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Sample records for schwannoma detected incidentally

  1. 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

  2. Adrenal Schwannoma: A Rare Incidentaloma.

    PubMed

    Kumar, Sumit; Karthikeyan, Vilvapathy S; Manohar, Chikkamoga S; Sreelakshmi, K; Shivalingaiah, Maregowda

    2016-08-01

    Adrenal schwannomas are very rare tumours that are difficult to diagnose preoperatively. A 42-year-old male presented with epigastric pain and indigestion. He had history of repeated operations for recurrent facial swelling on both sides of face diagnosed as Angiolymphoid Hyperplasia with Eosinophilia (ALHE). Physical examination revealed right facial swelling. Laboratory tests showed no evidence of hormonal hypersecretion. CECT abdomen showed a well-defined heterogenously enhancing right adrenal mass (5x4cm). Patient underwent right adrenalectomy. Histopathology revealed adrenal schwannoma, confirmed by immunohistochemistry (IHC) showing diffuse expression of S-100. Fine-needle aspiration biopsy of facial lesion confirmed ALHE recurrence. Less than 35 cases have been reported. Diagnosis of adrenal schwannoma on imaging studies is very difficult and surgical resection when performed for non-functioning adrenal masses >4cm clinches the diagnosis. Adrenal schwannoma is highly uncommon and was incidentally associated with recurrent ALHE. PMID:27656499

  3. Computed Tomography Features of Incidentally Detected Diffuse Thyroid Disease

    PubMed Central

    Rho, Myung Ho

    2014-01-01

    Objective. This study aimed to evaluate the CT features of incidentally detected DTD in the patients who underwent thyroidectomy and to assess the diagnostic accuracy of CT diagnosis. Methods. We enrolled 209 consecutive patients who received preoperative neck CT and subsequent thyroid surgery. Neck CT in each case was retrospectively investigated by a single radiologist. We evaluated the diagnostic accuracy of individual CT features and the cut-off CT criteria for detecting DTD by comparing the CT features with histopathological results. Results. Histopathological examination of the 209 cases revealed normal thyroid (n = 157), Hashimoto thyroiditis (n = 17), non-Hashimoto lymphocytic thyroiditis (n = 34), and diffuse hyperplasia (n = 1). The CT features suggestive of DTD included low attenuation, inhomogeneous attenuation, increased glandular size, lobulated margin, and inhomogeneous enhancement. ROC curve analysis revealed that CT diagnosis of DTD based on the CT classification of “3 or more” abnormal CT features was superior. When the “3 or more” CT classification was selected, the sensitivity, specificity, positive and negative predictive values, and accuracy of CT diagnosis for DTD were 55.8%, 95.5%, 80.6%, 86.7%, and 85.6%, respectively. Conclusion. Neck CT may be helpful for the detection of incidental DTD. PMID:25548565

  4. A rare adrenal incidentaloma: adrenal schwannoma.

    PubMed

    Adas, Mine; Ozulker, Filiz; Adas, Gokhan; Koc, Bora; Ozulker, Tamer; Sahin, Ilknur Mansuroglu

    2013-01-01

    Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [(18)F] fluorodeoxyglucose positron emission tomography (PET) were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging. PMID:24403879

  5. A Rare Adrenal Incidentaloma: Adrenal Schwannoma

    PubMed Central

    Adas, Mine; Ozulker, Filiz; Adas, Gokhan; Koc, Bora; Ozulker, Tamer; Sahin, Ilknur Mansuroglu

    2013-01-01

    Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [18F] fluorodeoxyglucose positron emission tomography (PET) were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging. PMID:24403879

  6. Retroperitoneal schwannoma.

    PubMed

    Takatera, H; Takiuchi, H; Namiki, M; Takaha, M; Ohnishi, S; Sonoda, T

    1986-12-01

    A case of retroperitoneal benign schwannoma is presented; in addition, 133 cases of retroperitoneal schwannoma reported in Japanese literature are studied. In our series 66 per cent of the cases were found to be cystic. Therefore, the cystic change may be one of the preoperative features of schwannomas, because other types of retroperitoneal tumor do not frequently form cysts. Furthermore, the necessity of postoperative electron microscopy for accurate histologic diagnosis is discussed.

  7. Incidentally detected ectopic right kidney following total abdominal hysterectomy and bilateral salpingoophorectomy.

    PubMed

    Aksoy, Nazlı; Güzel, Ali İrfan; Doğanay, Melike

    2014-01-01

    Congenital organ anomalies in surgical patients can be incidentally detected during operation. A pelvis located right kidney was found incidentally in 54 year-old women after total abdominal histerectomy and bilateral salpingoophorectomy. The clinical importance of pelvic kidney detected during the surgery was discussed in this case report.

  8. 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

  9. 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

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

    PubMed

    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.

  11. 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

  12. Laparoscopic Resection of an Adrenal Schwannoma

    PubMed Central

    Konstantinos, Toutouzas G.; Panagiotis, Kekis B.; Nikolaos, Michalopoulos V.; Ioannis, Flessas; Andreas, Manouras; Geogrios, Zografos

    2012-01-01

    Background and Objectives: Schwannomas are tumors originating from Schwann cells of the peripheral nerve sheath (neurilemma) of the neuroectoderm. Rarely, schwannomas can arise from the retroperitoneum and adrenal medulla. We describe a case of a 71-y-old woman who presented with an incidentally discovered adrenal tumor. Methods: Ultrasound and computed tomography scans revealed a lesion with solid and cystic areas originating from the left adrenal gland. The patient underwent complete laparoscopic resection of the tumor and the left adrenal gland. Results: Histopathological examination and immunohistochemical staining of the excised specimen revealed a benign schwannoma measuring 5.5×5×3.7 cm. To our knowledge, few other cases of laparoscopic resection of adrenal schwannomas have been reported. Conclusion: Because preoperative diagnosis of adrenal tumors is inconclusive, complete laparoscopic excision allows for definitive diagnosis with histological evaluation and represents the treatment of choice. PMID:23484583

  13. Clinical and Virologic Characteristics May Aid Distinction of Acute Adenovirus Disease from Kawasaki Disease with Incidental Adenovirus Detection.

    PubMed

    Song, Eunkyung; Kajon, Adriana E; Wang, Huanyu; Salamon, Doug; Texter, Karen; Ramilo, Octavio; Leber, Amy; Jaggi, Preeti

    2016-03-01

    Incidental adenovirus detection in Kawasaki disease (KD) is important to differentiate from acute adenovirus disease. Twenty-four of 25 children with adenovirus disease and mimicking features of KD had <4 KD-like features, predominance of species B or E, and higher viral burden compared with those with KD and incidental adenovirus detection. PMID:26707621

  14. Endovascular treatment of painless aortic ulcer detected by transesophageal echocardiography as an incidental finding.

    PubMed

    Citro, Rodolfo; Bossone, Eduardo; Patella, Marco Mariano; Provenza, Gennaro; Luongo, Francesco; Galasso, Luigi; Meucci, Eugenio; Gregorio, Giovanni; Masip, Arturo Evangelista

    2007-12-01

    Penetrating aortic ulcer (PAU) is defined as an ulcerating atherosclerotic lesion that disrupts the aortic wall layers, penetrating the internal elastic lamina. The natural history of the disease and the preferred treatment are still debated. We report a case of painless PAU in a 78-year-old man detected by transesophageal echocardiography at the level of proximal descending aorta as an incidental finding. The patient underwent endovascular stent-graft placement without any complications at early and late follow-up.

  15. 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

  16. Osteoma of the internal auditory canal mimicking vestibular schwannoma: case report and review of 17 recent cases.

    PubMed

    Suzuki, Jun; Takata, Yusuke; Miyazaki, Hiromitsu; Yahata, Izumi; Tachibana, Yasuhiko; Kobayashi, Toshimitsu; Kawase, Tetsuaki; Katori, Yukio

    2014-01-01

    Osteoma of the internal auditory canal (IAC) is an uncommon benign bone tumor. Its imaging features may be similar to other IAC lesions, such as vestibular schwannomas that are benign and usually slow-growing but sometimes life-threatening tumors. Thus, detecting IAC lesions and differentiating osteoma from other IAC lesions are both important clinically. We report a case of misdiagnosis of an IAC osteoma as an IAC schwannoma based on magnetic resonance (MR) imaging using the three-dimensional constructive interference in steady state (CISS) sequence instead of T1-weighted MR imaging with gadolinium. We also review 17 cases of IAC osteomas reported in the past 22 years. A 61-year-old female was admitted to our department with IAC lesion incidentally discovered by the CISS sequence. The lesion was diagnosed as an IAC schwannoma, and was followed up annually under "wait and scan" management. Follow-up T1-weighted MR imaging with gadolinium showed no enhancement of the tumor, and additional computed tomography (CT) of the temporal bone showed a solitary pedunculated bony lesion, resulting in the diagnosis of IAC osteoma. The CISS sequence is useful for detecting small IAC lesions, such as vestibular schwannomas. However, the CISS sequence has limitations for qualitative diagnosis and can misdiagnose osteomas as schwannomas. Use of the CISS sequence without T1-weighted MR imaging with gadolinium for the screening of a lesion of the IAC and cerebellopontine angle should consider the possibility of IAC osteomas, and temporal bone CT or T1-weighted MR imaging with gadolinium should be performed when an IAC lesion is detected.

  17. Incidentally detected hydatid cyst of the adrenal gland: A case report.

    PubMed

    Akbulut, Sami

    2016-09-16

    Hydatid cysts are a zoonotic disease that can involve many organs and tissues in the human body but primarily involve the liver and lungs. Of the main organs, adrenal glands are those seldom affected by hydatid cysts. The purpose of this study was to present a case with an incidentally detected hydatid cyst of the right adrenal gland on computed tomography, and a positive echincoccus IgG enzyme-linked immunosorbent assay test on top of a toxic multinodular thyroid goiter for which thyroidectomy was indicated. PMID:27672642

  18. Incidentally detected hydatid cyst of the adrenal gland: A case report

    PubMed Central

    Akbulut, Sami

    2016-01-01

    Hydatid cysts are a zoonotic disease that can involve many organs and tissues in the human body but primarily involve the liver and lungs. Of the main organs, adrenal glands are those seldom affected by hydatid cysts. The purpose of this study was to present a case with an incidentally detected hydatid cyst of the right adrenal gland on computed tomography, and a positive echincoccus IgG enzyme-linked immunosorbent assay test on top of a toxic multinodular thyroid goiter for which thyroidectomy was indicated. PMID:27672642

  19. [Lung cancer incidentally detected at the treatment of pneumothorax ; report of two cases].

    PubMed

    Hokka, Daisuke; Yoshikawa, Koichi; Morimoto, Masato; Hashimoto, Shotaro; Kamimura, Ryosuke; Tai, Kentaro; Hoshida, Yoshihiko

    2012-03-01

    We report 2 cases of lung cancer incidentally detected following pneumothorax. Case 1:A 40-year-old man complaining of dyspnea was admitted with right pneumothorax. Chest computed tomography (CT) after chest drainage showed a cavitary nodule with pleural indentations in the right lower lobe. It was indicated at surgery that pneumothorax was caused by perforation of the tumor into the pleural cavity. Right lower lobectomy was performed because the pathological diagnosis of the nodule was a large cell carcinoma. The final histopathological diagnosis was stage II A (pT2aN1M0). The patient died of recurrence 14 months after surgery. Case 2:A 47-year-old man who admitted with right pneumothorax was found to have a nodule with pleural indentations closely a bulla at the apex of the right lung by chest CT after chest drainage. Pneumothorax was indicated to be caused by rupture of the bulla at surgery. Right upper lobectomy was performed because the pathological diagnosis of the nodule was a squamous carcinoma. The final histopathological diagnosis was stage I A (pT1bN0M0). The patient is alive at 2 years after the operation without recurrence. Lung cancer detected following pneumothorax which was caused by perforation of the tumor is generally considered to have poor prognosis. Whereas, prognosis of lung cancer incidentally detected following pneumothorax depends on its staging. PMID:22374606

  20. 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 ( ...

