literature. Case Description: A 29-year-old female presented with a progressive history of visual blurring and intermittent diplopia over 2 months. A 29 mm of maximum intracranial diameter (ICD) VS with secondary obstructive hydrocephalus was diagnosed. The patient underwent a ventriculo-peritoneal shunt with resolution of her symptoms and opted for initial WWR management. Interval scanning between 2007 and 2014 showed progressive reduction in the maximum ICD together with reduction in the degree of central tumor enhancement. Maximum ICD at most recent follow up was 22 mm. A 28-year-old female was referred with right sensorineural deafness. A right VS of maximum ICD of 27 mm was diagnosed. Initial WWR management was planned after discussion. Serial imaging showed an initial increase in the size of the tumor followed by progressive reduction in size. The most recent follow up showed a maximum ICD of 20 mm. Conclusion: Early WWR management can be associated with spontaneous shrinkage of VS over time. Prospective clinical study of larger numbers of such cases using the UK VS database may help to identify predictive factors for the spontaneous regression of VS. PMID:27280055

  2. Vestibular schwannoma surgery and headache.

    PubMed

    Levo, H; Blomstedt, G; Pyykkö, I

    2000-01-01

    The aim of the study was to evaluate aetiological factors for postoperative headache after vestibular schwannoma (VS) surgery with respect to asymmetric activation of vestibular reflexes. After surgery, 27 VS patients with persistent postoperative headache, 16 VS patients without headache and 9 healthy controls were examined. The vestibular, cervicocollic and cervicospinal reflexes were evaluated to study whether asymmetric activation of vestibular reflexes could cause headache. The effect of neck muscle and occipital nerve anaesthesia and the effect of sumatriptan on headache were also evaluated. The vestibular function of VS patients with headache did not differ from that of VS patients without headache, but was abnormal when compared to that of normal controls. The cervicospinal and cervicocollic reflexes did not differ in the patient groups. Injection of lidocaine around the operation scar gave pain relief to two patients, and one of them had occipital nerve entrapment. Infiltration of lidocaine deep in the neck muscles in the vicinity of the C2 root did not alleviate headache, but caused vertigo. Nine patients with musculogenic headache got pain relief from supportive neck collars, and two patients with cervicobrachial syndrome got pain relief from manual neck traction. The study shows that asymmetric activation of cervicocollic reflexes does not seem to be the reason for headache. Headache seems to be linked to neuropathic pain, allegedly caused by trigeminal irritation of the inner ear and the posterior fossa, which has recently been linked to vascular pain. PMID:10908966

  3. Incidental and non-incidental thyroid microcarcinoma

    PubMed Central

    KALISZEWSKI, KRZYSZTOF; WOJTCZAK, BEATA; STRUTYŃSKA-KARPIŃSKA, MARTA; ŁUKIEŃCZUK, TADEUSZ; FORKASIEWICZ, ZDZISŁAW; DOMOSŁAWSKI, PAWEŁ

    2016-01-01

    There is no clear therapeutic approach for thyroid microcarcinoma (TMC). This may be as a consequence of recent observations that have reported biologically different types of TMC, which should be treated differently. The objective of the present study was to compare incidental TMC (ITMC) and non-incidental TMC (NITMC) in order to assess the differences in the incidence, diagnostic results, clinicopathological characteristics and surgical treatment. The study consisted of a retrospective chart review of 3,218 patients consecutively admitted and surgically treated in a single institution due to thyroid pathology. A total of 246 (7.64%) patients presented with a thyroid malignancy, and 97 (39.43%) of these individuals were diagnosed with TMC; 37 (38.14%) patients exhibited ITMC and 60 (61.86%) exhibited NITMC. All 37 (100.00%) patients with ITMC exhibited a papillary type of cancer. In the NITMC group, 1 (1.67%) patient presented with follicular microcarcinoma, 1 (1.67%) individual with papillary- and follicular-type microcarcinoma, 1 (1.67%) individual with medullary microcarcinoma, and the remaining 57 (95.00%) patients presented with papillary microcarcinoma. The number of younger patients (<45 years old) was higher in the NITMC group, but this difference was not significant (P=0.205). In all patients with ITMC, ultrasound-guided fine-needle aspiration biopsy did not reveal malignant processes. In the NITMC group, the number of larger tumors (>5 mm) was significantly higher compared with that in the ITMC group (P<0.001). ITMC was significantly associated with multinodular goiter (MNG) (P<0.001). Amongst the NITMC group, 18.33% of patients presented with cervical lymph node involvement (P<0.001). Overall, the incidence of TMC is high, and consists of ITMC and NITMC, although the prevalence of NITMC is higher than that of ITMC. The majority of ITMCs and NITMCs are composed of a papillary type of cancer. The majority of ITMCs have dimensions ≤5 mm in diameter and

  4. Psammomatous Melanotic Schwannoma: A Challenging Histological Diagnosis

    PubMed Central

    Merat, Rastine; Szalay-Quinodoz, Ildiko; Laffitte, Emmanuel; Kaya, Gürkan

    2015-01-01

    Psammomatous melanotic schwannoma (PMS) is a rare pigmented tumor that can be part of the Carney complex. Here, we describe the case of a 35-year-old female patient presenting an isolated subcutaneous PMS. Histopathological analysis could not formally exclude the malignant nature of the tumor. The challenging histological diagnosis and consequently the management of the patient are described. PMID:27047937

  5. Complications of Microsurgery of Vestibular Schwannoma

    PubMed Central

    Zvěřina, Eduard; Balogová, Zuzana; Skřivan, Jiří; Kraus, Josef; Syka, Josef; Chovanec, Martin

    2014-01-01

    Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery. PMID:24987677

  6. Vagal Schwannoma: A Rare Parapharyngeal Tumour.

    PubMed

    Kamath, Panduranga M; Dosemane, Deviprasad; Sreedharan, Suja S; Majeed, Nazeem A; Shenoy, Vijendra S

    2016-04-01

    Among the parapharyngeal tumours, salivary gland tumours are the commonest, followed by schwannomas, which are slow growing benign tumours. Half of the parapharyngeal schwannomas originate from the vagus. Complete surgical excision is the treatment of choice. We hereby present two cases of parapharyngeal schwannomas, one which had presented as an intraoral mass and the other as a swelling in the neck. The first case, a 57-year-old female patient complained of a slowly increasing swelling in the left side of the throat since 3 months, associated with pain and dysphagia. In the Contrast Enhanced CT scan of the neck, a well-defined cystic lesion with central enhancing solid components (4cm X 4.5cm X 3cm) was seen in the left parapharyngeal region. The second case, a 39-year-old male patient complained of a painless, gradually increasing swelling below the lobule of the right ear since one month. Examination revealed a solitary, nontender, firm and mobile swelling of 2cm X 2cm below the lobule of the right ear. In Contrast Enhanced CT scan of the neck, an enhancing lesion was seen involving the right parapharyngeal space, post-styloid compartment. Both the patients underwent trans-cervical surgical excision. Vagal nerve schwannoma is rare. The majority of the cases present with a slow growing neck swelling without neurological deficit. Complete surgical excision of the tumour is important to prevent recurrence. PMID:27190844

  7. Spontaneous Regression of an Incidental Spinal Meningioma

    PubMed Central

    Yilmaz, Ali; Kizilay, Zahir; Sair, Ahmet; Avcil, Mucahit; Ozkul, Ayca

    2016-01-01

    AIM: The regression of meningioma has been reported in literature before. In spite of the fact that the regression may be involved by hemorrhage, calcification or some drugs withdrawal, it is rarely observed spontaneously. CASE REPORT: We report a 17 year old man with a cervical meningioma which was incidentally detected. In his cervical MRI an extradural, cranio-caudal contrast enchanced lesion at C2-C3 levels of the cervical spinal cord was detected. Despite the slight compression towards the spinal cord, he had no symptoms and refused any kind of surgical approach. The meningioma was followed by control MRI and it spontaneously regressed within six months. There were no signs of hemorrhage or calcification. CONCLUSION: Although it is a rare condition, the clinicians should consider that meningiomas especially incidentally diagnosed may be regressed spontaneously. PMID:27275345

  8. Double migration of a schwannoma of thoracic spine

    PubMed Central

    Khan, Robert Ahmed; Rahman, Asifur; Bhandari, Paawan Bahadur; Khan, SIM Khairun Nabi

    2013-01-01

    Mobile intraspinal tumours have rarely been reported. In most cases, mobile tumours such as schwannomas or ependymomas were located in the cauda equina. Perusal of the literature revealed only two reports of mobile schwannomas in the cervical and thoracic regions. We report a case of thoracic schwannoma which migrated twice in successive operations resulting in negative exploration in the expected area. The aim of this report is to remind the surgeons about the possibility of migration of intradural-extramedullary tumour. PMID:23349180

  9. Intrasellar schwannoma mimicking pituitary adenoma: a case report.

    PubMed

    Whee, Sung Mock; Lee, Jung Il; Kim, Jong Hyun

    2002-02-01

    Intrasellar location of schwannoma is extremely rare, although intracranial schwannomas account for up to 8% of all primary brain tumors. An unusual case of an intrasellar schwannoma radiographically and clinically simulating a pituitary adenoma is reported. A 39-yr-old man presented a 10-month history of visual disturbance and decreased libido. Neurological examination showed poor visual acuity of both eyes with bitemporal hemianopsia. Computed tomography and magnetic resonance imaging showed a sellar tumor with suprasellar extension. Pituitary adenoma was considered as a preoperative diagnosis. The tumor was removed through a trans-sphenoidal approach. Microscopic examination of the tumor revealed schwannoma. PMID:11850608

  10. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case.

    PubMed

    Sulhyan, Kalpana R; Deshmukh, Bhakti D; Gosavi, Alka V; Ramteerthakar, Nayan A

    2015-10-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis. PMID:26715928

  11. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case

    PubMed Central

    Sulhyan, Kalpana R; Deshmukh, Bhakti D; Gosavi, Alka V; Ramteerthakar, Nayan A

    2015-01-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis. PMID:26715928

  12. Imaging diagnosis: cranial cervical intraspinal schwannoma in a dog.

    PubMed

    Oliveira, Maria; De La Fuente, Cristian; Pumarola, Martí; Añor, Sònia

    2014-01-01

    A 3-year-old, intact female Golden Retriever was presented with acute tetraplegia. Neurologic examination was consistent with a C1-C5 myelopathy. On magnetic resonance (MR) imaging a well-defined, extradural mass was detected within the spinal canal at the level of C1-C2. The mass was isointense to normal spinal cord gray matter on T1-weighted (T1W) images, hyperintense on T2-weighted (T2W), and gradient-echo (GE) images, and enhanced homogeneously after intravenous contrast administration. MR imaging features were mainly consistent with a meningioma. Surgical treatment was refused by the owners, and the dog was euthanized. Postmortem examination demonstrated that the intraspinal mass was a schwannoma. PMID:23738896

  13. Acute Shingles after Resection of Thoracic Schwannoma

    PubMed Central

    Muesse, Jason L.; Blackmon, Shanda H.; Harris, Richard L.; Kim, Min P.

    2012-01-01

    Herpes zoster is relatively uncommon after surgery in immunocompetent patients. To our knowledge, there have been no reports of herpes zoster after the resection of a thoracic schwannoma. We report the case of a 48-year-old woman in whom acute shingles developed after the video-assisted thoracic surgical resection of a posterior mediastinal schwannoma adjacent to the 4th thoracic vertebral body. The patient recovered after receiving timely antiviral therapy. Rash and pain are common in patients who have wound infections and contact dermatitis after surgery, so the possible reactivation of varicella virus might not be prominent in the surgeon's mind. This case serves as a reminder that viral infections such as shingles should be considered in the differential diagnosis of postoperative erythema and pain. PMID:22740749

  14. Melanotic schwannoma of the L5 root.

    PubMed

    Güzel, Ebru; Er, Uygur; Güzel, Aslan; Toktaş, Zafer; Yapıcıer, Özlem

    2016-06-01

    Melanotic neoplasm of the central nervous system is rare and the majority of them are metastatic. Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm accounting for less than 1% of primary nerve sheath tumors. A case involving a 36-year-old man with MS at the L5 root is presented. Surgery, differential diagnosis, radiology, histology, and treatment of this rare entity are discussed. PMID:26969197

  15. Radiotherapy for Vestibular Schwannomas: A Critical Review

    SciTech Connect

    Murphy, Erin S.; Suh, John H.

    2011-03-15

    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  16. Ancient schwannoma of the thumb pulp.