  1. Incidental Detection of Hairy Cell Leukaemia with Herpes Simplex Virus (HSV) Related Lip Ulcer Mimicking Carcinoma.

    PubMed

    Agrawal, Pallavi; Bhartiya, Richa; Singh, Ran Vijoy Narayan

    2016-08-01

    Hairy cell leukemia is a chronic lympho-proliferative disease. It is indolent but progressive in nature. It arises from B-cell lineage. We report an incidentally detected case of Hairy Cell Leukaemia (HCL) in a 55-year-old male patient with Herpes simplex virus (HSV) - related lip ulcer mimicking squamous cell carcinoma. Clinically the patient presented with lip ulceration without pain. He was found to have moderate hepatosplenomegaly and pancytopenia on general examination. Bone marrow aspiration and flow cytometric immunophenotyping revealed HCL. The oral lesion resolved after antiviral therapy. The intriguing possibility of a combined pathogenesis for the two disorders is considered, as HCL is known to be associated with immunosuppression, second malignancies and the production of cytokines promoting epithelial growth. PMID:27656454

  2. Incidental Detection Microfilaria in Subcutaneous Breast Nodule of Lactating Female Fnac: A Rare Case Report

    PubMed Central

    Gupta, Prashant; Yadav, Soma; Pahawa, H.S

    2014-01-01

    Filariasis is a major public health problem which is faced in tropical countries like India. Its diagnosis is made by using peripheral blood smears. However, microfilaria has been detected incidentally during FNACs of various lesions, which were done in clinically unsuspected cases. We are reporting here, an uncommon case of filariasis, which caused a nodular, subcutaneous swelling in left breast of a 30 year old lactating female. A nodular subcutaneous swelling can be caused in breast of a lactating female by lactational associated mastitis, but filaria causing a nodular swelling in a lactating breast is a rare presentation. Aspiration of the swelling demonstrated enormous pathogen presence caused by Woucheria bancrofti and the patient responded well to six weeks of daily anti-filarial treatment with diethylcarbamazine citrate. PMID:25120989

  3. Incidentally Detected Kaposi Sarcoma of Adrenal Gland with Anaplastic Features in an HIV Negative Patient

    PubMed Central

    Celik, Murat; Sen, Erdem; Cebeci, Hakan; Ata, Ozlem; Yavas, Cagdas

    2016-01-01

    Kaposi sarcoma (KS), a vascular tumor caused by infection with human herpesvirus 8 (HHV8), is a systemic disease that can present with cutaneous lesions with or without visceral involvement. Very few cases of KS, most of which were associated with AIDS, have been reported in the adrenal gland. Anaplastic transformation of KS is a rare clinical presentation known as an aggressive disease with local recurrence and metastatic potential. We report here a 47-year-old HIV negative male presented with extra-adrenal symptoms and had an incidentally detected anaplastic adrenal KS exhibited aggressive clinical course. To the best of our knowledge, this is the first case of anaplastic primary adrenal KS without mucocutaneous involvement but subsequently developed other side adrenal metastases in an HIV negative patient. PMID:27747121

  4. 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

  5. Soft palate schwannoma.

    PubMed

    Venkatachala, Sandhya; Krishnakumar, R; Rubby, Sheik Afzal

    2013-06-01

    Schwannomas are relatively uncommon, slow-growing benign neoplasms that can arise from any cranial, peripheral or autonomic nerves. These neoplasms are derived from Schwann cells. The involvement of the palate is a rare presentation although there have been a few reported cases of schwannomas arising in the tongue. This is a case report of one such rare presentation-a case of Schwannoma in a 43-year-old man at a rare site, soft palate. At this location, the clinical diagnosis is confounded by other tumours such as minor salivary gland tumour, pyogenic granuloma and lipoma.

  6. Primary hepatic benign schwannoma

    PubMed Central

    Hayashi, Michihiro; Takeshita, Atsushi; Yamamoto, Kazuhiro; Tanigawa, Nobuhiko

    2012-01-01

    Schwannoma is predominantly a benign neoplasm of the Schwann cells in the neural sheath of the peripheral nerves. Occurrence of schwannoma in parenchymatous organs, such as liver, is extremely rare. A 64-year-old man without neurofibromatosis was observed to have a space-occupying lesion of 23mm diameter in the liver during follow-up examination for a previously resected gastrointestinal stromal tumor (GIST) in the small intestine. He underwent lateral segmentectomy of the liver under a provisional diagnosis of hepatic metastatic recurrence of the GIST. Histological examination confirmed the diagnosis of a benign schwannoma, confirmed by characteristic pathological findings and positive immunoreactions with the neurogenic marker S-100 protein, but negative for c-kit, or CD34. The tumor was the smallest among the reported cases. When the primary hepatic schwannoma is small in size, preoperative clinical diagnosis is difficult. Therefore, this disease should be listed as differential diagnosis for liver tumor with clinically benign characteristics. PMID:22530081

  7. Follow-up Recommendation Detection on Radiology Reports with Incidental Pulmonary Nodules.

    PubMed

    Oliveira, Lucas; Tellis, Ranjith; Qian, Yuechen; Trovato, Karen; Mankovich, Gabe

    2015-01-01

    The management of follow-up recommendations is fundamental for the appropriate care of patients with incidental pulmonary findings. The lack of communication of these important findings can result in important actionable information being lost in healthcare provider electronic documents. This study aims to analyze follow-up recommendations in radiology reports containing pulmonary incidental findings by using Natural Language Processing and Regular Expressions. Our evaluation highlights the different follow-up recommendation rates for oncology and non-oncology patient cohorts. The results reveal the need for a context-sensitive approach to tracking different patient cohorts in an enterprise-wide assessment. PMID:26262328

  8. Vestibular schwannoma in patients with sudden sensorineural hearing loss.

    PubMed

    Lee, Jong Dae; Lee, Byung Don; Hwang, Sun Chul

    2011-03-01

    Sudden sensorineural hearing loss (SSNHL) has several etiologies. It may be a presenting symptom of vestibular schwannoma (VS). This study aimed to establish the incidence of VS in patients with SSNHL, and we report several unusual cases among these patients. We reviewed retrospectively the charts and magnetic resonance imaging (MRI) findings of all adult patients who presented with SSNHL between 2002 and 2008. We utilized three-dimensional fast imaging with steady-state acquisition temporal MRI as a screening method. Of the 295 patients with SSNHL, VS was found in 12 (4%). All patients had intrameatal or small to medium-sized tumors. There were three cases with SSNHL in one ear and an incidental finding of intracanalicular VS in the contralateral ear. There were four cases of VS that showed good recovery from SSNHL with corticosteroid treatment. There were two cases that mimicked labyrinthitis with hearing loss and vertigo. A greater number of cases than expected of VS were detected in patients with SSNHL, as a result of increasing widespread use of MRI. Various unusual findings in these patients were identified. MRI would seem to be mandatory in all cases of SSNHL.

  9. Solitary schwannoma of the gallbladder: a case report and literature review.

    PubMed

    Liu, Lin-Na; Xu, Hui-Xiong; Zheng, Shu-Guang; Sun, Li-Ping; Guo, Le-Hang; Wu, Jian

    2014-06-01

    Schwannomas occurring in the gallbladder are extremely rare. Preoperative diagnosis of gallbladder schwannomas appears to be very difficult because they are normally asymptomatic and are often found incidentally. Until now, only five cases have been reported in the literature. To our knowledge, the contrast-enhanced ultrasound (CEUS) features of gallbladder schwannomas have not been reported before in other studies. We treated a 55-year-old male patient with gallbladder schwannoma in China. He had no symptoms, and the lesion was incidentally found by conventional ultrasound (US) when performing a health examination. The patient had normal liver function; moreover, serum carcinoembryonic antigen and alpha-fetoprotein were within the normal ranges. The lesion showed no blood flow signals on color Doppler US, and the wall beneath the lesion was intact on CEUS. The lesion was believed to be a benign entity; in addition, gallbladder adenomyomatosis was suspected. A laparoscopic cholecystectomy was performed to remove the mass. Pathological examination revealed that the tumor was mainly composed of spindle-shaped cells; neither atypical cells nor signs of malignancy were found. Immunohistochemical staining showed a strong positive S-100 protein reaction. Vimentin and CD56 staining were also positive, whereas CD34 and CD117 were negative. Finally, the lesion was diagnosed as schwannoma. Herein, we report the case; the associated literature is also reviewed.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. [Infraorbital schwannoma. Case report].

    PubMed

    Mora-Ríos, Laura Evelyn; Ríos Y Valles-Valles, Dolores; Flores-Estrada, José Javier; Rodríguez-Reyes, Abelardo Antonio

    2014-01-01

    Antecedentes: el schwannoma infraorbitario es un tumor benigno de la vaina nerviosa periférica compuesto por células de Schwann. Suele aparecer entre los 20 y 70 años de edad, asintomático y producir proptosis progresiva e indolora durante su crecimiento. Caso clínico: paciente masculino de 32 años de edad que ingresó al hospital debido a un tumor no doloroso de crecimiento lentamente progresivo sobre el saco lagrimal izquierdo. A la exploración oftalmológica el tumor era de consistencia ahulada y estaba firmemente adherido a las estructuras vecinas. La transiluminación resultó negativa. El ultrasonido modo B mostró un ojo fáquico y un tumor infraorbitario homogéneo, bien circunstrito, con diámetro mayor de 19.7 mm, sin afectación de la vía lagrimal. El ultrasonido modo A mostró una reflectividad media-alta, con escasa vascularidad interna. La tomografía computada mostró un tumor de densidad homogénea, bien circunscrito a la región anterior y por debajo del globo ocular, sin erosión ósea. El tumor se extirpó mediante una incisión subdérmica. El diagnóstico histopatológico fue: schwannoma infraorbitario. Conclusiones: el schwannoma es un tumor benigno, poco frecuente en la órbita. Su diagnóstico definitivo se establece con base en los hallazgos histopatológicos, como: cápsula verdadera, áreas hiper e hipocelulares, engrosamiento y hialinización de las paredes vasculares. Sin esos hallazgos puede confundirse con tumores fusocelulares benignos. Se informa un nuevo caso de schwannoma infraorbitario y se compara con los casos previamente reportados.

  15. 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.

  16. 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

  17. 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

  18. Incidental detection of congenital Robertsonian translocation at diagnosis of Philadelphia chromosome-positive acute lymphocytic leukemia.

    PubMed

    Yamaguchi, Tsukasa; Igarashi, Aiko; Kawamura, Machiko; Ozasa, Yuka; Yoshida, Masayuki; Kakihana, Kazuhiko; Sakamaki, Hisashi; Ohashi, Kazuteru

    2015-05-01

    A man in his early forties who had undergone 3 years of unsuccessful treatment for infertility due to oligospermia and asthenospermia developed fever and bone pain in December 20XX. He was subsequently diagnosed with acute lymphocytic leukemia. Conventional cytogenetic analysis revealed Robertsonian translocation (RT) with der(13;14)(q10;q10) in addition to the Philadelphia (Ph) chromosome. Dasatinib and prednisolone induced complete remission (CR) with disappearance of the Ph chromosome. However, RT persisted despite achieving CR. We speculate that RT is possibly congenital in our present case and might also have been responsible for the aforementioned infertility. Hematologists should be aware of the possibility that congenital chromosomal disorders might be found incidentally through diagnostic chromosome analysis for leukemia.

  19. [Incidentally detected bronchial artery aneurysm with combined operation for mitral regurgitation;report of a case].

    PubMed

    Sato, Hisashi; Oteki, Hitoshi; Naito, Kozo; Yunoki, Junji

    2015-02-01

    A 77-year-old woman was admitted to the hospital for heart failure with orthopnea. Echocardiography revealed massive mitral regurgitation. During preoperative cardiac catheterization, an aneurysm was indentified incidentally just below the tracheal carina. Three dimensional computed tomography showed three bronchial artery aneurysms behind the pulmonary artery and the left atrium. The proximal aneurysm was the largest and was 22 mm in diameter. It was resected by retracting the ascending aorta to the left, the superior vana cava to the right and right pulmonary artery cranially under cardiopulmonary bypass, and mitral valve plasty was performed. We believed that resection of the proximal aneurysm would cause thrombotic occlusion of the other 2 aneurysms. Bronchial artery aneurysm is a rare entity that is observed in fewer than 1% of those who undergo selective bronchial arteriography. In addition, because bronchial artery aneurysm is a potentially life-threatening lesion, it should be treated promptly when diagnosed.