    PubMed

    Matsumine, Hajime; Takeuchi, Masaki

    2015-01-01

    A 21-year-old woman had become aware of a mass on the palmar aspect of the distal phalanx of her left thumb 11 years earlier. Her medical history was unremarkable, with no traumatic injury of the left thumb. Initial examination revealed a hard but elastic, immovable tumor of 30 × 25 mm on the palmar aspect of the distal phalanx of the left thumb, with an ulcer formed at the center. No pain, sensory disturbance, or motor dysfunction was noted. The patient underwent punch biopsy at the outpatient clinic, and the tumor was histopathologically diagnosed as benign schwannoma. Total excision of the tumor was performed with digital nerve block under surgical microscope. Histopathological findings revealed a fibrous capsule covering the tumor, directional growth of tightly organized spindle-shaped cells, and mixed Antoni A and B patterns. The tumor also contained many various sized cysts and showed histological degenerative changes not observed in ordinary schwannoma, such as hemorrhage and prominent blood vessels with hyalinized walls. The S-100 stain was positive. Based on these findings, the patient was diagnosed as having ancient schwannoma. There was no evidence of infection, pain, complications such as ulcer formation, or recurrent tumor at 6 months postoperative. PMID:25674369

  17. The importance of nerve microenvironment for schwannoma development.

    PubMed

    Schulz, Alexander; Büttner, Robert; Hagel, Christian; Baader, Stephan L; Kluwe, Lan; Salamon, Johannes; Mautner, Victor-Felix; Mindos, Thomas; Parkinson, David B; Gehlhausen, Jeffrey R; Clapp, D Wade; Morrison, Helen

    2016-08-01

    Schwannomas are predominantly benign nerve sheath neoplasms caused by Nf2 gene inactivation. Presently, treatment options are mainly limited to surgical tumor resection due to the lack of effective pharmacological drugs. Although the mechanistic understanding of Nf2 gene function has advanced, it has so far been primarily restricted to Schwann cell-intrinsic events. Extracellular cues determining Schwann cell behavior with regard to schwannoma development remain unknown. Here we show pro-tumourigenic microenvironmental effects on Schwann cells where an altered axonal microenvironment in cooperation with injury signals contribute to a persistent regenerative Schwann cell response promoting schwannoma development. Specifically in genetically engineered mice following crush injuries on sciatic nerves, we found macroscopic nerve swellings in mice with homozygous nf2 gene deletion in Schwann cells and in animals with heterozygous nf2 knockout in both Schwann cells and axons. However, patient-mimicking schwannomas could only be provoked in animals with combined heterozygous nf2 knockout in Schwann cells and axons. We identified a severe re-myelination defect and sustained macrophage presence in the tumor tissue as major abnormalities. Strikingly, treatment of tumor-developing mice after nerve crush injury with medium-dose aspirin significantly decreased schwannoma progression in this disease model. Our results suggest a multifactorial concept for schwannoma formation-emphasizing axonal factors and mechanical nerve irritation as predilection site for schwannoma development. Furthermore, we provide evidence supporting the potential efficacy of anti-inflammatory drugs in the treatment of schwannomas. PMID:27236462

  18. Schwannoma, a rare tumor of the seminal vesicle

    PubMed Central

    Carrasquinho, Eduardo; Ferreira, Marco; Afonso, Ana; Ferrito, Fernando

    2011-01-01

    We present a rare case of a schwannoma of the seminal vesicle that occurred in a 43-year-old male with symptoms of the lower urinary tract. Ultrasonography and magnetic resonance imaging documented a solid mass in the patient's left seminal vesicle. A transvesical approach with a transtrigonal midline incision was successfully performed. The microscopic aspect was compatible with schwannoma. PMID:24578861

  19. Latent Progression Pediatric Scrotal Schwannoma. A Case Report

    PubMed Central

    Gkikas, Christos; Ram, Manisha; Tsafrakidis, Petros

    2016-01-01

    We report the case of a 24 year old patient being diagnosed with scrotal schwannoma initially presenting at age 9. To our knowledge, this is the first case with such an early onset. The patient underwent an uncomplicated surgical excision. We are also reviewing the literature on scrotal schwannoma. PMID:27169021

  20. Incidental finding of lymphoma after septoplasty

    PubMed Central

    Tajudeen, Bobby A.; Bhuta, Sunita M.; Palma Diaz, Miguel Fernando; Kedeshian, Paul A.; Suh, Jeffrey D.

    2016-01-01

    Introduction: Septoplasty, or surgical correction of the deviated septum, is an elective, routinely performed rhinologic procedure to address nasal airway obstruction. In many cases, resected septal cartilage and bone fragments are sent for pathologic review, although there is no consensus on this practice. We reported two cases of incidentally diagnosed lymphoma after elective septoplasty and discussed clinical presentation, diagnosis, and management. Methods: Retrospective chart review of two patients who underwent septoplasty at a tertiary academic medical center and found to have incidental lymphoma based on histopathology. Results: Two patients who underwent septoplasty had an incidental diagnosis of lymphoma on pathologic analysis. One patient was noted to have an S-shaped septal deviation that produced bilateral nasal obstruction. She underwent a difficult septoplasty, in which the mucoperichondrial flap was firmly adherent to the underlying septum and bone. Final pathology demonstrated diffuse large B-cell lymphoma. She was treated with chemoradiation and remained free of disease at 59 months. The other patient had a history of nasal trauma, which produced left septal deviation. He underwent an uncomplicated septoplasty, with pathology that demonstrated low-grade B-cell lymphoma. Because there was no evidence of active disease, the decision was made to not treat and to observe the patient clinically. Conclusions: This is the first reported series of septal lymphoma incidentally diagnosed on routine septoplasty. Although histopathologic review of specimens from routine nasal and sinus surgery is not routinely performed, this report highlighted the importance of this process, on a case-by-case basis, in detecting unexpected malignancies that otherwise were clinically silent. PMID:27470206

  1. Frequent NF2 gene transcript mutations in sporadic meningiomas and vestibular schwannomas

    SciTech Connect

    Deprez, R.H.L.; Groen, N.A.; Zwarthoff, E.C.; Hagemeijer, A.; Van Drunen, E.; Bootsma, D.; Koper, J.W.; Avezaat, C.J.J. ); Bianchi, A.B.; Seizinger, B.R. )

    1994-06-01

    The gene for the hereditary disorder neurofibromatosis type 2 (NF2), which predisposes for benign CNS tumors such as vestibular schwannomas and meningiomas, has been assigned to chromosome 22 and recently has been isolated. Mutations in the NF2 gene were found in both sporadic meningiomas and vestibular schwannomas. However, so far only 6 of the 16 exons of the gene have been analyzed. In order to extend the analysis of an involvement of the NF2 gene in the sporadic counterparts of these NF2-related tumors, the authors have used reverse transcriptase-PCR amplification followed by SSCP and DNA sequence analysis to screen for mutations in the coding region of the NF2 gene. Analysis of the NF2 gene transcript in 53 unrelated patients with meningiomas and vestibular schwannomas revealed mutations in 32% of the sporadic meningiomas (n = 44), in 50% of the sporadic vestibular schwannomas (n = 4), in 100% of the tumors found in NF2 patients (n = 2), and in one of three tumors from multiple-meningioma patients. Of the 18 tumors in which a mutation in the NF2 gene transcript was observed and the copy number of chromosome 22 could be established, 14 also showed loss of (parts of) chromosome 22. This suggests that in sporadic meningiomas and NF2-associated tumors the NF2 gene functions as a recessive tumor-suppressor gene. The mutations detected resulted mostly in frameshifts, predicting truncations starting within the N-terminal half of the putative protein. 23 refs., 2 figs. 3 tabs.

  2. Thoracic Nerve Root Schwannoma Filling the Spinal Canal Almost Entirely Without any Neurological Deficits

    PubMed Central

    Godlewski, Bartosz; Klauz, Grzegorz; Czepko, Ryszard

    2016-01-01

    Introduction Spinal tumours may be classified in three groups: 1) extradural, 2) intradural extramedullary and 3) intramedullary spinal cord tumours. Intradural extramedullary tumours arise from the leptomeninges or nerve roots and include schwannomas. A schwannoma is usually a firm grey-whitish tumour growing near a nerve trunk or ramus. It can be separated from the nerve without damaging neural tissue. Schwannomas are usually solitary tumours. Case Presentation We present the case of a 37-year-old male who underwent surgery for a tumour in the upper thoracic segment of the spinal canal. Although the tumour filled the spinal canal almost entirely, the patient did not manifest any neurological deficits. During the surgery, the tumour was removed completely. A histological examination confirmed a benign schwannoma lesion (WHO G1). Conclusions The question whether doctors are keen to order more diagnostic investigations (including both laboratory and imaging studies) than are necessary is often asked in clinical practice. The cost factor is also important. Not every patient with back pain is referred for an MRI study in the absence of characteristic neurological signs. The case of our patient, however, speaks in favour of early referral for such diagnostic modalities. Appropriate imaging studies, even in patients presenting with no neurological deficits, may help detect pathologies than can lead to severe disability. A spinal canal tumour filling the spinal canal almost entirely and displacing the spinal cord could cause spinal cord damage at any time with all the dire consequences such as paraplegia and loss of the ability to walk. PMID:27110539

  3. Imaging of facial nerve schwannomas: diagnostic pearls and potential pitfalls

    PubMed Central

    Mundada, Pravin; Purohit, Bela Satish; Kumar, Tahira Sultana; Tan, Tiong Yong

    2016-01-01

    Schwannomas are uncommon in the facial nerve and account for less than 1% of tumors of temporal bone. They can involve one or more than one segment of the facial nerve. The clinical presentations and the imaging appearances of facial nerve schwannomas are influenced by the topographical anatomy of the facial nerve and vary according to the segment(s) they involve. This pictorial essay illustrates the imaging features of facial nerve schwannomas according to their various anatomical locations and also reviews the pertinent differential diagnoses and potential diagnostic pitfalls. PMID:26712680

  4. Malignant epithelioid schwannoma affecting the trigeminal nerve of a dog.

    PubMed

    Pumarola, M; Añor, S; Borràs, D; Ferrer, I

    1996-07-01

    A malignant epithelioid schwannoma was diagnosed affecting the trigeminal nerve of an 11-year-old dog. Neurologic abnormalities included an altered mental status, ataxia, left head tilt, postural reaction deficits of all four limbs, a pronounced left masticatory muscle atrophy, and absent left facial sensation. Histologically, a densely arranged epithelioid population with a very high mitotic index was surrounded by a spindle-shaped cell proliferation characteristic of schwannomas. Both cell populations stained positively for vimentin, but only spindle cells were occassionally positive for S-100 protein. The histologic and immunohistochemical features of this tumor were consistent with those found in human epithelioid schwannomas. PMID:8817843

  5. An enigmatic clinical entity: A new case of olfactory schwannoma.

    PubMed

    Manto, Andrea; Manzo, Gaetana; De Gennaro, Angela; Martino, Vincenzo; Buono, Vincenzo; Serino, Antonietta

    2016-06-01

    Olfactory schwannomas, also described as subfrontal or olfactory groove schwannomas, are very rare tumors, whose pathogenesis is still largely debated. We report a case of olfactory schwannoma in a 39-year-old woman who presented with anosmia and headache. The clinical examination did not show lesions in the nose-frontal region and there was no history of neurofibromatosis. Head MRI and CT scan revealed a lobulated extra-axial mass localized in the right anterior cranial fossa that elevated the ipsilateral frontal pole. Bilateral frontal craniotomy demonstrated a tumor strictly attached to the right portion of the cribriform plate that surrounded the right olfactory tract, not clearly identifiable. The immunohistochemical analysis suggested the diagnosis of typical schwannoma. The patient was discharged without any neurological deficit and a four-month postoperative MRI scan of the brain showed no residual or recurrent tumor. PMID:26944065

  6. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma.

    PubMed

    Huang, Xiaowen; Caye-Thomasen, Per; Stangerup, Sven-Eric

    2013-04-01

    We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed conservatively. Extreme shrinkage of the tumor may occur spontaneously. PMID:22858145

  7. Median nerve schwannoma: A case and review of literature

    PubMed Central

    Padasali, Praveen S.; Shankaregowda, V. S.; Kshirsagar, Shriram D.

    2015-01-01

    We report a case of a median nerve schwannoma, a rare type of a benign tumor of Schwann cells that presents as a palpable and painful mass on the flexor aspect of the forearm. Schwannomas of the median nerve make up 0.1–0.3% of all hand tumors. Symptoms are caused by an entrapment syndrome resulting from the growing tumor. Pain is the most common complaint of schwannomas. Imaging studies include computed tomography and magnetic resonance imaging and ultrasound. It is difficult to differentiate schwanommas from neurofibromas solely on the basis of a radiological investigation. Tumors of the median nerve are diagnostically challenging and median nerve schwannomas are rare. Diagnostic pearls are described to facilitate a more accurate and timely diagnosis. These characteristics include mobility, Tinel's sign, S-100 histological staining, and Antoni patterns. With a correct diagnosis, the tumor can be extirpated with preservation of nerve function and a low risk of recurrence. PMID:26396609

  8. Intraneural Hybrid Neurofibroma/Schwannoma In Scalp: A Case Report

    PubMed Central

    Reena, Naik

    2015-01-01

    Benign Peripheral Nerve Sheath Tumours (BPNSTs) are traditionally classified into schwannoma, neurofibroma and perinurioma. Due to advances in molecular techniques, hybrid BPNSTs containing more than one histologic types have been documented. Recent studies have demonstrated their frequent association with inherited syndromes like schwannomatosis and neurofibromatosis. Intraneural variant of hybrid neurofibroma/schwannoma is yet to be described. Here we report such a case in a 30-year-old male, who presented with a scalp swelling and histology showed intraneural neurofibromatous tumour admixed with schwannoma-like nodules. IHC (immunohistochemistry) showed variable S100 staining in neurofibromatous areas, diffuse S100 staining in schwannoma-like areas and negative EMA staining in the tumour. PMID:26557528

  9. Intraneural Hybrid Neurofibroma/Schwannoma In Scalp: A Case Report.

    PubMed

    Panda, Kishori Moni; Reena, Naik

    2015-10-01

    Benign Peripheral Nerve Sheath Tumours (BPNSTs) are traditionally classified into schwannoma, neurofibroma and perinurioma. Due to advances in molecular techniques, hybrid BPNSTs containing more than one histologic types have been documented. Recent studies have demonstrated their frequent association with inherited syndromes like schwannomatosis and neurofibromatosis. Intraneural variant of hybrid neurofibroma/schwannoma is yet to be described. Here we report such a case in a 30-year-old male, who presented with a scalp swelling and histology showed intraneural neurofibromatous tumour admixed with schwannoma-like nodules. IHC (immunohistochemistry) showed variable S100 staining in neurofibromatous areas, diffuse S100 staining in schwannoma-like areas and negative EMA staining in the tumour. PMID:26557528

  10. Mandibular tori as an incidental finding in MRI

    PubMed Central

    Schubert, Marika; Sieron, Dominik; Laniado, Michael

    2014-01-01

    Tori (singular: torus) are among the most common benign jaw lesions. The magnetic resonance imaging (MRI) characteristics have not been reported yet. We present a 72-year-old patient with mandibular tori, which were detected as an incidental finding on MRI and provide an overview of the imaging features of tori. PMID:24778803

  11. A pelvic retroperitoneal Schwannoma presenting as an adnexal mass.

    PubMed

    Khatib, R A; Khalil, A M; Saba, M I; Aswad, N K; Mroueh, A M

    1994-05-01

    Solitary nerve sheath tumors such as benign schwannomas arising in the pelvic retroperitoneum are infrequently reported. We report a case of a benign retroperitoneal pelvic schwannoma that presented with pelvic pain and an adnexal mass. Complete surgical excision was achieved only after transection of the S1 nerve root on the left side. The adjacent vascular and urinary channels sustained no injuries and the patient had minimal neurologic deficit. PMID:8188087

  12. Juxta-adrenal Ancient Schwannoma: A Rare Retroperitoneal Tumor

    PubMed Central

    Wollin, Daniel A; Sivarajan, Ganesh; Shukla, Pratibha; Melamed, Jonathan; Huang, William C; Lepor, Herbert

    2015-01-01

    Retroperitoneal schwannoma is a rare tumor that is often misdiagnosed as malignancy due to a concerning appearance on cross-sectional imaging. Pathology and immunohistochemistry form the gold standard for diagnosis; as such, local excision is the treatment of choice for this disease. We present two cases of juxta-adrenal ancient schwannoma that were treated with adrenalectomy and discuss the current literature regarding this entity.