  20. Radiosurgery of Spinal Meningiomas and Schwannomas

    PubMed Central

    Kufeld, M.; Wowra, B.; Muacevic, A.; Zausinger, Stefan; Tonn, Jörg-Christian

    2012-01-01

    Purpose of this study is to analyze local control, clinical symptoms and toxicity after image-guided radiosurgery of spinal meningiomas and schwannomas. Standard treatment of benign spinal lesions is microsurgical resection. While a few publications have reported about radiosurgery for benign spinal lesions, this is the first study analyzing the outcome of robotic radiosurgery for benign spinal tumors, treated exclusively with a non-invasive, fiducial free, single-fraction setup. Thirty-six patients with spinal meningiomas or schwannomas were treated, utilizing a robotic radiosurgery system (CyberKnife®, Accuray Inc. Sunnyvale CA), and were followed prospectively. Medical history, histology, clinical symptoms and radiographic outcome were recorded. Thirty-nine spinal lesions were treated because of tumor recurrence, remnants after microsurgery, multiple lesions, or rejection of open surgery. Median age was 45 years (range 18–80 years). Median target volume was 3.4 cm3 (range 0.2–43.4 cm3). Histology revealed 28 schwannomas and 11 meningiomas (WHO grade I). All spinal levels were affected. Median prescription dose was 14 Gray (95% C.I. 13.4–14 Gy) to the 70% isodose. After a median follow-up of 18 months (range 6–50 months) no local tumor progression was detected. 20 lesions (51%) remained stable, 19 tumors (49%) decreased in size. One patient with schwannomatosis was treated repeatedly for three new tumor locations. Pain was the initial symptom in 16 of 25 schwannoma patients, and in 3 of 11 patients with meningiomas. Pain levels decreased in 8/19 patients. All but one patient with motor deficits remained clinically stable. No myelopathic signs where found. Single-session radiosurgery for benign spinal tumors in selected patients has proven to inhibit tumor progression within the observed period without signs of early toxicity. Radiosurgery offers an additional treatment option, if microsurgery is not feasible in cases of tumor recurrence, post

  1. Radiographic association of schwannomas with sensory ganglia

    PubMed Central

    Tryggvason, Geir; Barnett, Andrew; Kim, John; Soken, Hakan; Maley, Joan; Hansen, Marlan R.

    2012-01-01

    Objective Clinical experience suggests that the majority of schwannomas arise within sensory ganglia, suggesting that intraganglionic glial cells represent a potential cell of origin for schwannomas. To support this clinical impression, we reviewed magnetic resonance imaging (MRI) studies performed over a 5 year period at our institution to determine the relationship of cranial and spinal nerve schwannomas with the ganglia of the associated nerves. Study design Retrospective cohort study Setting Tertiary referral center Patients Patients undergoing imaging study at our institution over a 5 year period. Intervention(s) Radiographical images at our institution were reviewed as well as published studies to determine the anatomic location of schwannomas. Main outcome measure(s) Anatomical location of schwannomas Results A total of 372 patients were found over the 5-year study period, 31 of those were diagnosed with neurofibromatosis type 2 (NF2). Vestibular schwannomas comprised the greatest number of schwannomas, followed by spinal schwannomas. In NF2 patients, spinal schwannomas were the most common tumor, followed by vestibular schwannomas. In NF2 patients and those with sporadic schwannomas, the overwhelming majority of tumors arose in nerves with a sensory component and were associated with sensory ganglia of the nerves (562/607, 92.6%). Very few tumors arose from pure motor nerves. This is supported by review of published articles on anatomic location of schwannomas. Conclusions Schwannomas are strongly associated anatomically with ganglia of sensory nerves. These findings raise the possibility that intraganglionic glial cells give rise to the majority of schwannomas. PMID:22858714

  2. 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

  3. Signal recognition particle immunoglobulin g detected incidentally associates with autoimmune myopathy

    PubMed Central

    Apiwattanakul, Metha; Milone, Margherita; Pittock, Sean J.; Kryzer, Thomas J.; Fryer, James P.; O'toole, Orna; Mckeon, Andrew

    2016-01-01

    ABSTRACT Introduction: Paraneoplastic autoantibody screening of 150,000 patient sera by tissue‐based immunofluorescence incidentally revealed 170 with unsuspected signal recognition particle (SRP) immunoglobulin G (IgG), which is a recognized biomarker of autoimmune myopathy. Of the 77 patients with available information, 54 had myopathy. We describe the clinical/laboratory associations. Methods: Distinctive cytoplasm‐binding IgG (mouse tissue substrate) prompted western blot, enzyme‐linked immunoassay, and immunoprecipitation analyses. Available histories were reviewed. Results: The immunostaining pattern resembled rough endoplasmic reticulum, and mimicked Purkinje‐cell cytoplasmic antibody type 1 IgG/anti‐Yo. Immunoblotting revealed ribonucleoprotein reactivity. Recombinant antigens confirmed the following: SRP54 IgG specificity alone (17); SRP72 IgG specificity alone (3); both (32); or neither (2). Coexisting neural autoantibodies were identified in 28% (low titer). Electromyography revealed myopathy with fibrillation potentials; 78% of biopsies had active necrotizing myopathy with minimal inflammation, and 17% had inflammatory myopathy. Immunotherapy responsiveness was typically slow and incomplete, and relapses were frequent on withdrawal. Histologically confirmed cancers (17%) were primarily breast and hematologic, with some others. Conclusions: Autoimmune necrotizing SRP myopathy, both idiopathic and paraneoplastic, is underdiagnosed in neurological practice. Serological screening aids early diagnosis. Cancer surveillance and appropriate immunosuppressant therapy may improve outcome. Muscle Nerve 53: 925–932, 2016 PMID:26561982

  4. 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

  5. Intramedullary schwannoma of conus medullaris with syringomyelia.

    PubMed

    Karatay, Mete; Koktekir, Ender; Erdem, Yavuz; Celik, Haydar; Sertbas, Idris; Bayar, Mehmet Akif

    2014-06-14

    Intramedullary schwannomas of the spinal cord are rare tumors. They are most commonly observed in the cervical region; however, few have been described in the conus medullaris. The association of intramedullary schwannomas with syringomyelia is also rare. In this report, we present a case of intramedullary schwannoma of the conus medullaris with syringomyelia, which was treated surgically.

  6. 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

  7. [Managing focal incidental renal lesions].

    PubMed

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

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

    PubMed

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

    2015-09-01

    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.

  9. Incidentally detected unilateral pulmonary artery agenesis with pulmonary hypoplasia in a 67 year old woman

    PubMed Central

    Muthusami, Prakash; Ananthakrishnan, Ramesh; Elangovan, S.

    2010-01-01

    Unilateral pulmonary artery agenesis is commonly seen associated with other congenital cardiovascular defects, when it is detected early in life, but isolated absence of the pulmonary artery is a rare entity, usually detected in adulthood. The latter patients are usually asymptomatic or might present with varied non-specific manifestations such as respiratory tract infections and hemoptysis. This report describes the imaging findings of a 67 year old female with absence of the right pulmonary artery. The embryology and clinical manifestations of the condition are reviewed. PMID:22470700

  10. An incidentally detected solitary fibrous tumor on (99m)Tc-sestamibi myocardial perfusion imaging.

    PubMed

    Hua, Qian; Ni, Jianming

    2015-06-01

    A 55-year-old woman with a mild transient chest pain but normal laboratory examination results underwent Tc-sestamibi myocardial perfusion imaging. An abnormal nodular radioactive uptake, which appeared protruding from the anterior segments, was detected. This activity was later proved to be benign solitary fibrous tumor of pleura after histopathological examination after the surgical exploration.

  11. 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

  12. Retroperitoneal Ancient Schwannoma: A Case Report.

    PubMed

    Çalişkan, Selahattin; Gümrükçü, Gülistan; Kaya, Cevdet

    2015-01-01

    Schwannomas are extremely rare tumors that are composed of Schwann cells. Retroperitoneal localization comprises 0.7% to 2.6% of all schwannomas. Patients usually present with nonspecific symptoms. There are no pathognomonic features on radiologic evaluation. Preoperative biopsy is not recommended because of complication risks; however, surgery is necessary for diagnosis and treatment. Although most schwannomas are benign tumors, those that are associated with von Recklinghausen disease are malignant. Schwannomas exhibit regions of high and low cellularity, termed Antoni A and Antoni B areas, with a diffuse positivity of S100 protein on pathologic evaluation. If there are degenerative changes, such as cyst formation, hemorrhage, calcification, and hyalinization, these tumors are termed ancient schwannomas. We present a case of retroperitoneal ancient schwannoma.

  13. Recurrence of spinal schwannoma: Is it preventable?

    PubMed Central

    Senapati, Satya B.; Mishra, Sudhansu S.; Dhir, Manmath K.; Patnaik, Ashis; Panigrahi, Souvagya

    2016-01-01

    Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed.

  14. Recurrence of spinal schwannoma: Is it preventable?

    PubMed Central

    Senapati, Satya B.; Mishra, Sudhansu S.; Dhir, Manmath K.; Patnaik, Ashis; Panigrahi, Souvagya

    2016-01-01

    Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed. PMID:27695564

  15. A case of occult contralateral breast cancer incidentally detected by contrast-enhanced MRI; report of a case with review of literature.

    PubMed

    Komatsu, Shuhei; Lee, Chol Joo; Hosokawa, Yohei; Hamashima, Takashi; Shirono, Koichi; Ichikawa, Daisuke; Okabe, Harumi; Kurioka, Hideaki; Yamagishi, Hisakazu; Oka, Takahiro

    2005-01-01

    We encountered a case of occult contralateral breast cancer, previously undetected by conventional imaging such as mammography (MMG) and ultrasonography (US), but incidentally detected by contrast-enhanced magnetic resonance imaging (CE-MRI). We present it here with a review of the literature. A 67-year-old Japanese woman was referred to our hospital in October 2000 because of a 1.5 cm right breast lump detected in a medical checkup. MMG, US and fine needle aspiration cytology revealed a cancerous lesion during the right breast. No mass lesion was palpable nor was any detected by MMG or US in the left breast. Bilateral breast CE-MRI was performed for more detailed evaluation. Consequently, an occult contralateral breast cancerous lesion was detected incidentally by CE-MRI, with the images showing rapid initial enhancement of time to signal intensity curves. Before surgery, bilateral breast lesions were diagnosed as invasive ductal carcinoma by open biopsy. She underwent bilateral breast conserving surgery with bilateral axillary lymph node dissection. The postoperative course was uneventful and no recurrence has been noted as of January 18th, 2004. CE-MRI of the contralateral breast should be of value as a routine screen in those patients with a known or suspected malignancy in one breast considering the limits of breast cancer detection by such conventional modalities as MMG and US. PMID:16286918

  16. Palatal schwannoma in an elderly woman.

    PubMed

    Shetty, Shishir Ram; Mishra, Chandni; Shetty, Pushparaj; Kaur, Arshdeep; Babu, Subhas

    2012-06-01

    Schwannoma also known as neurilemmoma is a benign tumour derived from schwann cells and is relatively rare in occurrence. Only 1% of the schwannomas in the head and neck region occur at intra-oral sites. Schwannomas usually occur during the third or fourth decades of life and the tongue is the most common intra-oral site. A case of intra-oral schwannoma in a 70-year-old female in the region of hard palate is described which is extremely rare.