  13. A rare case of concurrent penile and spinal schwannomas.

    PubMed

    Wang, Luke; Arachchi, Asiri; Makris, Antonios

    2016-01-01

    Schwannoma of the penis is extremely rare. This is the case of a young male who presented with pain on sexual intercourse, multiple lumps on the dorsal shaft of his penis, as well as a temporal headache. He was subsequently diagnosed with schwannoma affecting both his penile region and cauda equina. This clinical finding has not been previously described in the literature. Hence, its presentation is unique to our specialty. PMID:27141200

  14. A rare case of concurrent penile and spinal schwannomas

    PubMed Central

    Wang, Luke; Arachchi, Asiri; Makris, Antonios

    2016-01-01

    Schwannoma of the penis is extremely rare. This is the case of a young male who presented with pain on sexual intercourse, multiple lumps on the dorsal shaft of his penis, as well as a temporal headache. He was subsequently diagnosed with schwannoma affecting both his penile region and cauda equina. This clinical finding has not been previously described in the literature. Hence, its presentation is unique to our specialty. PMID:27141200

  15. Schwannoma of the Median Nerve: Diagnosis Sometimes Delayed

    PubMed Central

    Boufettal, Monsef; Azouz, Mohamed; Rhanim, Abdelkarim; Abouzahir, Mohamed; Mahfoud, Mustapha; Bardouni, Ahmed El; Berrada, Mohamed S; Yaacoubi, Moradh El

    2014-01-01

    Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation. PMID:25125990

  16. Sciatica due to Schwannoma at the Sciatic Notch.

    PubMed

    Haspolat, Yavuz; Ozkan, Feyza Unlu; Turkmen, Ismail; Kemah, Bahattin; Turhan, Yalcin; Sarar, Serhan; Ozkan, Korhan

    2013-01-01

    Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery. PMID:23762699

  17. Results of Surgical Treatment of Schwannomas Arising from Extremities

    PubMed Central

    Urban, Maciej; Wnukiewicz, Witold; Reichert, Paweł; Ziółkowski, Piotr

    2015-01-01

    Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low. PMID:25793198

  18. A rare occurrence of intramasseteric schwannoma - case report and literature review.

    PubMed

    Wang, H-K; Gong, Y-L; Wang, R-X; Zheng, X-T; Huang, S-Y; Zhang, D-S

    2016-06-01

    A schwannoma is a benign, solitary, well-defined, painless, slowly-enlarging nerve sheath tumor, composed of Schwann cells. Intramasseteric localization is very unusual. We report the case of a 33-year-old male who developed an intramasseteric schwannoma. Tumor could be completely removed under general anesthesia. Histopathological examination made the diagnosis of intramasseteric schwannoma through the presence of Antoni A areas and Verocay bodies. The diagnosis of schwannoma should be taken into consideration in case of parotideomasseteric tumors. PMID:27155941

  19. Spectrum of intracranial incidental findings on pediatric brain magnetic resonance imaging: What clinician should know?

    PubMed Central

    Gupta, Surya N; Gupta, Vikash S; White, Andrew C

    2016-01-01

    Intracranial incidental findings on magnetic resonance imaging (MRI) of the brain continue to generate interest in healthy control, research, and clinical subjects. However, in clinical practice, the discovery of incidental findings acts as a “distractor”. This review is based on existing heterogeneous reports, their clinical implications, and how the results of incidental findings influence clinical management. This draws attention to the followings: (1) the prevalence of clinically significant incidental findings is low; (2) there is a lack of a systematic approach to classification; and discusses (3) how to deal with the detected incidental findings based a proposed common clinical profile. Individualized neurological care requires an active discussion regarding the need for neuroimaging. Clinical significance of incidental findings should be decided based on lesion’s neuroradiologic characteristics in the given clinical context. Available evidence suggests that the outcome of an incidentally found “serious lesion in children” is excellent. Future studies of intracranial incidental findings on pediatric brain MRI should be focused on a homogeneous population. The study should address this clinical knowledge based review powered by the statistical analyses. PMID:27610341

  20. Spectrum of intracranial incidental findings on pediatric brain magnetic resonance imaging: What clinician should know?

    PubMed

    Gupta, Surya N; Gupta, Vikash S; White, Andrew C

    2016-08-01

    Intracranial incidental findings on magnetic resonance imaging (MRI) of the brain continue to generate interest in healthy control, research, and clinical subjects. However, in clinical practice, the discovery of incidental findings acts as a "distractor". This review is based on existing heterogeneous reports, their clinical implications, and how the results of incidental findings influence clinical management. This draws attention to the followings: (1) the prevalence of clinically significant incidental findings is low; (2) there is a lack of a systematic approach to classification; and discusses (3) how to deal with the detected incidental findings based a proposed common clinical profile. Individualized neurological care requires an active discussion regarding the need for neuroimaging. Clinical significance of incidental findings should be decided based on lesion's neuroradiologic characteristics in the given clinical context. Available evidence suggests that the outcome of an incidentally found "serious lesion in children" is excellent. Future studies of intracranial incidental findings on pediatric brain MRI should be focused on a homogeneous population. The study should address this clinical knowledge based review powered by the statistical analyses. PMID:27610341

  1. [Schwannoma of the penis: a case report].

    PubMed

    Inoue, Takaaki; Satou, Masahiko; Morii, Hideichi; Matsuda, Tadashi

    2008-08-01

    A 39-year-old man presented with a painless nodule on the left dorsal aspect of root of the penile shaft, which was first noticed in childhood, but had been left untreated. This nodule gradually increased in size, and he visited the Department of Urology. He had no urinary symptoms, and there was no interference with sexual intercourse. Upon physical examination, we observed a well-defined, firm 20 mm nodule on left dorsal aspect of root of the penile shaft that was tender and had no adhesion to overlying skin. There were no other abnormalities; in particular, no other similar lesions could be found. We suspected a benign tumor of the penis and removed it. Histological examination revealed a benign schwannoma composed of Antoni A and Antoni B areas. PMID:18788450

  2. [Schwannoma in the Middle Mediastinum Originating from the Vagal Nerve;Report of a Case].

    PubMed

    Hayakawa, Masanobu; Oda, Kazuyuki; Shino, Yoko

    2016-03-01

    A 44-year-old woman was referred to our department with a mediastinal tumor detected by computed tomography performed as a preoperative examination for cervical cancer. There was a 32 mm solid mass in the area surrounded by the descending thoracic aorta, esophagus, left atrium, left lower lobe, and mediastinal pleura. The tumor was removed thoracoscopically. The mass was regarded as a neurogenic tumor arisen from the branch of the vagus nerve. Neither symptoms of postoperative neurological disorders nor signs of recurrence have been noted to date. The histopathological diagnosis was schwannoma. PMID:27075293

  3. Repeat Gamma Knife surgery for vestibular schwannomas

    PubMed Central

    Lonneville, Sarah; Delbrouck, Carine; Renier, Cécile; Devriendt, Daniel; Massager, Nicolas

    2015-01-01

    Background: Gamma Knife (GK) surgery is a recognized treatment option for the management of small to medium-sized vestibular schwannoma (VS) associated with high-tumor control and low morbidity. When a radiosurgical treatment fails to stop tumor growth, repeat GK surgery can be proposed in selected cases. Methods: A series of 27 GK retreatments was performed in 25 patients with VS; 2 patients underwent three procedures. The median time interval between GK treatments was 45 months. The median margin dose used for the first, second, and third GK treatments was 12 Gy, 12 Gy, and 14 Gy, respectively. Six patients (4 patients for the second irradiation and 2 patients for the third irradiation) with partial tumor regrowth were treated only on the growing part of the tumor using a median margin dose of 13 Gy. The median tumor volume was 0.9, 2.3, and 0.7 cc for the first, second, and third treatments, respectively. Stereotactic positron emission tomography (PET) guidance was used for dose planning in 6 cases. Results: Mean follow-up duration was 46 months (range 24–110). At the last follow-up, 85% of schwannomas were controlled. The tumor volume decreased, remained unchanged, or increased after retreatment in 15, 8, and 4 cases, respectively. Four patients had PET during follow-up, and all showed a significant metabolic decrease of the tumor. Hearing was not preserved after retreatment in any patients. New facial or trigeminal palsy did not occur after retreatment. Conclusions: Our results support the long-term efficacy and low morbidity of repeat GK treatment for selected patients with tumor growth after initial treatment. PMID:26500799

  4. Lack of NF1 gene expression in a sporadic schwannoma from a patient without neurofibromatosis

    SciTech Connect

    Norton, K.K.; Dowton, B.; Silow-Santiago, I.

    1994-09-01

    The neurofibromatosis type 1 (NF1) gene encodes a tumor suppressor protein, neurofibromin, which is expressed at high levels in Schwann cells and other adult tissues. Loss of NF1 gene expression has been reported in Schwann cell tumors (neurofibrosarcomas) from patients with NF1 and its loss is associated with increased proliferation of these cells. We examined one spinal schwannoma from a patient without clinical features of neurofibromatosis type 1 or 2. The tumor was a typical schwannoma confirmed by standard neuropathologic criteria and expressed S100 by immunocytochemistry. NF1 gene expression in this tumor was examined by in situ hybridization using an NF1-specific riboprobe, Northern blot analysis and reverse-transcribed (RT) PCR. Little or no expression of NF1 RNA could be detected using these methods whereas abundant expression of S100, cyclophilin and beta-action RNA was found in the tumor. Fibroblast and Schwann cells were then individually cultured from this schwannoma and the RNA extracted for Northern blot and RT-PCR analysis. In these cultured Schwann cells both from early and late passages, abundant expression of NF1 RNA could be detected. It is unlikely that our culture technique preferentially expanded {open_quotes}normal{close_quotes} Schwann cells, since NF1 acts as a tumor suppressor gene and its presence would not confer any growth advantage over the tumor-derived, neurofibromin-negative Schwann cells which presumably have an increased proliferation rate. Similarly, the conditions used to expand these Schwann cells do not result in increased NF1 gene expression as shown in previous studies. These results suggest that, in some tumors, expression of the NF1 gene can be downregulated by factors produced within the tumor and that this type of tumor suppressor gene downregulation may represent another mechanism other than mutation for turning off the expression of these growth-suppressing genes and allowing for cell proliferation in tumors.

  5. Facial Nerve Outcome after Vestibular Schwannoma Surgery: Our Experience*

    PubMed Central

    Rinaldi, Vittorio; Casale, Manuele; Bressi, Federica; Potena, Massimiliano; Vesperini, Emanuela; De Franco, Antonio; Silvestri, Sergio; Zini, Carlo; Salvinelli, Fabrizio

    2012-01-01

    In this study we evaluate the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyze the factors that cause it. We included 97 consecutive patients undergoing surgical excision of sporadic unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor removal, perioperative complications are all analyzed through standardized systems. Four different surgical approaches are used: translabyrinthine, retrolabyrinthine, retrosigmoid, and middle cranial fossa. Anatomic preservation of the facial nerve is achieved in 97% of patients. The incidence of postoperative facial palsy is found to be statistically correlated to tumor size, but not to the surgical approach used and to extent of tumor penetration in the internal auditory canal. A significant improvement of the short-term facial nerve outcome is detected in patients undergone simultaneous intraoperative electromyography (EMG) and pneumatic facial nerve monitoring. Complete tumor excision is achieved in 94% of cases. Complication rates are excellent and no deaths are reported. Short- and long-term facial nerve outcome is good and comparable with those of other series reported in literature. In VS surgery both EMG and pneumatic facial nerve monitors should be simultaneously used. Further investigations are desirable to improve the facial outcome respecting the oncological radicality. PMID:23372991

  6. Schwannoma With Cystic Changes in the Pterygomandibular Space.

    PubMed

    Chung, Dong-Young; Sharma, Aditi; Choi, So-Young; Paeng, Jun-Young

    2016-03-01

    Schwannomas are tumors that arise from Schwann cells. Although schwannomas can occur almost anywhere in the body where nerve cells are present, they rarely occur in the head and neck region, including the oral and maxillofacial region. Cystic changes in schwannomas are extremely rare. This report is on a case of schwannoma with cystic changes that occurred in the pterygomandibular space.A 46-year-old woman presented with a complaint of limited mouth opening and pain on the left side of the mandible for 3 months. On panoramic radiography, radiolucency was seen on the left mandibular ramus. On enhanced computed tomography, a 4 × 3 cm cystic mass was found along the inner side of the left mandibular ramus area. Magnetic resonance imaging showed a multiseptated, well-demarcated cystic lesion on the inner side of the mandibular ramus on the left side. Under general anesthesia, the tumor was excised. The final diagnosis was schwannoma with cystic changes. Lower lip hypoesthesia occurred postoperatively. At the 1-year postoperative follow-up, maximum mouth opening was increased to 44 mm, and lip hypoesthesia was improved. PMID:26967099

  7. FT-IR spectroscopy characterization of schwannoma: a case study

    NASA Astrophysics Data System (ADS)

    Ferreira, Isabelle; Neto, Lazaro P. M.; das Chagas, Maurilio José; Carvalho, Luís. Felipe C. S.; dos Santos, Laurita; Ribas, Marcelo; Loddi, Vinicius; Martin, Airton A.

    2016-03-01

    Schwannoma are rare benign neural neoplasia. The clinical diagnosis could be improved if novel optical techniques are performed. Among these techniques, FT-IR is one of the currently techniques which has been applied for samples discrimination using biochemical information with minimum sample preparation. In this work, we report a case of a schwannoma in the cervical region. A histological examination described a benign process. An immunohistochemically examination demonstrated positivity to anti-S100 protein antibody, indicating a diagnosis of schwannoma. The aim of this analysis was to characterize FT-IR spectrum of the neoplastic and normal tissue in the fingerprint (1000-1800 cm-1) and high wavenumber region (2800-3600 cm-1). The IR spectra were collect from tumor tissue and normal nerve samples by a FT-IR spectrophotometer (Spotlight Perkin Elmer 400, USA) with 64 scans, and resolution of 4 cm-1. A total of twenty spectra were recorded (10 from schwannoma and 10 from nerve). Multivariate Analysis was used to classify the data. Through average and standard deviation analysis we observed that the main spectral change occurs at ≍1600 cm-1 (amide I) and ≍1400 cm-1 (amide III) in the fingerprint region, and in CH2/CH3 protein-lipids and OH-water vibrations for the high wavenumber region. In conclusion, FT-IR could be used as a technique for schwannoma analysis helping to establish specific diagnostic.

  8. Schwannomatosis presenting as pancreatic and submandibular gland schwannoma.

    PubMed

    Val-Bernal, José Fernando; Mayorga, Marta; Sedano-Tous, María José

    2013-12-01

    Schwannomatosis is a well-established third form of neurofibromatosis, characterized by the presence of multiple non-vestibular, non-intradermal schwannomas, often associated with chronic pain. Herein, we report a 41-year-old man with a history of paternal neurofibromatosis 1, who presented with partially cystic tumors in the pancreas and in the right submandibular gland. Besides, he complained of neuropathic pain in the right inguinal and suprapubic area. Magnetic resonance imaging revealed multiple intradural-extramedullary tumors at the cervical, thoracic and lumbar spinal canal, suggestive of schwannomas. The vestibular nerves were not involved. Pathological examination of the glandular tumors disclosed benign schwannomas. These tumors had substantial myxoid stroma and prominent cystic change, and showed a mosaic pattern of loss of INI1/SMARCB1 expression by immunohistochemistry. Later, the patient developed three nodules in the right lung which were interpreted as schwannomas. To our knowledge, this is the first report of schwannomatosis presenting as pancreatic and salivary gland schwannomas. PMID:24054034

  9. Raman spectroscopy and immunohistochemistry for schwannoma characterization: a case study

    NASA Astrophysics Data System (ADS)

    Neto, Lazaro P. M.; das Chagas, Maurilio J.; Carvalho, Luis Felipe C. S.; Ferreira, Isabelle; dos Santos, Laurita; Haddad, Marcelo; Loddi, Vinicius; Martin, Airton A.

    2016-03-01

    The schwannomas is a tumour of the tissue that covers nerves, called the nerve sheath. Schwannomas are often benign tumors of the Schwan cells, which are the principal glia of the peripheral nervous system (PNS). Preoperative diagnosis of this lesion usually is difficult, therefore, new techniques are being studied as pre surgical evaluation. Among these, Raman spectroscopy, that enables the biochemical identification of the tissue analyzed by their optical properties, may be used as a tool for schwannomas diagnosis. The aim of this study was to discriminate between normal nervous tissue and schwannoma through the confocal Raman spectroscopy and Raman optical fiber-based techniques combined with immunohistochemical analysis. Twenty spectra were analyzed from a normal nerve tissue sample (10) and schwannoma (10) by Holospec f / 1.8 (Kayser Optical Systems) coupled to an optical fiber with a 785nm laser line source. The data were pre-processed and vector normalized. The average analysis and standard deviation was performed associated with cluster analysis. AML, 1A4, CD34, Desmin and S-100 protein markers were used for immunohistochemical analysis. Immunohistochemical analysis was positive only for protein S-100 marker which confirmed the neural schwanomma originality. The immunohistochemistry analysis were important to determine the source of the injury, whereas Raman spectroscopy were able to differentiated tissues types indicating important biochemical changes between normal and benign neoplasia.

  10. Schwannoma in Sellar Region Mimics Invasive Pituitary Macroadenoma

    PubMed Central

    Kong, Xiangyi; Wu, Huanwen; Ma, Wenbin; Li, Yongning; Yang, Yi; Xing, Bing; Wei, Junji; Yao, Yong; Gao, Jun; Lian, Wei; Xu, Zhiqin; Dou, Wanchen; Ren, Zuyuan; Su, Changbao; Wang, Renzhi

    2016-01-01

    Abstract In central nervous system, schwannomas, as ubiquitous tumors, mostly originate from sensory nerves like auditory and trigeminal nerves. However, intrasellar schwannomas are extremely rare. They are often misdiagnosed as pituitary adenomas. We report a rare case of schwannoma in the sellar region—a challenging diagnosis guided by clinical presentations, radiological signs, and postoperative pathological test. We represent a 65-year-old woman who had suffered from headaches, hypothyroidism, and visual disturbance. Her MRI revealed an abnormal sellar region mixed-signal mass lesion with suprasellar, left parasellar, and sellar floor invasiveness. We present detailed analysis of the patient's disease course and review relevant literatures. Written informed consent was obtained from the patient for publication of this article. A copy of the written consent is available for review by the editors of MEDICINE. Because this article does not involve any human or animal trials, there is no need to conduct special ethic review and the ethical approval is not necessary. When surgically treated, her specimen revealed a typical histopathology pattern of schwannoma. The patient's symptoms improved a lot after surgery and he continues to be under observation. Despite its rarity, intrasellar schwannoma should be considered in the differential diagnosis of sellar lesions that mimic pituitary adenomas. PMID:26945398

  11. 78 FR 28411 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic... Marine Seismic Survey in the Chukchi Sea, Alaska AGENCY: National Marine Fisheries Service (NMFS... occur in the seismic survey area include nine cetacean species, beluga whale (Delphinapterus...

  12. Incidental Pelvic and Para-aortic Lymph Node Lymphangioleiomyomatosis Detected During Surgical Staging of Pelvic Cancer in Women Without Symptomatic Pulmonary Lymphangioleiomyomatosis or Tuberous Sclerosis Complex.

    PubMed

    Rabban, Joseph T; Firetag, Brandie; Sangoi, Ankur R; Post, Miriam D; Zaloudek, Charles J

    2015-08-01

    Extrapulmonary lymphangioleiomyomatosis (LAM) is a rare neoplasm of spindle cells exhibiting melanocytic and myoid differentiation that arises as a mass in the mediastinum, retroperitoneum, uterine wall, and/or intraperitoneal lymph nodes. Many patients also have pulmonary LAM, tuberous sclerosis complex (TSC), and/or other neoplasms of the perivascular epithelioid cell tumor family. This study reports 26 patients with clinically occult LAM involving pelvic/para-aortic lymph nodes removed from women undergoing surgical staging of a uterine (17), ovarian (5), cervical (3), or urinary bladder (1) neoplasm. None of the patients exhibited symptoms of pulmonary LAM, and the median patient age (56 y) was older than what would be expected for patients presenting with pulmonary LAM. Only 2/26 patients had TSC. Four patients also had uterine LAM. One of these 4 had uterine perivascular epithelioid cell tumor, and 1 had vaginal angiomyolipoma. In all 26 patients the lymph node LAM was grossly occult, measured 3.5 mm on average (1 to 19 mm), and involved either a single lymph node (12/26) or multiple lymph nodes (14/26). HMB45 was positive in 24/25 cases, mostly in a focal or patchy distribution. Other melanocytic markers included MiTF (12/14) and MelanA (2/12). Myoid markers included smooth muscle actin (23/23) and desmin (15/16), mostly in a diffuse distribution. Estrogen receptor was positive in all cases tested, as was D240 expression in the lymphatic endothelium lining the spindle cell bundles. Concurrent findings in the involved lymph nodes included metastatic carcinoma (3/26), endosalpingiosis (3/26), and reactive lymphoid hyperplasia (13/26). This study demonstrates that clinically occult lymph node LAM can be detected during surgical staging of pelvic cancer and is not commonly associated with pulmonary LAM or TSC, although these patients should still be formally evaluated for both of these diseases. PMID:25786086

  13. Schwannoma originating in lateral recess of the fourth ventricle

    PubMed Central

    Kachhara, Rajneesh; Raje, Prakash; Pauranik, Apoorva

    2012-01-01

    Intracranial schwannomas most commonly occur in relation to vestibular nerves followed by trigeminal nerves. Authors describe a very unusual case of schwannomas originating in lateral recess of the fourth ventricle. Tumor was completely excised micro-surgically via midline suboccipital craniectomy and C1 laminectomy. Dissection of the surgical specimen revealed that the tumor was completely free from surrounding structures and just hanging in the fourth ventricle. It was not attached to any cranial nerves, brain parenchyma, and blood vessel or to the dura mater. Histopathological examination confirmed the diagnosis of schwannoma. To our knowledge, no such case has been reported so far from this extremely rare location. Relevant literature is reviewed and hypothesis for ectopic location of these tumors has been highlighted. PMID:23293673

  14. 78 FR 64918 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... to PISCO to take marine mammals incidental to these same proposed activities (77 FR 72327, December 5... National Oceanic and Atmospheric Administration RIN 0648-XC893 Takes of Marine Mammals Incidental to... Atmospheric Administration (NOAA), Commerce. ACTION: Notice; proposed incidental harassment...

  15. 78 FR 77433 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-23

    ... to PISCO to take marine mammals incidental to these same proposed activities (77 FR 72327, December 5... National Oceanic and Atmospheric Administration RIN 0648-XC893 Takes of Marine Mammals Incidental to... Atmospheric Administration (NOAA), Commerce. ACTION: Notice; proposed incidental harassment...

  16. 77 FR 25829 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-01

    ... Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic... Marine Seismic Survey in the Beaufort Sea, Alaska AGENCY: National Marine Fisheries Service (NMFS... only, incidental to a proposed 3- dimensional (3D) ocean bottom cable (OBC) seismic survey in...

  17. Successful excision of a massive bleeding schwannoma by thoracoscopic surgery.

    PubMed

    Ishibashi, Hironori; Takasaki, Chihiro; Okubo, Kenichi

    2016-06-01

    Massive intrathoracic bleeding caused by rupture of a benign schwannoma is extremely rare. A 73-year-old man was admitted to our emergency department because of chest pain and dyspnea. Computed tomography revealed massive pleural effusion and a posterior mediastinal tumor. Chest tube thoracostomy was performed, and the initial blood drainage was 1700 mL. Magnetic resonance imaging revealed that the tumor at the 8th costal level measured 46 × 60 mm. The tumor, located beside the 8th vertebra, had ruptured and caused the bleeding. It was successfully excised by thoracoscopic surgery and diagnosed as a benign schwannoma. PMID:27095705

  18. Cochlear implantation after resection of an intralabyrinthine schwannoma.

    PubMed

    Schutt, Christopher A; Kveton, John F

    2014-01-01

    Intralabyrinthine schwannomas are rare tumors of the distal ends of the cochlear and vestibular nerve. Their presence can be debilitating secondary to symptoms of hearing loss, vertigo, tinnitus, and imbalance. Currently, treatment to restore hearing in those who have become profoundly deaf is not attempted. Additionally, resection in patients with functioning hearing is rare, as the surgery assures deafness. We report the first case demonstrating the feasibility of resection of an intralabyrinthine schwannoma with immediate cochlear implantation. This technique addresses the patients hearing status by taking into account advancing technology, allowing for an improved quality of life. PMID:24321750

  19. Abducens nerve palsy after schwannoma resection.

    PubMed

    Bobbio, Antonio; Hamelin-Canny, Emelyne; Roche, Nicolas; Taillia, Herve; Alifano, Marco

    2015-02-01

    Tumors of the posterior mediastinum are mostly neurogenic and could involve the intervertebral foramen and the medullary canal. We describe the case of a patient who underwent surgery for a nerve sheet tumor originating at the level of the right second neural root. Resection was associated with an incidental dural tear and cerebrospinal fluid leak that was promptly repaired. One week after surgery, horizontal diplopia occurred. A palsy of the left abducens nerve secondary to intracranial hypotension was diagnosed. We present the pathogenic cascade leading to this ocular complication after posterior mediastinal surgery. The surgical techniques to prevent this complication are discussed. PMID:25639411

  20. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    PubMed

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  1. Incidental thyroid nodules and thyroid cancer: considerations before determining management.

    PubMed

    Tufano, Ralph P; Noureldine, Salem I; Angelos, Peter

    2015-06-01

    The worldwide incidence of thyroid cancer is increasing substantially, almost exclusively attributable to small papillary thyroid cancers. Increased use of diagnostic imaging is considered the most likely explanation for this reported rise, but other factors may also be contributing. The increase in health care expenditures related to managing these presumably low-risk cancers, without a clear patient benefit, has resulted in a backlash against the early detection of thyroid cancer. Currently, there is no way to confidently predict which incidentally detected thyroid nodule may be the precursor to a more aggressive process. Predictions such as these would require more accurate characterization of the biology of individual thyroid cancers than is currently possible. With time, we might prove our ability to confidently differentiate low-risk from high-risk thyroid cancers, but until that happens, routine screening for thyroid cancer by imaging billed as a "health checkup" should not be performed. However, incidentally detected thyroid nodules should be reported, and a clear medical team management plan should be developed. Our ethical responsibility is to provide patients with objective, evidence-based information about their disease status, not to assume that we know what is best for them by selectively withholding information. In addition, providing patients with psychosocial assistance will help them process the information necessary to make informed decisions that will provide them with the most value when a small thyroid nodule or cancer is incidentally identified. Herein, we summarize the epidemiological data for disease incidence, discuss some controversies in disease management, and outline the key elements and ethical considerations of informed decision making as they apply to managing incidentally detected thyroid nodules and thyroid cancer. PMID:25928353

  2. Animation, Incidental Learning, and Continuing Motivation.

    ERIC Educational Resources Information Center

    Rieber, Lloyd P.