  17. Jugular Foramen Schwannomas

    PubMed Central

    Yoo, Heon; Jung, Hee-Won; Yang, Hee Jin

    1999-01-01

    Twelve cases of schwannomas of the jugular foramen that involved surgery in our department between 1983 and 1997 are described. Eight were women and 4 were men (mean age, 40 years), and the duration of their symptoms, the most predominant of which were hearing loss and tinnitus, ranged from 1 month to 20 years (median, 8.5 months). Depending on their radiological and surgical features, tumors were classified as type A, a tumor primarily at the cerebellopontine angle with minimal enlargement of the jugular foramen (n = 5); type B, a tumor primarily at the jugular foramen with or without intracranial extension (n = 4); type C, a primarily extracranial tumor with extension into the jugular foramen (n = 0); or type D, a dumbbell tumor with both intracranial and extracranial components (n = 3). A retrosigmoid suboccipital craniectomy (RSSOC) was performed for type A tumors; for types B and D, the RSSOC or staged infratemporal fossa approach (ITFA)/RSSOC was used. Total removal was achieved in 6 cases, near total removal in 3, and subtotal removal in 3. The most common complication was lower cranial nerve dysfunction (n = 5). The follow-up period ranged from 6 to 173 (mean, 48) months, and there was no recurrence. Two patients showed regrowth of the tumor after subtotal resection, however. In 1 of these, the residual tumor had progressed within 12 months of initial surgery, it was again resected and linac radiosurgery was successful. In the other, the residual mass had progressed within 8 months of initial surgery, and the pathological report indicated malignant peripheral nerve sheath tumor. Conclusively, type A tumors could be totally resected with the retrosigmoid approach alone. For type B and D tumors, however, combined ITFA and retrosigmoid approach showed the better results. In spite of our limited data, cases showing adhesion to critical structures can be managed by subtotal or near total resection followed by radiosurgery to reduce postoperative complications

  18. Retroperitoneal schwannoma misdiagnosed as a psoas abscess: report of a case.

    PubMed

    Kishi, Yoji; Kajiwara, Shuji; Seta, Shinsuke; Kawauchi, Nobuo; Suzuki, Tsunemichi; Sasaki, Katsumi

    2002-01-01

    A retroperitoneal cystic mass compressing the right psoas muscle was found incidentally by ultrasonography in a 67-year-old woman. The radiological findings and a history of costal caries led us to suspect a psoas cold abscess. Ultrasound-guided needle aspiration was done to establish the diagnosis and to drain the content, but only a small amount of sterile fluid was obtained. The patient complained of neuralgia in her right leg at the time of puncture. Under the preoperative diagnosis of a neurogenic tumor, the mass was surgically resected, and found to be filled with old blood. The solid region consisted of a proliferation of fusiform cells, leading to a diagnosis of benign schwannoma. Retroperitoneal schwannoma is often misdiagnosed as an adjacent anatomical structure. Thus, we conclude that both microbiological and cytological examination of an aspiration specimen is important when psoas abscess is considered in a differential diagnosis.

  19. 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.

  20. 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

  1. Schwannoma of the submandibular gland.

    PubMed

    Diaz, D D; Kennedy, K S; Parker, G S; White, V J

    1991-01-01

    Neurilemmomas (schwannomas) are solitary neurogenic tumors that arise from cells of the neural sheath. They are slow growing and represent a proliferation of Schwann cells. Extracranial neurogenic tumors of the head and neck are uncommon, with benign tumors occurring with greater frequency than malignant tumors. These tumors often mimic primary or metastatic disease in the head and neck. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor, with most presenting in the parotid gland originating from a peripheral branch of the facial nerve. An unusual case of neurilemmoma of the submandibular gland is presented, and the literature concerning this subject is reviewed. We believe this tumor originated in an autonomic nerve of the submandibular gland. The mass was discrete and well demonstrated on CT scan. Total excision of the gland resulted in complete resolution of symptoms with no cranial nerve deficits.

  2. Malignant schwannoma of kidney capsule.

    PubMed

    Romics, I; Bach, D; Beutler, W

    1992-11-01

    This report is of a malignant schwannoma originating in the capsule of the right kidney. Using sonography, nephroangiography, cavography, computer tomography, and bone scanning, metastases in the kidney or a retroperitoneal tumor could be diagnosed. After transperitoneal exploration, the right kidney and mesenteric metastases were removed. Due to tumor infiltration into the liver and tumor masses in the retroperitoneum, only nephrectomy and palliative excision of retroperitoneal metastases were done. Pulmonary metastases developed postoperatively, and the patient died three months after the operation.

  3. [Retroperitoneal schwannoma: a case report].

    PubMed

    Turitto, Giacinto; Di Bisceglie, Maurizio; Moraca, Lucia; Sasso, Nicola; Suriano, Angela; De Angelis, Carlo Paolo; Cione, Giampiero; Angrisani, Luigi; Romito, Sante

    2011-01-01

    Schwannomas are degenerate peripheral nerve sheath tumors that very rarely occur in the retroperitoneum. They are usually benign than malignancy is very rare and is usually observed in patients with von Recklinghausen disease. We report a case of female adult patient who presented with vague abdominal discomfort. The preoperative diagnosis was difficult and the treatment was complete surgical excision. The patient is with no evidence of recurrence more than four years after surgery.

  4. Endoscopic Resection of Vestibular Schwannomas

    PubMed Central

    Setty, Pradeep; D'Andrea, Kenneth P.; Stucken, Emily Z.; Babu, Seilesh; LaRouere, Michael J.; Pieper, Daniel R.

    2015-01-01

    Objective To report our results and the technical details of fully endoscopic resection of vestibular schwannomas. Design Prospective observational study. Setting A single academic institution involving neurosurgery and neurotology. Participants Twelve consecutive patients who underwent fully endoscopic resection of a vestibular schwannoma. Main Outcome Measures Hearing preservation, based on the American Association of Otolaryngology-Head and Neck Surgeons (AAO-HNS) score as well as the Gardener and Robertson Modified Hearing Classification (GR). Facial nerve preservation based on the House-Brackmann (HB) score. Results All patients successfully underwent gross total resection. Facial nerve preservation rate was 92% with 11 of 12 patients retaining an HB score of 1/6 postoperatively. Hearing preservation rate was 67% with 8 of 12 patients maintaining a stable AAO-HNS grade and GR score at follow-up. Mean tumor size was 1.5 cm (range: 1–2 cm). No patients experienced postoperative cerebrospinal fluid leak, infection, or cranial nerve palsy for a complication rate of 0%. Mean operative time was 261.6 minutes with an estimated blood loss of 56.3 mL and average length of hospital stay of 3.6 days. Conclusion A purely endoscopic approach is a safe and effective option for hearing preservation surgery for vestibular schwannomas in appropriately selected patients. PMID:26225307

  5. 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

  6. CT and MRI findings in a case of pelvic schwannoma.

    PubMed

    Nasu, K; Arima, K; Yoshimatsu, J; Miyakawa, I

    1998-08-01

    We compared the diagnostic utility of computed tomography (CT) and magnetic resonance imaging (MRI) in a patient with a pelvic schwannoma. This 46-year-old woman was admitted for evaluation of a retroperitoneal pelvic mass and myoma uteri. The retroperitoneal pelvic mass had been detected by a CT scan at a routine health examination. A CT scan revealed a well-circumscribed cystic tumor (4 x 3 cm) at the right internal obturator muscle portion. The CT number of the inner part of the tumor was 21. Only the cyst wall was enhanced by injection of a contrast medium. MRI showed a 4 x 3 x 3-cm retroperitoneal cystic tumor that demonstrated low-intensity signals on T1-weighted images and high-intensity signals on T2-weighted images. Small areas of low intensity inside the tumor were observed on T2-weighted images. Histological examination revealed a typical schwannoma of mixed Antoni type A and type B. These findings indicate that both MRI and CT are useful for diagnosis of retroperitoneal schwannomas.

  7. Cranial Nerve Schwannomas: Diagnostic Imaging Approach.

    PubMed

    Skolnik, Aaron D; Loevner, Laurie A; Sampathu, Deepak M; Newman, Jason G; Lee, John Y; Bagley, Linda J; Learned, Kim O

    2016-01-01

    Schwannomas are benign nerve sheath tumors that may arise along the complex course of the cranial nerves (CNs), anywhere in the head and neck. Sound knowledge of the CN anatomy and imaging features of schwannomas is paramount for making the correct diagnosis. In this article, we review approaches to diagnosing CN schwannomas by describing their imaging characteristics and the associated clinical presentations. Relevant anatomic considerations are highlighted by using illustrative examples and key differential diagnoses categorized according to regions, which include the anterior skull base, orbit, cavernous sinus, basal cisterns, and neck. The clinical presentations associated with CN schwannomas vary and range from no symptoms to symptoms caused by mass effect or CN deficits. Individuals with the inherited disorder neurofibromatosis type 2 are predisposed to multiple schwannomas. When a lesion follows the course of a CN, the radiologist's roles are to confirm the imaging features of schwannoma and exclude appropriate differential considerations. The characteristic imaging features of CN schwannomas reflect their slow growth as benign neoplasms and include circumscribed margins, displacement of local structures, and smooth expansion of osseous foramina. These neoplasms exhibit various degrees of solid enhancement, often with internal cystic spaces on magnetic resonance (MR) and computed tomographic (CT) images and heterogeneous high signal intensity specifically on T2-weighted MR images. Clinical and/or imaging evidence of end-organ compromise of the involved CN may exist and aid in the identification of the nerve of origin. With a detailed understanding of the course of the CNs, the diagnostic features of CN schwannomas, and the correlation between these data and the associated clinical presentations of these tumors, the radiologist can have a key role in the diagnosis of CN schwannomas and the treatment planning for affected patients. (©)RSNA, 2016. PMID

  8. 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

  9. 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

  10. 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

  11. [A case report of retroperitoneal malignant schwannoma].

    PubMed

    Okamura, K; Ito, K; Aota, Y; Suzuki, Y; Shimoji, T

    1984-08-01

    A case of retroperitoneal malignant schwannoma is reported. The patient was a 66-years-old man who was referred to our clinic because of an abdominal lump. CT scan and renal arteriography pointed out right renal cyst, but the tumor was separate from the right kidney at operation. Pathological diagnosis of this retroperitoneal tumor was malignant schwannoma. After 10 months he developed local recurrence and had transabdominal excision. He has been doing well 12 months after the second operation. Thirty-one cases of retroperitoneal malignant schwannoma in Japan are reviewed.

  12. Incidentally detected squamous cell carcinoma of renal pelvis in patients with staghorn calculi: case series with review of the literature.

    PubMed

    Jain, Ayushi; Mittal, Deepti; Jindal, Arpita; Solanki, Ranjana; Khatri, Suman; Parikh, Archana; Yadav, Kamlesh

    2011-01-01

    Squamous cell carcinoma of the renal pelvis is a rare neoplasm, often unsuspected clinically due to its rarity and ambiguous clinical and radiological features, and hence patients present at advanced stages resulting in poor prognosis. We report here four cases of incidentally diagnosed primary renal squamous cell carcinoma, treated at our hospital over a short span of one year, and review the relevant literature. Mean age of the patients (3 males, 1 female) was 60 years. All suffered from staghorn stones. Interestingly, renal carcinoma was unsuspected clinically in all patients. In one case, a computerised tomography scan showed a suspicious nodule. All underwent nephrectomy for nonfunctioning kidney. In just two cases, tumor was identified on gross examination, while the other two only showed thickened pelvis. Our series emphasises the need for pelvicalyceal biopsy during treatment for long-standing nephrolithiasis, and thorough sampling of the renal pelvis in nephrectomy specimen of such patients.

  13. Usefulness of PRESTO magnetic resonance imaging for the differentiation of schwannoma and meningioma in the cerebellopontine angle.