    1991-01-01

    Effects of animated graphics presentations on incidental learning and the degree to which various computer practice activities contain intrinsically motivating characteristics were studied with 70 fourth graders learning about Newton's laws of motion. Incidental learning occurred without sacrifice of intentional learning. Students were highly…

  3. 47 CFR 15.13 - Incidental radiators.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Incidental radiators. 15.13 Section 15.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES General § 15.13 Incidental radiators. Manufacturers of these devices shall employ good engineering practices to minimize the risk...

  4. 47 CFR 15.13 - Incidental radiators.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Incidental radiators. 15.13 Section 15.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES General § 15.13 Incidental radiators. Manufacturers of these devices shall employ good engineering practices to minimize the risk...

  5. 47 CFR 15.13 - Incidental radiators.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Incidental radiators. 15.13 Section 15.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES General § 15.13 Incidental radiators. Manufacturers of these devices shall employ good engineering practices to minimize the risk...

  6. 47 CFR 15.13 - Incidental radiators.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Incidental radiators. 15.13 Section 15.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES General § 15.13 Incidental radiators. Manufacturers of these devices shall employ good engineering practices to minimize the risk...

  7. 47 CFR 15.13 - Incidental radiators.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Incidental radiators. 15.13 Section 15.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES General § 15.13 Incidental radiators. Manufacturers of these devices shall employ good engineering practices to minimize the risk...

  8. 12 CFR 975.4 - Incidental powers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Incidental powers. 975.4 Section 975.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD MISCELLANEOUS FEDERAL HOME LOAN BANK OPERATIONS AND AUTHORITIES COLLECTION, SETTLEMENT, AND PROCESSING OF PAYMENT INSTRUMENTS § 975.4 Incidental powers....

  9. 12 CFR 975.4 - Incidental powers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Incidental powers. 975.4 Section 975.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD MISCELLANEOUS FEDERAL HOME LOAN BANK OPERATIONS AND AUTHORITIES COLLECTION, SETTLEMENT, AND PROCESSING OF PAYMENT INSTRUMENTS § 975.4 Incidental powers....

  10. 12 CFR 975.4 - Incidental powers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Incidental powers. 975.4 Section 975.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD MISCELLANEOUS FEDERAL HOME LOAN BANK OPERATIONS AND AUTHORITIES COLLECTION, SETTLEMENT, AND PROCESSING OF PAYMENT INSTRUMENTS § 975.4 Incidental powers....

  11. 12 CFR 1271.4 - Incidental powers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Incidental powers. 1271.4 Section 1271.4 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS MISCELLANEOUS FEDERAL HOME LOAN... Incidental powers. In connection with the collection, processing, and settlement of items and...

  12. 12 CFR 975.4 - Incidental powers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Incidental powers. 975.4 Section 975.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD MISCELLANEOUS FEDERAL HOME LOAN BANK OPERATIONS AND AUTHORITIES COLLECTION, SETTLEMENT, AND PROCESSING OF PAYMENT INSTRUMENTS § 975.4 Incidental powers....

  13. Focal liver lesions found incidentally

    PubMed Central

    Algarni, Abdullah A; Alshuhri, Abdullah H; Alonazi, Majed M; Mourad, Moustafa Mabrouk; Bramhall, Simon R

    2016-01-01

    Incidentally found focal liver lesions are a common finding and a reason for referral to hepatobiliary service. They are often discovered in patients with history of liver cirrhosis, colorectal cancer, incidentally during work up for abdominal pain or in a trauma setting. Specific points should considered during history taking such as risk factors of liver cirrhosis; hepatitis, alcohol consumption, substance exposure or use of oral contraceptive pills and metabolic syndromes. Full blood count, liver function test and tumor markers can act as a guide to minimize the differential diagnosis and to categorize the degree of liver disease. Imaging should start with B-mode ultrasound. If available, contrast enhanced ultrasound is a feasible, safe, cost effective option and increases the ability to reach a diagnosis. Contrast enhanced computed tomography should be considered next. It is more accurate in diagnosis and better to study anatomy for possible operation. Contrast enhanced magnetic resonance is the gold standard with the highest sensitivity. If doubt still remains, the options are biopsy or surgical excision. PMID:27028805

  14. Malignant Schwannoma of Anterior Abdominal Wall: Report of a Case

    PubMed Central

    Khorgami, Zhamak; Nasiri, Shirzad; Rezakhanlu, Freshteh; Sodagari, Nassim

    2009-01-01

    Malignant schwannoma of the anterior abdominal wall nerves is extremely rare. Malignant peripheral nerve sheath tumors (MPNST) represent approximately 10% of all soft tissue sarcomas and it is found in 4% of patients with neurofibromatosis 1. We present a case of malignant schwannoma in a 28-year-old female patient with neurofibromatosis 1. She presented with a painful mass in the right upper quadrant of her abdomen. The tumor location was in the abdominal wall in explorative laparatomy and malignant schwannoma was diagnosed in pathologic assessment. The tumor recurred in 3 months and computed tomography showed two masses in the right side of abdominopelvic cavity. Thereafter, second complete surgical resection was performed and pathologic finding was the same. In spite of administering chemotherapy after second surgery,the tumor recurred and magnetic resonance imaging finding showed a huge heterogeneously enhancing mass with adhesion to the inner side of the abdominal wall. The patient died because of acute respiratory failure due to multiple bilateral pulmonary metastases. Tumor location and rapid recurrence was unique in our patient. Keywords Malignant peripheral nerve sheath tumor; Malignant schwannoma; Abdominal wall PMID:22461875

  15. Clinical Features and Treatment of Penile Schwannoma: A Systematic Review.

    PubMed

    Nguyen, Austin Huy; Smith, Megan L; Maranda, Eric L; Punnen, Sanoj

    2016-06-01

    Schwannomas, although common in the head and limbs, are an exceedingly rare tumor of the penis. We conducted a systematic review to include 33 patients with schwannoma of the penile shaft or glans penis. Most patients presented with a single painless nodule on the dorsal aspect of the penile shaft. These nodules were slow growing, with an average of 62 months from the onset to presentation. Several cases were accompanied by sexual dysfunction. Most histologic studies were consistent, with a benign schwannoma that showed a palisading Antoni A and Antoni B pattern without malignant changes in cell morphology. Of the 14 studies in which a history of genetic disease was investigated, only 2 reported a connection to neurofibromatosis. These tumors were treated with surgical excision, and 4 malignant cases received additional chemotherapy or radiotherapy. All the patients had achieved full remission by the final follow-up examination. Given the rarity of this tumor, the present review of available case studies serves to comprehensively describe the clinical presentation and treatment approaches to penile schwannoma. PMID:26797586

  16. Pudendal schwannoma: A case report and literature review

    PubMed Central

    Mazzola, Clarisse R.; Power, Nicholas; Bilsky, Mark H.; Robert, Roger; Guillonneau, Bertrand

    2014-01-01

    Schwannomas are benign nerve sheath tumours most often associated with the cranial nerves and the peripheral nerve system of the neck and extremities. Pelvic schwannomas are rare, with only about 25 cases reported. We report the case of a 34-year-old man referred for worsening pain of 10 years duration involving the right testicle and right penile shaft. Magnetic resonance imaging discovered a well-circumscribed pelvic tumour of 3.2 × 2.8 × 3.2 cm. Considering the possible complications involved in exposing the pudendal nerve during surgical resection, we performed an extensive literature search to aid preoperative planning. The most commonly described surgical approach for pelvic schwannomas has been open median laparotomy with transperitoneal dissection. To our knowledge, pudendal schwannomas have never been described in the literature. However, after considering the location and characteristics of the tumour, we chose laparoscopy because it offers the advantages of better visualization of anatomical structures with minimal invasiveness and faster recovery. At the 3-week follow-up, the patient described a significant decrease in pain and normal neurological and urological examinations. PMID:24678366

  17. B7-H1 Expression in Vestibular Schwannomas

    PubMed Central

    Archibald, David J.; Neff, Brian A.; Voss, Stephen G.; Splinter, Patrick L.; Driscoll, Colin L. W.; Link, Michael J.; Dong, Haidong; Kwon, Eugene D.

    2014-01-01

    Hypothesis B7-H1 is expressed in vestibular schwannomas. Background Little is known about how benign human vestibular schwannomas interact with antibody-mediated or cell-mediated immunity. We report on the aberrant expression of a novel T-cell coregulatory molecule, B7 homolog 1 (B7-H1), in vestibular schwannomas and discuss the implications of B7-H1 expression and tumor aggressiveness and a potential regulator of B7-H1 expression. Methods Immunohistochemical staining for B7-H1, CD8+, CD3+, and CD4+ lymphocytes were performed on 48 fresh-frozen vestibular schwannoma tissue specimens. A clinical review of patient presenting symptoms and tumor characteristics was performed. Real-time polymerase chain reaction was used to determine if there was differential expression of B7-H1 messenger RNA and microRNA-513, a known regulator of B7-H1, in several strongly positive and negative B7-H1 vestibular schwannomas. Results Nine (19%) of 48 tumors were negative, 23 (48%) tumors were 1+ mildly positive (<20% section area), and 16 (33%) stained 2+ strongly positive (≥20% section area) for B7-H1. The average number of CD8+ cells per high-power field was 2.1 for positive-staining tumors and 1.0 for negative tumors (p = 0.16). Failure of tumor control with stereotactic radiation (p = 0.029) was significantly greater in the strongly positive B7-H1 tumors. Real-time polymerase chain reaction did not show significant differential expression of microRNA-513 (p = 0.62) or B7-H1 messenger RNA (p = 0.35) between the tumors showing strong and negative immunohistochemical staining for B7-H1 protein. Conclusion Vestibular schwannoma tumors express B7-H1, which has been associated with immune tolerance and adverse disease characteristics in several malignancies. Growing tumors that were surgically removed after failed stereotactic radiation therapy were significantly more likely to strongly express B7-H1 protein, which lends some credibility to the hypothesis that immuno-evasion may play

  18. Surgical outcome in cystic vestibular schwannomas

    PubMed Central

    Nair, Suresh; Baldawa, Sachin S.; Gopalakrishnan, Chittur Viswanathan; Menon, Girish; Vikas, Vazhayil; Sudhir, Jayanand B.

    2016-01-01

    Background: Cystic vestibular schwannomas (VS) form a rare subgroup that differs from the solid variant clinically, radiologically, and histopathologically. These tumors also vary in their surgical outcome and carry a different risk of post-operative complications. We analyzed our series of 64 patients with cystic VS and discuss the technical difficulties related to total excision of these tumors and focus on complication avoidance. Materials and Methods: A retrospective review of cystic VS surgically managed over a span of 11 years. The case records were evaluated to record the clinical symptoms and signs, imaging findings, surgical procedure, complications, and follow-up data. Post-operative facial nerve palsy was analyzed with respect to tumor size and tumor type. Results: Progressive hearing impairment was the most common initial symptom (76.6%). Atypical initial symptoms were present in 15 patients (23.4%). Preoperatively, 78% patients had good facial nerve function (HB grade 1, 2) and 22% had intermediate (HB grade 3, 4) to poor (HB grade 5 and 6) function. Mean tumor size was 4.1 cm. Complete tumor removal was achieved in 53 patients (83%). The facial nerve was anatomically intact but thinned out after tumor excision in 38 patients (59.4%). Ninety percent patients had either intermediate or poor facial nerve function at follow-up. Poor facial nerve outcome was associated with giant tumors and peripherally located, thin-walled cystic tumors. Conclusion: Resection of cystic VS is complicated by peritumoral adhesions of the capsule to the nerve. Extensive manipulation of the nerve in order to dissect the tumor–nerve barrier results in worse facial nerve outcome. The outcome is worse in peripherally located, thin-walled cystic VS as compared to centrally located, thick-walled cystic tumors. Subtotal excision may be justified, especially in tumors with dense adhesion of the cyst wall to the facial nerve in order to preserve nerve integrity. PMID:27366248

  19. Incidental findings on brain and spine imaging in children.

    PubMed

    Maher, Cormac O; Piatt, Joseph H

    2015-04-01

    In recent years, the utilization of diagnostic imaging of the brain and spine in children has increased dramatically, leading to a corresponding increase in the detection of incidental findings of the central nervous system. Patients with unexpected findings on imaging are often referred for subspecialty evaluation. Even with rational use of diagnostic imaging and subspecialty consultation, the diagnostic process will always generate unexpected findings that must be explained and managed. Familiarity with the most common findings that are discovered incidentally on diagnostic imaging of the brain and spine will assist the pediatrician in providing counseling to families and in making recommendations in conjunction with a neurosurgeon, when needed, regarding additional treatments and prognosis. PMID:25825535

  20. The outermost “dura-like membrane” of vestibular schwannoma

    PubMed Central

    Tomio, Ryosuke; Yoshida, Kazunari; Kohno, Maya; Kamamoto, Dai; Mikami, Shuji

    2016-01-01

    Background: The membranous structure of vestibular schwannoma is an important factor in its surgical treatment. Herein, we report intraoperative and microscopic findings relating to an outermost dura-like membrane in cases of vestibular schwannoma and the importance of these findings. Methods: Intraoperative findings of 16 cases of vestibular schwannoma treated with an initial surgery were studied with an aim to determine if the cases had a dura-like membrane. Then we studied microscopic findings of the dura-like membrane using hematoxylin and eosin, Masson trichrome, and immunohistochemical staining in 2 cases. Results: The dura-like membrane was observed in 8 out of 16 cases. The average tumor size of the cases that had a dura-like membrane was 30 ± 8.1 mm, and Koos grading 4 was in 7 out of 8 cases, and one was grade 3. In cases without a dura-like membrane, these values were significantly smaller, with an average tumor size of 12.8 ± 5.2 mm, and Koos grading 4 was only in 1 of 8 cases, grade 3 was in 2 cases, and other 5 cases were grade 2. The outermost dura-like membrane enveloped the vestibular schwannoma around the internal acoustic meatus and was continuous with the dura mater. Reactive angiogenesis was observed in the dura mater. Microscopic findings proved its continuity with the dura mater. In one case, the facial nerve was damaged before it was identified during subcapsular dissection. In that case, the dura-like membrane negatively affected our ability to identify the facial nerve. Conclusions: A dura-like membrane sometimes envelops vestibular schwannoma around the internal acoustic meatus. Recognition of this membranous structure is important for the surgical preservation of facial and acoustic nerves. PMID:27453796

  1. Intrinsic brainstem schwannoma – A rare clinical entity and a histological enigma

    PubMed Central

    Sharma, Anil Kumar; Savardekar, Amey R.; Nandeesh, B. N.; Arivazhagan, A.; Rao, Malla Bhaskar

    2016-01-01

    Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma. PMID:27114669

  2. [Treatment research progress on the treatment of neurofibromatosis type 2-associated vestibular schwannoma].