    PubMed

    Tomogane, Yusuke; Mori, Kanji; Izumoto, Shuichi; Kaba, Keizo; Ishikura, Reiichi; Ando, Kumiko; Wakata, Yuki; Fujita, Shigekazu; Shirakawa, Manabu; Arita, Norio

    2013-01-01

    The principles of echo-shifting with a train of observations (PRESTO) magnetic resonance (MR) imaging technique employs an MR sequence that sensitively detects susceptibility changes in the brain. The effectiveness of PRESTO MR imaging was examined for distinguishing between cerebellopontine angle (CPA) schwannomas and meningiomas in 24 patients with CPA tumors, 12 with vestibular schwannomas, and 12 with meningiomas. Histopathological study of surgical specimens showed that 11 of the 12 schwannomas contained hemosiderin deposits and all had microhemorrhages. One meningioma contained hemosiderin deposits and two involved microhemorrhages. Abnormal vessel proliferation, and dilated and thrombosed vessels were observed in all schwannomas and in 4 meningiomas. In addition to MR imaging with all basic sequences, PRESTO MR imaging and computed tomography were performed. PRESTO imaging showed significantly more schwannomas (n = 12) than meningiomas (n = 2) exhibited intratumoral spotty signal voids which were isointense to air in the mastoid air cells (p < 0.001). These spotty signal voids were significantly associated with histopathologically demonstrated hemosiderin deposits (p < 0.001), microhemorrhages (p < 0.01), and abnormal vessels (p < 0.04). The visualization of spotty signal voids on PRESTO images is useful to distinguish schwannomas from meningiomas.

  14. Management of growing vestibular schwannomas.

    PubMed

    Ferri, Gian Gaetano; Pirodda, Antonio; Ceroni, Alberto Rinaldi; Fioravanti, Antonio; Calbucci, Fabio; Modugno, Giovanni Carlo

    2013-07-01

    Conservative management of small vestibular schwannomas is frequently proposed as most tumours do not grow. Anyway, tumour growth is reported in 30-40 % of the cases, so that surgery is consequently generally proposed. We primarily observed 161 patients affected by unilateral vestibular schwannomas. All patients were examined by means of gadolinium-enhanced magnetic resonance imaging scans. Tumour growth was recorded in 58 cases (35.8 %) and these subjects set up the group of study. Twenty-two (37.9 %) patients were surgically treated; tumour was always completely removed, all patients had normal facial function after surgery and only one patient suffered from a major complication (cerebellar haematoma). Fourteen patients (24.1 %) were submitted to radiotherapy, while one patient was lost at follow-up and another one died because of other medical reasons. Finally, 20 (34.5 %) subjects continued to be observed for different reasons. The mean follow-up period after identification of growth was 6.1 years. Nine tumours continued to grow, nine tumours stopped growing, one tumour grew and then regressed in size and one tumour decreased. Sixty percent of patients with useful hearing at diagnosis preserved it during the entire observation period. In conclusion, most of VS do not grow; in case of tumour growth, a surgical procedure may be suggested and the outcomes are not negatively influenced by the delay of the procedure. But in some cases, patients can still follow the "wait and scan" policy. In fact, only less than half of the growing tumours continued to grow. Moreover, most of the patients continued to retain a useful hearing. PMID:23135237

  15. 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.

  16. 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

  17. Audiovestibular Function Deficits in Vestibular Schwannoma

    PubMed Central

    2016-01-01

    Introduction. Vestibular schwannomas (VS) are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. Methods. Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. Results. The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS. Since hearing loss correlates poorly with tumour size, a retrocochlear lesion is probably not the only cause for hearing loss. Also cochlear mechanisms seem to play a role. This can be revealed by abnormal otoacoustic emissions, despite normal ABR and new MRI techniques which have demonstrated endolymphatic hydrops of the inner ear. Caloric and head impulse tests show frequency specific dynamics and vestibular evoked myogenic potentials may help to identify the location of the tumour regarding the involved nerve parts. Conclusion. In order to preserve audiovestibular function in VS, it is important to stop the growth of the tumour and to avoid degenerative changes in the inner ear. A detailed neurotological workup helps to diagnose VS of all sizes and can also provide useful prognostic information. PMID:27747231

  18. Incidental detection of a small solid pseudopapillary neoplasm of the pancreas after a traffic accident in a 12-year-old girl: a case report

    PubMed Central

    Kim, Younglim; Moon, Suk-Bae

    2015-01-01

    Solid pseudopapillary neoplasm (SPN) is a rare tumor of the pancreas that tends to grow silently in patients at a young age, to a large size and mass. We report here a case of a small-sized SPN detected incidentally in a 12-year-old girl following a traffic accident. The tumor was 3.5 cm in maximal diameter and was found to have hemorrhagic necrosis without a solid component. Laparoscopic spleen-preserving distal pancreatectomy was performed which cured the patient. SPN is generally accepted to be a low grade malignant tumor, but its clinical behavior is sometimes unpredictable. Tumor size and the proportion of solid portion of the tumor have both recently been identified as predictors of malignancy. Although the initial presentation in this case was that of the traffic accident, the subsequent detection of a small, totally cystic SPN, and then the complete eradication of the lesion, led to a favorable outcome for the patient. Long-term monitoring should prevent any chance of recurrence. PMID:26527903

  19. 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

  20. 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

  1. 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 ...

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Trigeminal schwannoma extending into the parapharyngeal space.

    PubMed

    Yumuşakhuylu, Ali Cemal; Sari, Murat; Topuz, Muhammet Fatih; Bağlam, Tekin; Binnetoğlu, Adem

    2014-07-01

    Parapharyngeal space tumors are very rarely seen, and surgical approach to these tumors has not been well established. Most of these tumors are benign and originated from salivary glands and neurogenic in nature. In this case, we report a patient who has a trigeminal schwannoma extending into the deep parapharyngeal space and explain our surgical approach.

  8. The effects of incidentally learned temporal and spatial predictability on response times and visual fixations during target detection and discrimination.

    PubMed

    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.

  9. Pineal region schwannoma arising from the trochlear nerve.

    PubMed

    Chaudhry, Nauman S; Ahmad, Faiz U; Morcos, Jacques J

    2016-10-01

    Schwannomas arising from the trochlear nerve are very rare and to our knowledge, less than 35 histologically documented cases have been reported in the literature. There are no reports of a schwannoma in the pineal region. We report a 24-year-old woman who underwent a para-occipital trans-tentorial approach and gross total excision of a pineal region schwannoma arising from the trochlear nerve. This is the first such reported case. PMID:27496528

  10. The early detection of Salla disease through second-tier tests in newborn screening: how to face incidental findings.

    PubMed

    Couce, María L; Macías-Vidal, Judit; Castiñeiras, Daisy E; Bóveda, María D; Fraga, José M; Fernández-Marmiesse, Ana; Coll, María J

    2014-09-01

    We describe here a 34 months child, practically asymptomatic which presented with high levels of free sialic acid in urine by biochemical detection in second-tier tests newborn screening and with two disease causing mutations in SLC17A5 gene. SLC17A5 mutation analysis showed p.Tyr306* previously described and the novel mutation p.Leu167Pro. This early onset diagnosis allowed us to perform a fast and accurate genetic counseling to the family, helped to better understanding the natural history of this rare disease and probably it could promote cost reduction in future diagnostic tests in the hypothetic case of starting symptoms without diagnosis established. Moreover, an early diagnosis could save family from a long period of time until achieving a definitive diagnostic and to develop an early symptomatic and supportive management of patient to attenuate, as much as possible, disease complications. But, above all, this case illustrates the huge ethical dilemma which arises from any secondary finding (second tier) in newborn screening.

  11. 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

  12. Conflation of gingival overgrowth and schwannoma

    PubMed Central

    Purwar, Parth; Dixit, Jaya; Bhartiya, Kishlay; Sareen, Sagar

    2014-01-01

    The authors describe a seminal case report of a 10-year-old boy with enlarged gingivae in relation to his maxillary anterior teeth. The lesion, provisionally diagnosed as idiopathic gingival enlargement, was completely excised and divided into two sections. The histological and immunohistochemical findings in one of the sections showed it to be characteristic of schwannoma while the other section showed indications of idiopathic gingival enlargement. The patient has been followed up carefully and no recurrence has been noted. PMID:25331149

  13. [Benign pelvic schwannoma. A case report].

    PubMed

    Fauchery, A; de Meeûs, J B; Turc, I; Bascou, V; Goujon, J M; Magnin, G

    1994-01-01

    A rare case of benin pelvic schwannoma was observed fortuitously during normal echographic follow-up of a cyst of the ovary. The usually silent tumours are difficult to diagnose. Computed tomography appears to be the most informative examination concerning the nature of these tumours and their relations with the surrounding structures. Nevertheless, the exact nature cannot be determined before curative surgical exeresis and pathology examination. The risk of relapse is extremely small, but does exist, justifying follow-up.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. [A case of retroperitoneal schwannoma of the vagus nerve].

    PubMed

    Yoo, Byoung Kwan; Yoo, Kyo Sang; Park, Chul Sung; Lee, Jung Wha; Yoo, Ji Youn; Moon, Joon Ho; Jung, Jae One; Kim, Jong Pyo; Kim, Kyoung Oh; Park, Cheol Hee; Hahn, Tae Ho; Park, Sang Hoon; Kim, Jong Hyeok; Min, Soo Kee; Yang, Dae Hyun; Park, Choong Kee

    2005-10-01

    Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most schwannomas occur in the head, neck or limbs, but rarely occur in the retroperitoneal space. Furthermore, the schwannoma originating from the vagus nerve of retroperitoneal space is much rare. We experienced a case of retroperitoneal schwannoma of the vagus nerve. A 34-year-old male was referred to our hospital for the evaluation of abdominal mass on ultrasonography. Endoscopic examination revealed submucosal tumor-like lesion on high body of the stomach. Computed tomography (CT) revealed that the stomach was compressed by a solid tumor in the retroperitoneum. On exploratory laparotomy, this mass turned out to be a baseball sized mass in the retroperitoneal space. The mass was excised in an encapsulated state. Histological examination with immunohistochemical stains revealed a schwannoma of the vagus nerve.

  19. 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

  20. Electrical Vestibular Stimulation after Vestibular Deafferentation and in Vestibular Schwannoma

    PubMed Central

    Aw, Swee Tin; Todd, Michael John; Lehnen, Nadine; Aw, Grace Elizabeth; Weber, Konrad Peter; Eggert, Thomas; Halmagyi, Gabor Michael

    2013-01-01

    Background Vestibular reflexes, evoked by human electrical (galvanic) vestibular stimulation (EVS), are utilized to assess vestibular function and investigate its pathways. Our study aimed to investigate the electrically-evoked vestibulo-ocular reflex (eVOR) output after bilateral and unilateral vestibular deafferentations to determine the characteristics for interpreting unilateral lesions such as vestibular schwannomas. Methods EVOR was recorded with dual-search coils as binocular three-dimensional eye movements evoked by bipolar 100 ms-step at EVS intensities of [0.9, 2.5, 5.0, 7.5, 10.0]mA and unipolar 100 ms-step at 5 mA EVS intensity. Five bilateral vestibular deafferented (BVD), 12 unilateral vestibular deafferented (UVD), four unilateral vestibular schwannoma (UVS) patients and 17 healthy subjects were tested with bipolar EVS, and five UVDs with unipolar EVS. Results After BVD, bipolar EVS elicited no eVOR. After UVD, bipolar EVS of one functioning ear elicited bidirectional, excitatory eVOR to cathodal EVS with 9 ms latency and inhibitory eVOR to anodal EVS, opposite in direction, at half the amplitude with 12 ms latency, exhibiting an excitatory-inhibitory asymmetry. The eVOR patterns from UVS were consistent with responses from UVD confirming the vestibular loss on the lesion side. Unexpectedly, unipolar EVS of the UVD ear, instead of absent response, evoked one-third the bipolar eVOR while unipolar EVS of the functioning ear evoked half the bipolar response. Conclusions The bidirectional eVOR evoked by bipolar EVS from UVD with an excitatory-inhibitory asymmetry and the 3 ms latency difference between normal and lesion side may be useful for detecting vestibular lesions such as UVS. We suggest that current spread could account for the small eVOR to 5 mA unipolar EVS of the UVD ear. PMID:24349188

  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. Molecular characterization of a 17q11.2 translocation in a malignant schwannoma cell line.

    PubMed

    Reynolds, J E; Fletcher, J A; Lytle, C H; Nie, L; Morton, C C; Diehl, S R

    1992-12-01

    Malignant schwannomas are soft-tissue neoplasms that occur at increased frequency with germline alterations of the neurofibromatosis-1 (NF1) gene at 17q11.2. We report molecular and cytogenetic characterization of a malignant schwannoma cell line established from an individual affected with NF1. This cell line has a complex hyperdiploid karyotype with two cytogenetically identical der(13)t(13;17)(p11,q11.2) chromosomes. Using somatic cell hybrids, we mapped twelve chromosome-17 probes to either the der(13)t(13;17) chromosome or a small der(17) chromosome. Two chromosome-17p loci, including the p53 tumor suppressor gene, were present in the schwannoma cell line, but did not map to either of these chromosomes. Loss of heterozygosity studies indicated that the two der(13)t(13;17) chromosomes arose by duplication, presumably after the translocation event. The 17q11.2 translocation break-point maps distal to the NF1 gene, and may not disrupt its functioning. Although NF1 mRNA was detected in this cell line by polymerase chain reaction, Northern blot analysis revealed very little or none of the 13-kb mature NF1 transcript. This suggests that the single remaining allele of the NF1 gene contains a mutation that results in either greatly reduced transcription or message instability.

  3. Incidental detection of increased (18)F-FDG uptake and its follow-up in patients with granulomatous prostatitis after BCG treatment for urinary bladder cancer.

    PubMed

    Kim, Choon-Young; Lee, Sang-Woo; Yoon, Ghilsuk; Jeong, Shin Young; Ahn, Byeong-Cheol; Lee, Jaetae

    2014-01-01

    Incidental prostate uptake of fluorine-18-fluorodeoxyglucose in positron emission tomography/computed tomography ((18)F-FDG PET/CT) may represent malignancies like prostate malignancy, inflammation or benign prostatic lesions. We report two cases of bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis that showed (18)F-FDG uptake of the prostate gland on (18)F-FDG PET/CT in patients who had previously received intravesical BCG treatment for bladder cancer. The degree of (18)F-FDG uptake was decreased on the follow-up PET/CT scan after one year, without any specific treatment.

  4. The incidental diagnosis.

    PubMed

    Silverberg, L I

    1999-04-01

    Incidental findings transcend medical practice. Two cases are discussed in which significant conditions were discovered during clinical examination for an unrelated disorder. The first case presents a disease reported for the first time in a male. Recent literature has alluded to missed diagnoses found only at autopsies. With cost constraint as a national theme, the appropriate use of technology presents a challenge to the physician. The cases discussed raise questions about the process of diagnosis. Both situations bring to light the limitations of clinical investigation early in the pathologic process.

  5. Schwannoma of the conus medullaris: a rare case.

    PubMed

    Canbay, Suat; Hasturk, Askin Esen; Markoc, Fatma; Caglar, Sukru

    2011-12-01

    Intradural schwannoma of the conus medullaris is a rare form of spinal neoplasm, which commonly occurs in the lumbar region. Conus medullaris level is unusual for schwannomas. A 49-year-old woman presented with chronic sciatica, mild bladder dysfunction, and paresthesia in the buttocks. Magnetic resonance imaging of the spine showed a mass lesion in the conus medullaris region with nerve compression. The tumor was completely resected and diagnosed histologically as schwannoma. The patient recovered after surgery. Clinical and radiologic features of this rare tumor are reviewed and are accompanied by literature findings.

  6. Cystic olfactory schwannoma of the anterior cranial base.

    PubMed

    Daglioglu, E; Okay, Onder; Dalgic, Ali; Albayrak, Ahmet Levent; Ergungor, Fikret

    2008-10-01

    Olfactory groove schwannomas are extremely uncommon and less than 30 cases are reported in the literature. We report a 21-year-old developmentally-retarded boy who experienced severe headache and aggressive behaviour for 5 months. Imaging showed a cystic mass in the subfrontal region, which was removed by craniotomy. The lesion had a vascular supply from the anterior ethmoidal arteries and it was noted to be attached to the right olfactory nerve. It was removed completely and histology showed it to be a schwannoma. Olfactory groove schwannomas are rare lesions and should be differentiated from meningiomas, neuroblastomas and dural-based metastatic lesions of the anterior cranial base.

  7. 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

  8. Rare synchronous association of vestibular schwannoma and indolent insular oligodendroglioma in a patient without neurofibromatosis: controversial issue of timing for surgical treatment of asymptomatic low-grade gliomas.

    PubMed

    Iacoangeli, Maurizio; Di Rienzo, Alessandro; Colasanti, Roberto; Alvaro, Lorenzo; Nocchi, Niccolò; Polonara, Gabriele; Di Somma, Lucia Giovanna Maria; Zizzi, Antonio; Scarpelli, Marina; Scerrati, Massimo

    2012-01-01

    The co-occurrence of a vestibular schwannoma and a low-grade glioma is rare, and even rarer is the association with an oligodendroglioma. Although various authors have addressed the problem of treating patients with incidentally discovered indolent low-grade gliomas, an established protocol does not exist to date. The common approach is to reserve surgery until there is radiological evidence of tumor growth or high-grade transformation. However, because incidental low-grade glioma may represent the first stage of unavoidable pathological progression towards high-grade glioma, early and radical surgical resection should be advocated in order to increase the chance of a "cure" and prolonged survival. This case report supports this view, and suggests reflection on a possible change from a conservative philosophy to preventative surgical treatment.

  9. Schwannoma originating from lower cranial nerves: report of 4 cases.

    PubMed

    Oyama, Hirofumi; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Noda, Tomoyuki; Wada, Kentaro

    2012-02-01

    Four cases of schwannoma originating from the lower cranial nerves are presented. Case 1 is a schwannoma of the vagus nerve in the parapharyngeal space. The operation was performed by the transcervical approach. Although the tumor capsule was not dissected from the vagus nerve, hoarseness and dysphagia happened transiently after the operation. Case 2 is a schwannoma in the jugular foramen. The operation was performed by the infralabyrinthine approach. Although only the intracapsular tumor was enucleated, facial palsy, hoarseness, dysphagia and paresis of the deltoid muscle occurred transiently after the operation. The patient's hearing had also slightly deteriorated. Case 3 is a dumbbell-typed schwannoma originating from the hypoglossal nerve. The hypoglossal canal was markedly enlarged by the tumor. As the hypoglossal nerves were embedded in the tumor, the tumor around the hypoglossal nerves was not resected. The tumor was significantly enlarged for a while after stereotactic irradiation. Case 4 is an intracranial cystic schwannoma originating from the IXth or Xth cranial nerves. The tumor was resected through the cerebello-medullary fissure. The tumor capsule attached to the brain stem was not removed. Hoarseness and dysphagia happened transiently after the operation. Cranial nerve palsy readily occurs after the removal of the schwannoma originating from the lower cranial nerves. Mechanical injury caused by retraction, extension and compression of the nerve and heat injury during the drilling of the petrous bone should be cautiously avoided.

  10. 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

  11. Solid cystic trigeminal schwannoma with intraorbital extension causing proptosis and vision loss

    PubMed Central

    Gupta, Pankaj; Sharma, Arvind; Singh, Jitendra

    2016-01-01

    Schwannomas are slowly growing, well capsulated, benign tumors. Involvement of vestibular nerve is most commonly followed by trigeminal nerve. Trigeminal schwannoma is rare entity, and cystic degeneration with intraorbital extension of trigeminal schwannoma is even rarer. These tumors occur in fourth and fifth decades of life and patients have variable presentation depending on which cranial compartment is involved. Orbital schwannoma usually presents with proptosis with or without vision loss. We are reporting such a rare case of solid cystic trigeminal schwannoma with intraorbital extension through superior orbital fissure that was removed surgically.

  12. Solid cystic trigeminal schwannoma with intraorbital extension causing proptosis and vision loss

    PubMed Central

    Gupta, Pankaj; Sharma, Arvind; Singh, Jitendra

    2016-01-01

    Schwannomas are slowly growing, well capsulated, benign tumors. Involvement of vestibular nerve is most commonly followed by trigeminal nerve. Trigeminal schwannoma is rare entity, and cystic degeneration with intraorbital extension of trigeminal schwannoma is even rarer. These tumors occur in fourth and fifth decades of life and patients have variable presentation depending on which cranial compartment is involved. Orbital schwannoma usually presents with proptosis with or without vision loss. We are reporting such a rare case of solid cystic trigeminal schwannoma with intraorbital extension through superior orbital fissure that was removed surgically. PMID:27695572

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. PACS: effect on incidental findings.

    PubMed

    Green, Larissa

    2004-01-01

    Previous studies have addressed the increased volume of incidental findings when interpreting MRI lumbar spine studies after the implementation of a picture archiving and communication system (PACS). The purpose of this study is to confirm prior findings and contribute additional knowledge that supports the use of technology in complimenting the quality of patient care. Lumbar spine interpretations were reprinted from 900 studies and individually reviewed. These lumbar spine studies were performed on a 1.5-tesla magnet. Included were 300 consecutive lumbar spine reports over a two year period: four months prior to PACS introduction, four months during the transition to PACS, and four months post PACS implementation. Reports stating incidental findings were tabulated, along with the frequency patient gender, age, location (outpatient, inpatient or emergency room), reporting radiologist, specific finding and radiologist recommendations in each case were documented. The number of incidental findings increased from five pre-PACS to nine during the transition phase to PACS, followed by 11 post-PACS. This results in a maximum increase of 120 percent from pre- to post-PACS. The most common incidental findings include renal mass, cyst or lesions, aortic aneurysms and lymph node abnormalities. Statistical data confirms that the implementation of PACS into a radiology practice for MRI lumbar spine imaging appears to have a beneficial impact on the number of reported incidental findings and recommended follow-up studies.

  18. Meningioma and schwannoma risk in adults in relation to family history of cancer

    PubMed Central

    Hill, Deirdre A.; Linet, Martha S.; Black, Peter M.; Fine, Howard A.; Selker, Robert G.; Shapiro, William R.; Inskip, Peter D.

    2004-01-01

    Relatively little is known about factors that contribute to the development of meningioma and vestibular schwannoma, two intracranial nervous system tumors. We evaluated the risk of these tumors in relation to family history of malignant or benign tumors. Incident cases of meningioma (n = 197) or schwannoma (n = 96) were identified at three U.S. referral hospitals between June 1994 and August 1998. Controls (n = 799) admitted to the same hospitals for nonmalignant conditions were matched to cases on age, sex, race/ethnicity, hospital, and proximity of residence to hospital. We found that risk of meningioma was increased among persons reporting a family history of a benign brain tumor (odds ratio [OR], 4.5; 95% confidence interval [CI], 1.0–21.0; n = 5) or melanoma (OR, 4.2; 95% CI, 1.2–15.0; n = 5). A family history of breast cancer was associated with an elevated meningioma risk among participants aged 18 to 49 years (OR, 3.9; 95% CI, 1.4 –11.0; n = 8) but a reduced risk among older respondents (OR, 0.2; 95% CI, 0.1–0.7; n = 3). Family history of cancer did not differ between schwannoma cases and controls, although the statistical power to detect associations was limited. Some relative risk estimates were based on a small number of observations and may have arisen by chance. Inheritance of predisposing genes, shared environmental factors, or both within families with a history of benign brain tumors, melanoma, or possibly breast cancer may be related to altered meningioma risk. PMID:15494094

  19. Extraconal cystic schwannoma mimicking an orbital dermoid cyst.

    PubMed

    Feijó, Eduardo Damous; Nery, Ana Carla de Souza; Caiado, Fábio Ramos; Prehis, Aline Maria; Limongi, Roberto Murillo

    2016-01-01

    To our knowledge, we report the first case of an extraconal orbital cystic schwannoma in Brazilian literature. The tumor grew slowly and progressively and was associated with minimal eccentric proptosis and diplopia. The radiologic study (orbital computed tomography) revealed a rounded, encapsulated, and extraconal cystic mass in the superior medial region of the right orbit in the supraorbital and supratrochlear nerve topography. An anterior orbitotomy with full excision of the tumor was performed, and the histopathology examination revealed that the tumor was a schwannoma. After the surgery, the patient experienced total remission of his symptoms. PMID:27626153

  20. Acute presentation of brachial plexus schwannoma secondary to infarction.

    PubMed

    Sidani, Charif; Saraf-Lavi, Efrat; Lyapichev, Kirill A; Nadji, Mehrdad; Levi, Allan D

    2015-06-01

    Schwannomas of the brachial plexus are rare and typically present as slowly growing masses. We describe a case of a 37-year-old female who presented with acute onset of severe left upper extremity pain. Magnetic resonance imaging (MRI) showed a 2.3 × 2.1 cm peripherally enhancing centrally cystic lesion in the left axilla, along the cords of the left brachial plexus, with significant surrounding edema and enhancement. The mass was surgically removed. Pathology was consistent with a schwannoma with infarction. The pain completely resolved immediately after surgery.