    PubMed

    Zhao, Yingchao; Yang, Qin; Jiang, Yao

    2015-05-01

    Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition. Bilateral vestibular schwannoma, which are benign tumors, composed of neoplastic Schwann cells that arise from the eighth cranial nerve, are the hallmark of NF2. Standard approaches for treatment of growing vestibular schwannoma include observation, surgical removal and radiation therapy. Molecular targeted therapies also present great prosperity in recent years. In this review, we summarize the latest progresses on the treatment of NF2-associated vestibular schwannoma. PMID:26596021

  3. [Research advances in molecular mechanisms underlying the different biological behaviors of vestibular schwannoma].

    PubMed

    Wang, Z Y; Yang, J; Wu, H

    2016-06-01

    Current treatment options of vestibular schwannomas should not be limited to conventional surgery because of the variability of tumor growth. Recent studies of vestibular schwannomas suggested that the development of the tumor tended to depend on the shuttle between the nucleus and cytoplasm, and the expression patterns of merlin protein. New drug targets for schwannoma therapies might be identified through future in-depth investigations of the function of merlin, thus contributing to tumor control. PMID:27345892

  4. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report

    PubMed Central

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun

    2016-01-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  5. A rare cause of chronic sciatic pain: Schwannoma of the sciatic nerve

    PubMed Central

    Rhanim, Abdelkarim; El Zanati, Rachid; Mahfoud, Mustapha; Berrada, Mohammed Saleh; El Yaacoubi, Moradh

    2013-01-01

    Schwannomas are common, benign tumors of the shelth of peripheral nerves. Sciatic schwannomas are rare. Their symptomatology usually mimics sciatic pain due to a herniated disc, which can delay the diagnosis. If there is no lumbar pain and lumbar MRI is normal, the sciatic nerve must be clinically and radiologically examined all along its course. We report a case of sciatic nerve schwannoma presenting with chronic sciatica which was diagnosed and monitored radiologically for several years before successful surgical resection. PMID:26403631

  6. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report.

    PubMed

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun; Kuo, Yen-Liang

    2016-05-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  7. Intrinsic brainstem schwannoma - A rare clinical entity and a histological enigma.

    PubMed

    Sharma, Anil Kumar; Savardekar, Amey R; Nandeesh, B N; Arivazhagan, A; Rao, Malla Bhaskar

    2016-01-01

    Intraparenchymal schwannomas arising in the brainstem are very rare, and only eight cases have been reported in literature till now. We report an intraparenchymal brainstem schwannoma presenting with the classical clinical presentation of an intrinsic brainstem lesion, and discuss its clinicoradiological characteristics and histological origins. We highlight the importance of an intraoperative frozen section diagnosis in such cases. Intraoperative tissue diagnosis significantly may alter the surgical strategy, which should be aimed at near total intracapsular decompression of the schwannoma. PMID:27114669

  8. Trauma-induced schwannoma of the recurrent laryngeal nerve after thyroidectomy.

    PubMed

    Kennedy, William P; Brody, Robert M; LiVolsi, Virginia A; Wang, Amber R; Mirza, Natasha A

    2016-06-01

    Laryngeal schwannomas are rare, benign tumors, most often arising from the superior laryngeal nerve. We describe a case of a 68-year-old female with a laryngeal schwannoma of the recurrent laryngeal nerve after traumatic injury. We postulate that trauma to the recurrent laryngeal nerve during thyroidectomy or thyroplasty incited growth of a nerve sheath tumor. This is the first reported case of a trauma-induced schwannoma of the recurrent laryngeal nerve and second case of a recurrent laryngeal nerve schwannoma. Although rare, this case demonstrates that these tumors should be considered during workup of vocal cord paresis after surgery or failed thyroplasty. Laryngoscope, 126:1408-1410, 2016. PMID:26421595

  9. Acute hemorrhage within intradural extramedullary schwannoma in cervical spine presenting with quadriparesis

    PubMed Central

    Sahoo, Ranjan Kumar; Das, Pulin Bihari; Sarangi, Gouri Sankar; Mohanty, Sureswar

    2015-01-01

    Schwannoma with acute hemorrhage is rarely seen. A 44-years-old male patient presented with complaint of neck pain and acute onset of quadriparesis. Magnetic resonance imaging (MRI) of his cervical spine revealed evidence of an intradural extramedullary tumor with intratumoral acute hemorrhage. He was operated in emergency and the mass was found to be schwannoma with acute hemorrhage. Post operatively the patient improved significantly. Though schwannomas show microscopic intratumoral hemorrhage and necrosis at times, schwannoma with acute hemorrhage resulting acute onset of neurological deficit is very uncommon. PMID:25972715

  10. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

    PubMed Central

    Ogbole, Godwin I.; Adeleye, Amos O.; Owolabi, Mayowa O.; Olatunji, Richard B.; Yusuf, Bolutife P.

    2015-01-01

    Background: Incidental findings on computed tomography (CT) scans are occasionally noted in patients presenting with head injury. Since it can be assumed that head injured patients are of normal health status before the accident, these findings may be a representation of their frequency in the general population. Our aim was to determine the prevalence of such incidental findings among head injured patients in Nigeria's foremost center of clinical neurosciences. Materials and Methods: We conducted a retrospective review of CT scan images of 591 consecutive eligible patients over a 5-year period (2006-2010) to identify incidental findings. The images were evaluated by consensus agreement of two radiologists. Associations with gender and age were explored using appropriate statistical tests with an alpha level of 0.05. Results: The mean patient age was 34.6 ± 21.2 years, and male to female ratio was 3.2: 1. Incidental findings were noted in 503/591 (85.1 %) of the scans. Intracranial calcification was the commonest finding occurring in 61.8% of patients. Over 90% of the findings were benign. Compared with older ones, patients under the age of 60 were less likely, (P < 0.001), to have incidental findings. Conclusion: Although the majority of incidental findings in this African cohort of head injury patients are benign some clinically significant lesions were detectable. It is therefore recommended that such findings be adequately described in the radiological reports for proper counseling and follow-up. PMID:25949036

  11. Giant solitary ancient schwannoma of the pleura masquerading as bronchopneumonia.

    PubMed

    Gilbert, Shegu; Singh, Devender; Kaliappan, Sivakumar Manjanaikkanpatti; Mehta, Sangita Sharma

    2016-01-01

    We report a 53-year-old female who presented with complaints of sudden onset breathlessness, cough with expectoration for 6 months, and a right lung base lesion in the chest X-ray, which was diagnosed and treated as bronchopneumonia by the family physician. High-resolution computed tomography of the chest was done which revealed a large heterogeneously enhancing mass in the right thoracic cavity. She underwent thoracotomy and was found to have a giant encapsulated and well-circumscribed mass arising from the pleura. Excision biopsy of the mass revealed it to be an ancient schwannoma. Ancient schwannoma of the pleura is a very rare entity. Complete surgical resection is curative. PMID:27578943

  12. Giant solitary ancient schwannoma of the pleura masquerading as bronchopneumonia

    PubMed Central

    Gilbert, Shegu; Singh, Devender; Kaliappan, Sivakumar Manjanaikkanpatti; Mehta, Sangita Sharma

    2016-01-01

    We report a 53-year-old female who presented with complaints of sudden onset breathlessness, cough with expectoration for 6 months, and a right lung base lesion in the chest X-ray, which was diagnosed and treated as bronchopneumonia by the family physician. High-resolution computed tomography of the chest was done which revealed a large heterogeneously enhancing mass in the right thoracic cavity. She underwent thoracotomy and was found to have a giant encapsulated and well-circumscribed mass arising from the pleura. Excision biopsy of the mass revealed it to be an ancient schwannoma. Ancient schwannoma of the pleura is a very rare entity. Complete surgical resection is curative.

  13. Cerebellopontine angle primitive neuroectodermal tumor mimicking trigeminal schwannoma

    PubMed Central

    Khan, Saad Akhtar; Ujjan, Badar Uddin; Salim, Adnan; Shamim, Shahzad

    2016-01-01

    Background: Primitive neuroectodermal tumors (PNETs) comprise a group of aggressive, poorly differentiated embryonal tumors occurring in central nervous system as well as in peripheral locations. Primary cerebellopontine angle (CPA) PNET is an extremely rare entity. It is important to have knowledge of this pathology and to be able to differentiate it from other commonly occurring CPA tumors, such as vestibular and trigeminal schwannomas. This distinction is essential because of the difference in the overall treatment plan and prognosis. Case Description: This report describes a case of a young male presenting with diplopia and numbness of face; magnetic resonance imaging showed a CPA mass. With a provisional diagnosis of trigeminal schwannoma, the patient underwent surgery. Histopathology provided a diagnosis of PNET. Conclusion: We discuss the importance of recognizing this rare condition and how this entity differs from the commonly occurring tumors. PMID:26862446

  14. Malignant schwannoma in an American buffalo (Bison bison bison).

    PubMed

    Cho, H S; Kim, Y S; Choi, C; Lee, J H; Masangkay, J S; Park, N Y

    2006-10-01

    A case of a malignant schwannoma in a 20-year-old male American buffalo (Bison bison bison) from the Grand Park Zoo, Gyeonggi Province, Republic of Korea is reported. The animal showed no apparent clinical signs before death except for wound on the neck. Grossly, neoplastic nodules of various sizes were observed on the skin, lung, heart, liver, stomach, mesentery and kidney. Histologically, the neoplastic nodules were composed of fusiform cells that formed multidirectional bundles. The tumour cells were arranged in interlacing bands and bundles. The nuclei were atypical, hyperchromatic, with blunt or round ends. In addition, few mitotic figures were observed in the skin, lung, heart, liver, stomach, intestine and kidney. Several immunohistochemical stains, e.g. vimentin, cytokeratin (CK), smooth muscle actin (SMA), S-100 and HMB45, were used in an attempt to differentially diagnose the tumour. The neoplastic cells tested positive to S-100, but negative to vimentin, CK, SMA and HMB45. Based on the above findings, this case was diagnosed as a malignant schwannoma. To the best of our knowledge, this is the first report of a schwannoma in an American buffalo (B. b. bison). PMID:16970634

  15. Paediatric Extracranial Spinal Accessory Nerve Schwannoma: An Extremely Rare Case Report

    PubMed Central

    Garg, Sunil; Bhargava, Rahul

    2016-01-01

    Schwannoma in head and neck region are quiet common and generally arise from last four cranial nerves. Spinal accessory nerve involvement is very rare. We are hereby presenting an extremely rare case of paediatric XI nerve schwannoma hitherto unreported in English medical literature till date.

  16. Cervical intramedullary schwannoma: a case report and review of the literature

    PubMed Central

    Nicácio, Jardel Mendonça; Rodrigues, José Carlos; Galles, Marcos Henrique Lima; Faquini, Igor Vilela; de Brito Pereira, Clemente Augusto; Ganau, Mario

    2009-01-01

    Intramedullary schwannomas unrelated with neurofibromatosis are uncommon tumors, but if correctly diagnosed and properly treated they may have a good prognosis. They have a wide range of clinical presentations, commonly presenting as a slowly progressive motor or sensory syndrome. We present a case report of a patient without neurofibromatosis with a surgically treated cervical intramedullary schwannoma. PMID:21139923

  17. 76 FR 69758 - Draft Environmental Assessment, Incidental Take Plan, and Application for an Incidental Take...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... the applicant that would authorize take of the federally threatened Canada lynx incidental to... Attn: Lynx HCP, Laury Zicari, Field Supervisor, U.S. Fish and Wildlife Service, Maine Field Office, 17... an incidental take permit to take the federally threatened Canada lynx (Lynx canadensis)...

  18. 78 FR 24731 - Taking Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to an...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ...Notice is hereby given that ConocoPhillips Company (COP) has withdrawn its application for an Incidental Harassment Authorization (IHA). The following action is related to a proposed IHA to COP for the take of small numbers of marine mammals, by Level B harassment, incidental to conducting offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Chukchi Sea, Alaska, during......

  19. 77 FR 49921 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-17

    ... from ION Geophysical (ION) for an Incidental Harassment Authorization (IHA) to take marine mammals, by... comments on its proposal to issue an IHA to ION to take, by harassment, nine species of marine mammals... March 1, 2012, from ION for the taking, by harassment, of marine mammals incidental to a marine...

  20. 76 FR 68973 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ...NMFS received an application from Shell Offshore Inc. (Shell) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Beaufort Sea, Alaska. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to Shell to take, by......

  1. 78 FR 12541 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ...NMFS received an application from ConocoPhillips Company (COP) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Chukchi Sea, Alaska. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to COP to take, by......

  2. 75 FR 25729 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ...NMFS received an application from Shell Offshore Inc. (Shell) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Chukchi Sea, Alaska. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to Shell to take, by......

  3. 75 FR 20481 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ...NMFS received an application from Shell Offshore Inc. (Shell) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Beaufort Sea, Alaska. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to Shell to take, by......