  1. Simultaneous right retroperitoneal schwannoma and left renal hydatid cyst.

    PubMed

    Kamalati, Ali; Tabrizchi, Hamid

    2013-01-01

    Retroperitoneal schwannomas are quite rare tumors. Isolated renal hydatid cyst is also rare, and it forms 2-4% of hydatid disease. Because of their infrequent occurrence, nonspecific signs and symptoms, and lack of distinguishing radiologic features, we report herein a case of right retroperitoneal mass in a 26-year-old woman which was found to be benign schwannoma following a percutaneous core needle biopsy and a large cortical cyst in the lower pole of the left kidney which was diagnosed as isolated renal hydatid cyst following exploration.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. [Impact of Microsurgical Exstirpation of Vestibular Schwannomas on the Sense of Taste].

    PubMed

    Boeßert, P; Hempel, J M; van Ewijk, R; Mann, W J; Haxel, B R

    2016-05-01

    Patients with single sided vestibular schwannoma may report about a taste dysfunction apart from the well known cardinal symptoms. Very few data are published so far on that topic. The aim of this study was to investigate the influence of microsurgery for vestibular schwannomas on taste perception prospectively using a well validated taste test. 25 patients could be included in the study. No ageusia was claimed by the patients. In average a decrease of the taste score postoperatively could be detected on the tumor as well as on the non treated side. The differences were not statistically significant. But a subgroup of ¼ of the subjects revealed a new onset of side difference in the taste score that was not present before surgery. In all those cases the treated side showed a clinically significant reduced taste score of 6,2 in average. Within this subgroup the temporal access was overpresented in contrast to the whole group. This may indicate an influence of the choosen approach and that for the position of the tumor to the change of the taste score. The observations should be verified on a greater collective.

  7. Schwannoma of the Median Nerve at Mid Forearm Level

    PubMed Central

    Dusad, Tarun; Meena, D.S.; Saini, Narendra; Sharma, Yogesh; Khurana, Deepak

    2016-01-01

    Introduction: Schwannomas are also known as neurilemmoma that usually originate from Schwann cells located in the peripheral nerve sheaths. It usually occurs in the age group of 20 to 70 years. These are the commonest tumors of the peripheral nerves, 5% of which occur in the adults and 19% of the tumors occur in upper extremities. Schwannomas are generally presented as an asymptomatic mass. Discomfort may be the only presenting complaint of the patient. Paresthesia may be elicited on tapping the swelling. Magnetic resonanceimaging, and ultrasound are helpful in the diagnosis. Surgical removal is usually curative. Case Presentation: A 28-year-old male came to our hospital for a lump located at the volar side of the right mid forearm for 10 years with discomfort and paresthesia in median nerve distribution of hand which appeared in last two years. Total excision was performed for the lesion. Histopathological examination of the mass revealed typical features of schwannoma. At two months follow-up, the patient was symptom free with mild paresthesia in his index and middle fingers. Conclusion: Benign tumours involving peripheral nerves of the upper extremity are uncommon. Schwannomas are theoretically removable because they repulse fascicular groups without penetrating them, thus allowing their enucleation while preserving nerve continuity, as reported in our patient.

  8. 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

  9. 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

  10. Infantile Cellular Schwannoma Developing on the Skin with Atypical Clinical Features

    PubMed Central

    Fujimura, Taku; Tagami, Hachiro; Aiba, Setsuya

    2014-01-01

    Cellular schwannoma (CS) is a variety of schwannoma with a predominantly cellular growth, normally developing in middle-aged patients. In this report, we describe a 15-month-old infant with primary cutaneous CS on the knee. Because of its histologically malignant features, CS is sometimes overdiagnosed as a malignant nerve tumor. Therefore, awareness of this variant of schwannoma is important for dermatologists to avoid needless treatments for patients with CS. PMID:25232315

  11. 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

  12. 75 FR 80773 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-23

    ... Incidental to Specified Activities; Taking Marine Mammals Incidental to Space Vehicle and Missile Launch... to launching space launch vehicles, long-range ballistic target missiles, and other smaller missile... small numbers of marine mammals incidental to launching space launch vehicles, long-range...

  13. 77 FR 27321 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ... of an incidental harassment authorization. SUMMARY: 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 Gulf of Mexico Inc. (Shell) to take marine mammals, by harassment, incidental...

  14. Rosette-forming glioneuronal tumor of the cerebellum in statu nascendi: an incidentally detected diminutive example indicates derivation from the internal granule cell layer.

    PubMed

    Thommen, François; Hewer, Ekkehard; Schäfer, Stephan C; Vassella, Erik; Kappeler, Andreas; Vajtai, Istvan

    2013-01-01

    Rosette-forming glioneuronal tumor (RGNT) is a recently introduced, indolent neoplasm composed of diminutive circular aggregates of neurocytic-like cells on a noninfiltrative astrocytic background, typically located in the cerebellar midline The traded concept of RGNT being derived from site-specific periventricular precursors may be questioned in the face of extracerebellar examples as well as ones occurring in combination with other representatives of the glioneuronal family. We describe a hitherto not documented example of asymptomatic RGNT discovered during autopsy of a 74-year-old male. Located in the tuberal vermis, this lesion of 6 mm diameter consisted of several microscopic nests of what were felt to represent nascent stages of RGNT, all of them centered on the internal granular layer, and ranging from mucoid dehiscences thereof to fully evolved - if small - tumor foci. Molecular genetic analysis revealed a missense mutation in Exon 20 of the PIK3CA gene involving an A→G transition at Nucleotide 3140. On the other hand, neither codeletion of chromosomes 1p/19q nor pathogenic mutations of IDH1/2 were detected. By analogy with in situ paradigms in other organs, we propose that this tumor is likely to have arisen from the internal granular layer, rather than the plate of the 4th ventricle. A suggestive departure from the wholesale argument of "undifferentiated precursors", this finding also indirectly indicates that a subset of non-classical RGNTs - in particular extracerebellar examples, whose origin cannot be mechanistically accounted for by either of the above structures - may possibly reflect an instance of phenotypic convergence, rather than a lineage-restricted entity.

  15. Rosette-forming glioneuronal tumor of the cerebellum in statu nascendi: an incidentally detected diminutive example indicates derivation from the internal granule cell layer.

    PubMed

    Thommen, François; Hewer, Ekkehard; Schäfer, Stephan C; Vassella, Erik; Kappeler, Andreas; Vajtai, Istvan

    2013-01-01

    Rosette-forming glioneuronal tumor (RGNT) is a recently introduced, indolent neoplasm composed of diminutive circular aggregates of neurocytic-like cells on a noninfiltrative astrocytic background, typically located in the cerebellar midline The traded concept of RGNT being derived from site-specific periventricular precursors may be questioned in the face of extracerebellar examples as well as ones occurring in combination with other representatives of the glioneuronal family. We describe a hitherto not documented example of asymptomatic RGNT discovered during autopsy of a 74-year-old male. Located in the tuberal vermis, this lesion of 6 mm diameter consisted of several microscopic nests of what were felt to represent nascent stages of RGNT, all of them centered on the internal granular layer, and ranging from mucoid dehiscences thereof to fully evolved - if small - tumor foci. Molecular genetic analysis revealed a missense mutation in Exon 20 of the PIK3CA gene involving an A→G transition at Nucleotide 3140. On the other hand, neither codeletion of chromosomes 1p/19q nor pathogenic mutations of IDH1/2 were detected. By analogy with in situ paradigms in other organs, we propose that this tumor is likely to have arisen from the internal granular layer, rather than the plate of the 4th ventricle. A suggestive departure from the wholesale argument of "undifferentiated precursors", this finding also indirectly indicates that a subset of non-classical RGNTs - in particular extracerebellar examples, whose origin cannot be mechanistically accounted for by either of the above structures - may possibly reflect an instance of phenotypic convergence, rather than a lineage-restricted entity. PMID:23547894

  16. Calcification of vestibular schwannoma: a case report and literature review.

    PubMed

    Zhang, Yang; Yu, Jinlu; Qu, Limei; Li, Yunqian

    2012-10-02

    Calcification rarely occurs in vestibular schwannoma (VS), and only seven cases of calcified VS have been reported in the literature. Here, we report a 48-year-old man with VS, who had a history of progressive left-sided hearing loss for 3 years. Neurological examination revealed that he had left-sided hearing loss and left cerebellar ataxia. Magnetic resonance imaging and computerized tomography angiography showed a mass with calcification in the left cerebellopontine angle (CPA). The tumor was successfully removed via suboccipital craniotomy, and postoperative histopathology showed that the tumor was a schwannoma. We reviewed seven cases of calcified VS that were previously reported in the literature, and we analyzed and summarized the characteristics of these tumors, including the calcification, texture, and blood supply. We conclude that calcification in VS is associated with its texture and blood supply, and these characteristics affect the surgical removal of the tumor.

  17. 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. PMID:27578943

  18. 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

  19. 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

  20. Olfactory region schwannoma: Excision with preservation of olfaction.

    PubMed

    Salunke, Pravin; Patra, Devi Prasad; Futane, Sameer; Nada, Ritambhara

    2014-07-01

    Olfactory region schwannomas are rare, but when they occur, they commonly arise from the meningeal branches of the trigeminal nerve and may present without involvement of the olfaction. A 24 year old lady presented with hemifacial paraesthesias. Radiology revealed a large olfactory region enhancing lesion. She was operated through a transbasal with olfactory preserving approach. This manuscript highlights the importance of olfactory preservation in such lesions.

  1. Schwannoma-like pleomorphic adenoma of the parotid.

    PubMed

    Tille, Jean-Christophe; Reychler, Hervé; Hamoir, Marc; Schmitz, Sandra; Weynand, Birgit

    2011-10-21

    Pleomorphic adenoma is the most common benign salivary gland tumour. It can occur in any salivary gland, but is most frequently found in the parotid gland. Chondroid metaplasia is a frequent finding in pleomorphic adenoma. Other forms of metaplasia have been described, but are encountered less frequently. We report a rare case of unusual pleomorphic adenoma of the parotid gland with schwannoma-like feature.

  2. 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

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

    PubMed

    Chakravarti, Arunabha; Garg, Sunil; Bhargava, Rahul

    2016-07-01

    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. PMID:27630872

  4. 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. PMID:27630872

  5. Incidental isolated pancreatic hydatid cyst.

    PubMed

    Kısaoğlu, Abdullah; Özoğul, Bünyami; Atamanalp, Sabri Selçuk; Pirimoğlu, Berhan; Aydınlı, Bülent; Korkut, Ercan

    2015-03-01

    Isolated pancreatic hydatid cysts are a rare parasitic disease even in endemic areas. It is difficult to discriminate primary pancreatic hydatid cysts from other cystic and solid lesions of the pancreas. This is a case report of an incidental isolated pancreatic hydatid cyst. A heterogeneous cystic lesion in the body of the pancreas was identified on magnetic resonance imaging of a patient previously diagnosed patient with cholelithiasis, and because of the malignant possibility of the lesion, splenectomy with distal pancreatectomy and cholecystectomy was performed. The histopathologic diagnosis was reported as a hydatid cyst. Pancreatic hydatid cysts should be kept in mind in the differential diagnosis of pancreatic pseudocysts and cystic malignancies.

  6. 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....