  4. 76 FR 62778 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-11

    ...In accordance with the regulations implementing the Marine Mammal Protection Act (MMPA) as amended, notification is hereby given that NMFS has issued an Incidental Harassment Authorization (IHA) to the Northeast Gateway[supreg] Energy BridgeTM L.P. (Northeast Gateway or NEG) to incidentally harass, by Level B harassment only, small numbers of marine mammals during operation of an......

  5. 75 FR 53672 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-01

    ...In accordance with the regulations implementing the Marine Mammal Protection Act (MMPA) as amended, notification is hereby given that NMFS has issued an Incidental Harassment Authorization (IHA) to the Northeast Gateway Energy BridgeTM LP (Northeast Gateway or NEG) and its partner, Algonquin Gas Transmission, LLC (Algonquin), to incidentally harass, by Level B harassment only, small......

  6. 77 FR 50990 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ...NMFS has received an application from the National Ocean Service's Office of National Marine Sanctuaries Gulf of the Farallones National Marine Sanctuary (GFNMS) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to rocky intertidal monitoring work and searching for black abalone, components of the Sanctuary Ecosystem Assessment Surveys. Pursuant......

  7. 75 FR 49709 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ...In accordance with the Marine Mammal Protection Act (MMPA) regulations, notification is hereby given that NMFS has issued an Incidental Harassment Authorization (IHA) to Shell Offshore Inc. (Shell) to take, by harassment, small numbers of 8 species of marine mammals incidental to a marine survey program, which includes site clearance and shallow hazards, ice gouge, and strudel scour surveys,......

  8. 76 FR 69957 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ...NMFS received an application from Shell Offshore Inc. (Shell) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to offshore exploration drilling on Outer Continental Shelf (OCS) leases in the Chukchi Sea, Alaska. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to Shell to take, by......

  9. 78 FR 37209 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC564 Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic Survey in the Beaufort Sea,...

  10. Level 1: Incidental crane operator`s and incidental rigger`s manual. Revision

    SciTech Connect

    Neubauer, P.

    1992-11-01

    This document is a safety manual for incidental crane operators and incidental riggers. The information contained in this manual includes: Terminology and definitions, safety orientation, general operating procedures, high-consequence/high value lifts, sling safety, basic rules of hitching and rigging, and common errors in hitching.

  11. 77 FR 64320 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... National Oceanic and Atmospheric Administration RIN 0648-XC283 Takes of Marine Mammals Incidental to... Atmospheric Administration (NOAA), Commerce. ACTION: Notice; proposed incidental harassment authorization... and to determine if any relationship exists between changing ocean chemistry and the states of two...

  12. 78 FR 35507 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ...NMFS received an application from TGS-NOPEC Geophysical Company ASA (TGS) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment only, incidental to a marine 2- dimensional (2D) seismic survey program in the Chukchi Sea, Alaska, during the open water season of 2013. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal......

  13. 76 FR 58473 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ...NMFS received an application from Apache Alaska Corporation (Apache) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to a proposed 3D seismic survey in Cook Inlet, Alaska, between November 2011 and November 2012. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS requests comments on its proposal to issue an IHA to Apache to take, by......

  14. 77 FR 40007 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-06

    ...In accordance with the Marine Mammal Protection Act (MMPA) regulations, notification is hereby given that NMFS has issued an Incidental Harassment Authorization (IHA) to BP Exploration (Alaska), Inc. (BP) to take, by harassment, small numbers of 10 species of marine mammals incidental to ocean bottom cable (OBC) seismic surveys in the Simpson Lagoon area of the Beaufort Sea, Alaska, during the......

  15. 78 FR 51147 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ...In accordance with the Marine Mammal Protection Act (MMPA) regulations, notification is hereby given that NMFS has issued an Incidental Harassment Authorization (IHA) to TGS-NOPEC Geophysical Company ASA (TGS) to take, by harassment, small numbers of marine mammals incidental to a marine 2-dimensional (2D) seismic survey program in the Chukchi Sea, Alaska, during the 2013 Arctic open-water......

  16. Gastric Schwannoma Mimicking Malignant Gastrointestinal Stromal Tumor Exhibiting Increased Fluorodeoxyglucose Uptake

    PubMed Central

    Oh, Sung Jin; Suh, Byoung Jo; Park, Jong Kwon

    2016-01-01

    A schwannoma is a kind of neurogenic tumor that rarely occurs in the gastrointestinal tract. Gastric schwannomas make up 0.2% of all gastric neoplasms. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors and up to 60–70% of GIST occur in the stomach. Schwannoma and GIST are similar in clinical features, so they are difficult to differentiate preoperatively. Differential diagnosis of these two submucosal tumors is important because of the malignant potential of GIST and the relatively benign course of gastric schwannomas. We report a 49-year-old woman who was diagnosed after operation with a gastric schwannoma, which was suspected a malignant GIST by fluorine-18-fluorodeoxyglucose positron emission computed tomography imaging. PMID:27194983

  17. Charcot-Marie-Tooth 1A concurrent with schwannomas of the spinal cord and median nerve.

    PubMed

    Kwon, Joo Young; Chung, Ki Wha; Park, Eun Kyung; Park, Sun Wha; Choi, Byung-Ok

    2009-08-01

    We identified Charcot-Marie-Tooth disease type 1A (CMT1A) in a family with schwannomas in the spinal cord and median nerve. The CMT1A in this family showed an autosomal dominant pattern, like other CMT patients with PMP22 duplication, and the family also indicated a possible genetic predisposition to schwannomas by 'mother-to-son' transmission. CMT1A is mainly caused by duplication of chromosome 17p11.2-p12 (PMP22 gene duplication). A schwannoma is a benign encapsulated tumor originating from a Schwann cell. A case of hereditary neuropathy with liability to pressure palsies (HNPP) concurrent with schwannoma has been previously reported. Although it seems that the co-occurrence of CMT1A and schwannomas in a family would be the result of independent events, we could not completely ignore the possibility that the coincidence of two diseases might be due to a shared genetic background. PMID:19654968

  18. Schwannoma of the left foot: a brief overview with focus on associated clinical syndromes.

    PubMed

    Kallini, Joseph R; Khachemoune, Amor

    2014-01-01

    In this article, we present a 25-year-old man who developed an asymptomatic schwannoma on his left lateral heel and review the salient features of this cutaneous condition. A schwannoma is a slowly growing neoplasm of Schwann cell origin. Histology shows high cellularity (Antoni A regions), nuclear palisades (Verocay bodies), and alternating myxoid regions (Antoni B regions). Very few cases have been reported on the foot or ankle. As with this patient, most schwannomas do not cause symptoms, but some result in dysesthesia and nerve dysfunction. Multiple schwannomas may indicate an underlying syndrome such as neurofibromatosis type 1, type 2, and schwannomatosis. The differential diagnosis for schwannoma includes fibrosarcoma, leiomyosarcoma, and neurofibroma. The definitive treatment is surgical excision. This usually results in complete resolution with minimal recurrence, as was the case for this patient. PMID:25275746

  19. Negative incidental emotions augment fairness sensitivity

    PubMed Central

    Liu, Cuizhen; Chai, Jing Wen; Yu, Rongjun

    2016-01-01

    Previous studies have shown that task-unrelated emotions induced incidentally exert carryover effects on individuals’ subsequent decisions in financial negotiations. However, the specificity of these emotion effects are not clear. In three experiments, we systematically investigated the role of seven transiently induced basic emotions (disgust, sadness, anger, fear, happiness, surprise and neutral) on rejection of unfair offers using the ultimatum game. We found that all negative emotions (disgust, sadness, anger and fear), but not happiness or surprise, significantly increased rejection rates, suggesting that the effect of incidental negative emotions on fairness is not specific to the type of negative emotion. Our findings highlight the role of fleeting emotions in biasing decision-making processes and suggest that all incidental negative emotions exert similar effects on fairness sensitivity, possibly by potentiating attention towards negative aspects of the situation. PMID:27101931

  20. Negative incidental emotions augment fairness sensitivity.

    PubMed

    Liu, Cuizhen; Chai, Jing Wen; Yu, Rongjun

    2016-01-01

    Previous studies have shown that task-unrelated emotions induced incidentally exert carryover effects on individuals' subsequent decisions in financial negotiations. However, the specificity of these emotion effects are not clear. In three experiments, we systematically investigated the role of seven transiently induced basic emotions (disgust, sadness, anger, fear, happiness, surprise and neutral) on rejection of unfair offers using the ultimatum game. We found that all negative emotions (disgust, sadness, anger and fear), but not happiness or surprise, significantly increased rejection rates, suggesting that the effect of incidental negative emotions on fairness is not specific to the type of negative emotion. Our findings highlight the role of fleeting emotions in biasing decision-making processes and suggest that all incidental negative emotions exert similar effects on fairness sensitivity, possibly by potentiating attention towards negative aspects of the situation. PMID:27101931

  1. Incidental copy-number variants identified by routine genome testing in a clinical population

    PubMed Central

    Boone, Philip M.; Soens, Zachry T.; Campbell, Ian M.; Stankiewicz, Pawel; Cheung, Sau Wai; Patel, Ankita; Beaudet, Arthur L.; Plon, Sharon E.; Shaw, Chad A.; McGuire, Amy L.; Lupski, James R.

    2013-01-01

    Purpose Mutational load of susceptibility variants has not been studied on a genomic scale in a clinical population, nor has the potential to identify these mutations as incidental findings during clinical testing been systematically ascertained. Methods Array comparative genomic hybridization, a method for genome-wide detection of DNA copy-number variants, was performed clinically on DNA from 9,005 individuals. Copy-number variants encompassing or disrupting single genes were identified and analyzed for their potential to confer predisposition to dominant, adult-onset disease. Multigene copy-number variants affecting dominant, adult-onset cancer syndrome genes were also assessed. Results In our cohort, 83 single-gene copy-number variants affected 40 unique genes associated with dominant, adult-onset disorders and unrelated to the patients’ referring diagnoses (i.e., incidental) were found. Fourteen of these copy-number variants are likely disease-predisposing, 25 are likely benign, and 44 are of unknown clinical consequence. When incidental copy-number variants spanning up to 20 genes were considered, 27 copy-number variants affected 17 unique genes associated with dominant, adult-onset cancer predisposition. Conclusion Copy-number variants potentially conferring susceptibility to adult-onset disease can be identified as incidental findings during routine genome-wide testing. Some of these mutations may be medically actionable, enabling disease surveillance or prevention; however, most incidentally observed single-gene copy-number variants are currently of unclear significance to the patient. PMID:22878507

  2. Ethical and Practical Considerations in the Management of Incidental Findings in Pediatric MRI Studies

    ERIC Educational Resources Information Center

    Kumra, Sanjiv; Ashtari, Manzar; Anderson, Britt; Cervellione, Kelly L.; Kan, Li

    2006-01-01

    Objective: The authors examined the ethical and practical management issues resulting from the detection of incidental abnormal findings on magnetic resonance imaging (MRI) research studies in healthy pediatric volunteers. Method: A retrospective examination of the findings from 60 clinical reports of research MRI scans from a cohort of healthy…

  3. Tumors displaying hybrid schwannoma and neurofibroma features in patients with neurofibromatosis type 2.

    PubMed

    Montgomery, Blake K; Alimchandani, Meghna; Mehta, Gautam U; Dewan, Ramita; Nesvick, Cody L; Miettinen, Markku; Heiss, John D; Asthagiri, Ashok R; Quezado, Martha; Germanwala, Anand V

    2016-01-01

    Although schwannoma and neurofibroma tumors are generally reported as distinct pathologic diagnoses, sporadic schwannoma/neurofibroma hybrid nerve sheath tumors have been reported in the general population with components of both entities. We report the clinicopathological features of these hybrid nerve sheath tumors in patients with neurofibromatosis type 2 (NF2). A retrospective review of nerve sheath tumor surgical specimens from patients with NF2 enrolled at the National Institutes of Health was performed. Those specimens reported to have schwannoma-like and neurofibromalike features were selected for further characterization by morphology, immunohistochemical panel (CD34, S100, neurofilament triplet protein (immunostain) (NFTP), epithelial membrane antigen (EMA)), and confirmation as hybrid tumors. Of 43 total NF2 patients undergoing resection of nerve sheath tumors, 11 specimens from 11 (26%) patients were found to be benign nerve sheath tumors exhibiting hybrid features of both neurofibroma and schwannoma. Immunohistochemical studies showed the schwannoma component to be S100+, CD 34- while the neurofibroma component was CD34+, variable S100+. Our experience emphasizes the importance of including this distinct tumor subtype, the schwannoma/neurofibroma hybrid tumor, in the differential diagnosis of nerve sheath tumors in NF2 patients and suggests that the relationship between neurofibroma and schwannoma tumors is closer than previously suspected.. PMID:26709712

  4. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but...

  5. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but...

  6. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but...

  7. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but...

  8. 21 CFR 1307.13 - Incidental manufacture of controlled substances.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Incidental manufacture of controlled substances... MISCELLANEOUS Special Exceptions for Manufacture and Distribution of Controlled Substances § 1307.13 Incidental manufacture of controlled substances. Any registered manufacturer who, incidentally but...

  9. [Schwannoma in the epipharynx: a rare differential diagnosis].

    PubMed

    Meyer, M F; Anagiotos, A; Lüers, J C; Löser, H; Wardelmann, E; Beutner, D

    2013-05-01

    There are many benign and malignant tumors of the epipharynx, which makes differential diagnosis difficult. As a very rare differential diagnosis, a schwannoma is possible. The origin of the tumor is most likely a small branch of a sensitive nerve of the glossopharyngeal nerve or the trigeminus nerve. A clear differentiation in the MRI scan is often not possible; especially differentiation from MPNST (malignant peripheral nerve sheath tumors) is difficult. To confirm the diagnosis and exclude malignancy, every tumor in the epipharynx should be surgically excised if possible, even if the patient has no discomfort. PMID:23241860

  10. An Intraventricular Schwannoma with Associated Hydrocephalus and Ventricular Entrapment: A Case Report

    PubMed Central

    Curran-Melendez, Sheilah M.; Fukui, Melanie; Bivin, William; Oliver-Smith, David

    2015-01-01

    Intraventricular schwannomas are rare primary brain tumors, with fewer than 25 cases reported in the literature. Here, we present the case of a 20-year-old male patient with a 2 year history of blurry vision and dysesthesia involving his right occiput and upper neck. Imaging demonstrated a homogeneously enhancing mass located within the atrium of the right lateral ventricle with associated right lateral ventricular entrapment. Pathology confirmed the tumor to be an intraventricular schwannoma. Imaging findings, presentation, complications, and treatment options for intraventricular schwannomas are described. PMID:26251806

  11. 76 FR 74805 - Draft Environmental Assessment, Incidental Take Plan, and Application for an Incidental Take...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ... application from the MDIFW for an incidental take permit in a November 9, 2011, Federal Register notice (76 FR.... ADDRESSES: Send comments by U.S. mail to Attn: Lynx HCP, Laury Zicari, Field Supervisor, U.S. Fish...

  12. 77 FR 51773 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ...NMFS has received an application from the U.S. Fish and Wildlife Service (USFWS) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to a bird mitigation research trial in the Farallon National Wildlife Refuge. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to the USFWS to take, by......

  13. Incidental Foreign Language Acquisition from Media Exposure

    ERIC Educational Resources Information Center

    Kuppens, An H.

    2010-01-01

    A number of experimental studies have demonstrated the incidental acquisition of a foreign language by children and adolescents when watching foreign language television. While such experiments can only establish short-term effects, this article investigates the extent to which children's foreign language skills benefit from their long-term…

  14. Central and Incidental Learning in Children.

    ERIC Educational Resources Information Center

    Hagen, John W.; Sabo, Ruth

    Earlier studies found that recall scores of information central to the task increased with age while incidental information recall scores remained constant. This study repeated the earlier ones modifying procedures of instructions, testing, and schedule of recall. Also, it tested the effect of labeling pictorial stimuli. The sample of 253 children…

  15. Spatial Reference Frame of Incidentally Learned Attention

    ERIC Educational Resources Information Center

    Jiang, Yuhong V.; Swallow, Khena M.

    2013-01-01

    Visual attention prioritizes information presented at particular spatial locations. These locations can be defined in reference frames centered on the environment or on the viewer. This study investigates whether incidentally learned attention uses a viewer-centered or environment-centered reference frame. Participants conducted visual search on a…

  16. Incidental Learning in a Complex Clinical Workplace

    ERIC Educational Resources Information Center

    Harner, Michael Dean

    2013-01-01

    Workplace learning is complex as employees engage in activities to meet organizational objectives. This study investigates incidental learning in a complex clinical environment. The systems created to collect information and perform patient-visit functions involve several people who have distinct roles that can impact how subsequent people in the…

  17. 25 CFR 700.199 - Incidental expenses.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Commission determines to be incidental to the purchase. (b) Truth in lending charge. Any expense, which is determined to be part of the debt service or finance charge under 15 U.S.C. 131-1641 and Regulation Z (12 CFR... OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES...

  18. Incidental Sequence Learning across the Lifespan

    ERIC Educational Resources Information Center

    Weiermann, Brigitte; Meier, Beat

    2012-01-01

    The purpose of the present study was to investigate incidental sequence learning across the lifespan. We tested 50 children (aged 7-16), 50 young adults (aged 20-30), and 50 older adults (aged >65) with a sequence learning paradigm that involved both a task and a response sequence. After several blocks of practice, all age groups slowed down…

  19. Incidental Education (for Women) in Rural Communities.

    ERIC Educational Resources Information Center

    Crosby, Valmai

    The Country Women's Association (CWA) is a nationwide Australian group that started in the 1920s in response to isolated women's need to socialize. The group's activities have expanded greatly over time. It distributes essential food and clothing to needy rural families, and its extensive involvement in incidental education for women includes…

  20. Incidental fear cues increase monetary loss aversion.

    PubMed

    Schulreich, Stefan; Gerhardt, Holger; Heekeren, Hauke R

    2016-04-01

    In many everyday decisions, people exhibit loss aversion-a greater sensitivity to losses relative to gains of equal size. Loss aversion is thought to be (at least partly) mediated by emotional--in particular, fear-related--processes. Decision research has shown that even incidental emotions, which are unrelated to the decision at hand, can influence decision making. The effect of incidental fear on loss aversion, however, is thus far unclear. In two studies, we experimentally investigated how incidental fear cues, presented during (Study 1) or before (Study 2) choices to accept or reject mixed gambles over real monetary stakes, influence monetary loss aversion. We find that the presentation of fearful faces, relative to the presentation of neutral faces, increased risk aversion-an effect that could be attributed to increased loss aversion. The size of this effect was moderated by psychopathic personality: Fearless dominance, in particular its interpersonal facet, but not self-centered impulsivity, attenuated the effect of incidental fear cues on loss aversion, consistent with reduced fear reactivity. Together, these results highlight the sensitivity of loss aversion to the affective context. PMID:26595436

  1. Transoral Robotic Surgery in Retrostyloid Parapharyngeal Space Schwannomas

    PubMed Central

    Ansarin, Mohssen; Tagliabue, Marta; Chu, Francesco; Zorzi, Stefano; Proh, Michele; Preda, Lorenzo

    2014-01-01

    Parapharyngeal space (PPS) tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS) excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI). In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new “J”-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space. PMID:25202464

  2. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    PubMed

    Carlson, Matthew L; Gompel, Jamie J Van

    2016-06-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appearing to arise from the superior vestibular nerve. The patient denied a family history of NF2. Neurotologic examination was unremarkable and close review of magnetic resonance imaging did not find any other stigmata of NF2. Results The patient underwent left-sided retrosigmoid craniotomy with gross total resection of both tumors. Final pathology confirmed benign schwannoma. The INI1/SMARCB1 staining pattern did not suggest NF2 or schwannomatosis. Conclusions This is only the third report of a case with multiple unilateral VSs occurring in a patient without other features of NF2. Herein, the authors review the two other reports and discuss potential mechanisms for this rare phenomenon. PMID:27354931

  3. Small Vestibular Schwannomas: Does Surgery Remain a Viable Treatment Option?

    PubMed

    Anaizi, Amjad N; DiNapoli, Vincent V; Pensak, Myles; Theodosopoulos, Philip V

    2016-06-01

    Background Surgery for small vestibular schwannomas (Koos grade I and II) has been increasingly rejected as the optimal primary treatment, instead favoring radiosurgery and observation that offer lower morbidity and potentially equal efficacy. Our study assesses the outcomes of contemporary surgical strategies including tumor control, functional preservation, and implications of pathologic findings. Design Retrospective review. Setting/Participants Eighty consecutive patients (45 women, 35 men; mean: 47 years of age). Main Outcomes Measures Approaches included retrosigmoid approach (52%), translabyrinthine (40%), and middle fossa (8%). Operated on by the same surgical team, we analyzed presentation, radiographic imaging, surgical data, and outcomes. Results At last follow-up (mean: 34 months), 95% had good facial nerve function (House-Brackmann grade I or II); 36% who presented with serviceable hearing retained it; and 93% who presented with vestibular dysfunction reported resolution. Pathology identified two grade I meningiomas. Conclusions As one of the largest contemporary surgical series of small vestibular schwannomas, we discuss some nuances to help refine treatment algorithms. Although observation and radiosurgery have established roles, our results reinforce microsurgery as a viable, safe option for a subgroup of patients. PMID:27175315

  4. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    PubMed Central

    Nishizaki, Takafumi; Ikeda, Norio; Nakano, Shigeki; Sakakura, Takanori; Abiko, Masaru; Okamura, Tomomi

    2011-01-01

    Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI) revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve. PMID:24765294

  5. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    PubMed Central

    Carlson, Matthew L.; Gompel, Jamie J. Van

    2016-01-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appearing to arise from the superior vestibular nerve. The patient denied a family history of NF2. Neurotologic examination was unremarkable and close review of magnetic resonance imaging did not find any other stigmata of NF2. Results The patient underwent left-sided retrosigmoid craniotomy with gross total resection of both tumors. Final pathology confirmed benign schwannoma. The INI1/SMARCB1 staining pattern did not suggest NF2 or schwannomatosis. Conclusions This is only the third report of a case with multiple unilateral VSs occurring in a patient without other features of NF2. Herein, the authors review the two other reports and discuss potential mechanisms for this rare phenomenon. PMID:27354931

  6. Schwannoma of the colon: A case report and review of the literature

    PubMed Central

    WANG, WEI-BING; CHEN, WEN-BIN; LIN, JIAN-JIANG; XU, JIA-HE; WANG, JIN-HAI; SHENG, QIN-SONG

    2016-01-01

    Colonic schwannomas are rare gastrointestinal mesenchymal tumors, and only a limited number of cases has been reported. The occurrence of these tumors is less common in the large intestine than in the stomach. The present study reports a case of colonic schwannoma in a 62-year-old female patient with no specific symptoms. The patient was diagnosed with a mass in the ascending colon by colonoscopy and abdominal computed tomography scanning. A right hemicolectomy was performed. The postoperative pathological diagnosis was ascending schwannoma. This case is noteworthy as colonic schwannomas are rare and are typically treated as colon cancer. No recurrence of the lesion was observed after 24 months of follow-up. PMID:27073520

  7. Computed tomography and magnetic resonance imaging findings of intrasellar schwannoma: A case report and literature review

    PubMed Central

    LIU, MENGQI; OUYANG, YU; LV, FAJIN

    2016-01-01

    Intrasellar schwannoma is extremely rare, and only a few cases have been reported in the literature to date. In the present study, the clinical, radiological and pathological features of a 50-year-old male patient with primary intrasellar schwannoma are presented. The patient presented with decreased visual acuity, and a subsequent computed tomography (CT) scan revealed a giant well-demarcated intrasellar mass with suprasellar extension, without cavernous sinus invasion. The lesion was slightly hyperdense with heterogeneous enhancement. On magnetic resonance imaging (MRI), the mass was isointense on T1 weighted images (WI), and slightly hyperintense on T2WI, with significant heterogeneous enhancement. Previous literature was reviewed to summarize the CT and MRI characteristics of intrasellar schwannoma. Despite the rarity of this tumor, intrasellar schwannoma must be included in the differential diagnosis of intrasellar lesions. PMID:26998169

  8. Simultaneous Translabyrinthine Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patients.

    PubMed

    Kim, Jin Won; Han, Ji Hyuk; Kim, Jin Woong; Moon, In Seok

    2016-11-01

    Refinement of surgical techniques has allowed hearing preservation after tumor resection to be prioritized. Moreover, restoration of hearing after tumor removal can be attempted in patients with bilateral vestibular schwannomas or those with a schwannoma in the only-hearing ear. Cochlear implantation (CI) has emerged as a proper method of acoustic rehabilitation, provided that the cochlear nerve remains intact. Studies of electrical promontory stimulation in patients after vestibular schwannoma resection have demonstrated favorable results. We describe herein two cases of hearing rehabilitation via CI implemented at the time of vestibular schwannoma resection. Tumors were totally removed, and cochlear implant electrodes were successfully inserted in both cases. Also, post operative CI-aided hearing showed improved results. PMID:27593888

  9. Denervation of the Eustachian Tube and Hearing Loss Following Trigeminal Schwannoma Resection

    PubMed Central

    Ito, Christopher J.; Malone, Alexander K.; Wong, Ricky H.; van Loveren, Harry R.; Boyev, K. Paul

    2016-01-01

    Objectives To discuss eustachian tube dysfunction (ETD) as a cause of hearing loss and to discuss its pathogenesis following resection of trigeminal schwannomas. Methods Presented herein are two cases of trigeminal schwannoma that were resected surgically with sacrifice of the motor branch of the trigeminal nerve. Neither of the cases had evidence of extracranial extension nor preoperative ETD. Both patients developed ETD and have been followed without evidence of schwannoma recurrence. Conclusions Trigeminal schwannomas are rare tumors that typically require surgical resection. Hearing loss is a potential postsurgical deficit and warrants evaluation by an otolaryngologist with consideration given to a preoperative audiogram. ETD as a result of trigeminal motor branch sacrifice should be included in the differential diagnosis of postoperative hearing loss in this patient subset as it may be reversed with placement of a tympanostomy tube. PMID:26937336

  10. Scrotal extratesticular schwannoma: a case report and review of the literature

    PubMed Central

    2014-01-01

    Background Schwannomas are tumours arising from Schwann cells, which sheath the peripheral nerves. Here, we report a rare case of left intrascrotal, extratesticular schwannoma. Although rare, scrotal localisation of schwannomas has been reported in male children, adult men, and elderly men. They are usually asymptomatic and are characterised by slow growth. Patients generally present with an intrascrotal mass that is not associated with pain or other clinical signs, and such cases are self-reported by most patients. Imaging modalities (such as ultrasonography, computed tomography, and magnetic resonance imaging) can be used to determine tumour size, exact localisation, and extension. However, the imaging findings of schwannoma are non-specific. Therefore, only complete surgical excision can result in diagnosis, based on histological and immunohistochemical analyses. If the tumour is not entirely removed, recurrences may develop, and, although malignant change is rare, this may occur, especially in patients with a long history of an untreated lesion. Thus, follow up examinations with clinical and imaging studies are recommended for scrotal schwannomas. Case presentation A 52-year-old man presented with a 3-year history of asymptomatic scrotal swelling. Physical examination revealed a palpable, painless, soft mass in the left hemiscrotum. After surgical removal of the mass, its histological features indicated schwannoma. Conclusions Schwannoma should be considered in cases of masses that are intrascrotal but extratesticular. Ultrasonography provides the best method of confirming the paratesticular localisation of the tumour, before surgical removal allows histopathological investigation and definitive diagnosis. Surgery is the standard therapeutic approach. To prevent recurrence, particular care should be taken to ensure complete excision. This case report includes a review of the literature on scrotal schwannomas. PMID:24776090