  7. Incidental fleurodeoxyglucose uptake in the prostate

    PubMed Central

    Wong, W L; Moule, R N; Nunan, T

    2010-01-01

    This commentary confirms the rarity of prostatic cancer associated with incidental prostatic fleurodeoxyglucose (FDG) uptake. The study adds to the literature by showing that even if a prostate lesion is FDG avid it is unlikely to be due to cancer. The commentary considers the management of incidental prostate FDG uptake on the basis of the available evidence. PMID:20965899

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 25 CFR 700.199 - Incidental expenses.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Incidental expenses. 700.199 Section 700.199 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES Incidental... determined to be part of the debt service or finance charge under 15 U.S.C. 131-1641 and Regulation Z (12...

  14. 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....

  15. 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...

  16. 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....

  17. 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....

  18. 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…

  19. Focal liver lesions found incidentally.

    PubMed

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

    2016-03-28

    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

  20. Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

    PubMed Central

    Kumar, Lovekesh; Chejara, Rajkumar; Prasad, Om Prakash; Kolhe, Yuvraj

    2014-01-01

    Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma. PMID:25247101

  1. Cystic Abducens Schwannoma without Abducens Paresis : Possible Role of Cisternal Structures in Clinical Manifestation.

    PubMed

    Lee, Seul-Kee; Moon, Kyung-Sub; Lee, Kyung-Hwa; Jung, Shin

    2013-06-01

    The abducens nerve paresis generally can aid in the presumptive diagnosis of abducens schwannoma along with the typical radiological features of schwannomas. The authors present a case of a 76-year-old male patient with a abducens schwannoma without abducens nerve paresis. Peroperatively, abducens nerve located in the cerebellopontine cistern had normal in contour and diameter, despite the mass originated from this nerve. We hypothesize that anatomic location of abducens nerve may affect the vector of tumor growth to prevent destruction of its origin, the abducens nerve.

  2. [Schwannoma with purely cystic form originating from the adrenal area: a case report].

    PubMed

    Ikemoto, Isao; Yumoto, Takafumi; Yoshino, Yasumasa; Furuta, Nozomu; Kiyota, Hirosi; Oishi, Yukihiko

    2002-05-01

    A 62-year-old woman was hospitalized with complaints of right upper abdominal discomfort. Various imaging studies showed an extremely large suprarenal mass with solitary cystic formation. Partial adrenalectomy was successfully performed through the transperitoneal approach. The resected mass measured 12 x 10 x 10 cm and weighed 600 g. A pathological examination showed an Antoni-B predominant-type benign schwannoma containing a large volume of degenerative fluid. Our search of literature yielded few reports of solitary cystic schwannomas in the retroperitoneal cavity or throughout the body. This unusual cystic manifestation is thought to be a terminal stage of degeneration of a long-standing schwannoma.

  3. Incidental and online learning of melodic structure.

    PubMed

    Rohrmeier, Martin; Rebuschat, Patrick; Cross, Ian

    2011-06-01

    The cognition of music, like that of language, is partly rooted in enculturative processes of implicit and incidental learning. Musicians and nonmusicians alike are commonly found to possess detailed implicit knowledge of musical structure which is acquired incidentally through interaction with large samples of music. This paper reports an experiment combining the methodology of artificial grammar learning with musical acquisition of melodic structure. Participants acquired knowledge of grammatical melodic structures under incidental learning conditions in both experimental and untrained control conditions. Subsequent analysis indicates a large effect of unsupervised online learning in the experimental and control group throughout the course of the testing phase suggesting an effective ongoing learning process. Musicians did not outperform nonmusicians, indicating that musical expertise is not advantageous for the learning of a new, unfamiliar melodic system. Confidence ratings suggest that participants became aware of the knowledge guiding their classification performance despite the incidental learning conditions.

  4. Small Incidental Renal Masses in Adults

    PubMed Central

    Al-Marhoon, Mohammed S

    2010-01-01

    Incidental renal tumours are becoming an important clinical problem that many physicians will need to deal with. A good knowledge of the nature of these tumours and how to manage them is therefore needed. The aim of this paper is to review the literature about incidental renal tumours in adults. Many incidentally discovered small renal tumours (<4 cm) are benign and of low stage, grade and progression potential. The preferred management in young fit patients is open or laparoscopic nephron-sparing surgery. Treatment alternatives include needle-ablative therapies and surveillance in elderly unfit patients. Tumour renal biopsy is encouraged prior to needle-ablative therapy and surveillance. Awareness about incidental renal masses and their management is essential for treating doctors. PMID:21509229

  5. Staged Resection of Large Hypervascular Vestibular Schwannomas in Young Adults

    PubMed Central

    Abe, Takumi; Izumiyama, Hitoshi; Imaizumi, Youichi; Kobayashi, Shinsuke; Shimazu, Motohiko; Sasaki, Ken; Matsumoto, Kiyoshi; Kushima, Miki

    2001-01-01

    Two young adults underwent resection of large hypervascular vestibular schwannomas (acoustic neuromas) via two-stage surgery. The first patient, a 27-year-old woman with hydrocephalus, had a large hypervascular vestibular tumor in the left cerebellopontine angle (CPA) supplied by the left anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA). The second patient, a 34-year-old woman, had a large AICA-supplied hypervascular vestibular tumor in the left CPA that displaced the brain stem significantly. At the initial stage, only the lateral aspect of the tumor was debulked due to excessive bleeding from the tumor bed. Angiography 1 or 2 months after the initial operation showed that the tumor was hypovascular. At the second stage, the remnant medial aspect of the tumor was relatively avascular and nonadherent to the brain stem. Without blood transfusion during the second stage, the tumor was removed totally in the first patient and subtotally in the second patient. Pathological examination revealed that dilatated blood vessels were prominently increased at the first surgery; however, at the second surgery, the number of blood vessels had decreased, showing necrosis and degeneration. Although there are no absolute indications for the staged resection of vestibular schwannomas, this procedure may represent one of the safest options for these difficult lesions in young adults. ImagesFigure 1p201-bFigure 1p202-bFigure 2p203-bFigure 2p204-b PMID:17167621

  6. 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

  7. Vestibular schwannoma: 825 cases from a 25-year experience

    PubMed Central

    Pinna, Mariana Hausen; Bento, Ricardo Ferreira; Neto, Rubens Vuono de Brito

    2012-01-01

    Summary Introduction: Acoustic nerve tumors have been recognized as a clinico-pathologic entity for at least 200 years, and they represent 90% of cerebellopontine angle diseases. Histologically, the tumors are derived from Schwann cells of the myelin sheath, with smaller tumors consisting of elongated palisade cells, while in large tumors, cystic degeneration can be found in the central areas, possibly due to deficient vascularization. We retrospectively reviewed 825 cases of vestibular schwannomas, reported between January 1984 and August 2006, in which the patients underwent surgery to remove the tumor. Objective: To evaluate signs, symptoms, aspects of clinical diagnosis, including the results of audiological and imaging studies, and surgical techniques and complications. Methods: A retrospective chart review. The medical records of all patients undergoing surgical treatment for schwannoma during the period indicated were reviewed. Results and Conclusion: Hearing loss was the first symptom reported in almost all cases, and tumor size was not proportional to the impairment of the auditory threshold. The surgical techniques allowed safe preservation of facial function. In particular, the retrolabyrinthine route proved useful in small tumors, with 50% preservation of hearing. PMID:25991975

  8. Microdebrider cavitation and transcervical removal of parapharyngeal schwannomas approaching the skull base.

    PubMed

    Nicolai, Piero; Paderno, Alberto; Farina, Davide; Piazza, Cesare

    2014-12-01

    Removal of parapharyngeal space (PPS) schwannomas approaching the skull base through a purely transcervical approach requires adequate visualization of the surgical field to obtain complete resection with minimal sequelae. This is a retrospective series of four patients undergoing transcervical removal of sympathetic chain PPS schwannomas abutting the skull base by an intracapsular microdebrider tumor cavitation. Radiologic data, complications, functional outcomes, and follow-up status were considered. MRI was suggestive of PPS schwannoma in all cases, and correctly predicted the nerve of origin in three out of four cases. All patients developed postoperative Claude Bernard-Horner and first-bite syndromes. One patient also presented temporary neuropraxia of the IX cranial nerve, and another of the IX and X cranial nerves. Microdebrider cavitation of sympathetic chain PPS schwannoma abutting the skull base proved to be a reliable technique allowing good visualization of adjacent neural and vascular structures through a purely transcervical approach, while maintaining a low complication rate.

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

    PubMed Central

    Kim, Jin Won; Han, Ji Hyuk; Kim, Jin Woong

    2016-01-01

    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

  10. A giant vagal schwannoma with unusual extension from skull base to the mediastinum.

    PubMed

    Vijendra, Shenoy S; Rao, Raghavendra A; Prasad, Vishnu; Haseena, S; Niprupama, M

    2015-01-01

    Cervical vagal schwannoma is an extremely rare neoplasm. Middle aged people are usually affected. These tumors usually present as asymptomatic masses. These tumors are almost always benign. Preoperative diagnosis of these lesions is important due to the morbidity associated with its excision. Preoperative tissue diagnosis is not accurate. The imaging modality can be done to assess the extent and for planning the treatment. Surgical excision with preservation of neural origin is the treatment option. Giant vagal schwannomas are extremely rare. Only one case has been reported in the literature till date. There has no reported case of extensive vagal schwannoma from skull base to the mediastinum. Here, we describe the asymptomatic presentation of an unusual appearing giant cervical vagal schwannoma with an extension from skull base to the mediastinum. PMID:26881559

  11. 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

  12. 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

  13. Benign retroperitoneal schwannoma mimicking a pancreatic cystic tumor: case report and literature review.

    PubMed

    Hsiao, W C; Lin, P W; Chang, K C

    1998-01-01

    A rare case of benign retroperitoneal schwannoma mimicking a pancreatic cystic tumor is reported herein. The tumor mass, based on a computed tomography scan and an abdominal echo examination, was initially suspected to be a mucinous cystadenoma or cystadenocarcinoma of the pancreas. However, the surgical and pathohistological findings made a final diagnosis of benign pancreatic schwannoma. The patient is doing well at a 2-year follow-up. The tumor, 18x17x15 cm in size, represented the largest among reported pancreatic schwannomas. Furthermore, a comprehensive review of reported cases of pancreatic schwannoma was carried out to summarize corresponding findings, including benign or malignant forms, adherence to other tissues, cystic change of the tumor, as well as relation to von Recklinghausen's neurofibromatosis.

  14. Schwannoma-like pleomorphic adenoma: a case report with review of the literature.

    PubMed

    Lombardi, Mariangela; Socciarelli, Fabio; Fini, Giuseppina; Leonardi, Alessandra; Bartolazzi, Armando

    2014-06-01

    Pleomorphic adenoma is a common benign salivary gland tumor, which represents about 66 % of benign neoplasms of the salivary glands. Although it can occur in any salivary gland, it is most frequently found in the parotid. Pleomorphic adenomas are renowned for their cytomorphological and architectural heterogeneity that are characterized by intermixed epithelial and mesenchymal-like components. We report a rare case of pleomorphic adenoma of the parotid gland with prevalent schwannoma-like features mimicking a benign schwannoma. Microscopically the tumor showed a prevalence (about 95 %) of schwannoma-like areas with focal (about 5 %) epithelial component with tubular organization. The tumor showed positive immunoexpression for cytokeratin, S-100 protein, and focal expression of p63, CD10 and smooth muscle actin. To the best of our knowledge only six cases of schwannoma-like pleomorphic adenoma have been reported in the literature. The differential diagnosis between this entity and neurogenic and myogenic tumors is discussed.

  15. 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......

  16. 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

    ...NMFS received an application from ION Geophysical (ION) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment only, incidental to a proposed marine seismic survey in the Beaufort and Chukchi Seas, Alaska, between October and December 2012. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to ION to......

  17. 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......

  18. 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,...

  19. Triad of Intraspinal Meningioma, Schwannoma, and Ependymoma: Report of an Extremely Rare Case.

    PubMed

    Rasheed, Faiza; Fatima, Saira; Ahmad, Zubair

    2016-02-01

    Mixed tumors composed of schwannoma and meningioma are extremely rare and are usually associated with neurofibromatosis type 2. So far, all the cases reported have involved the cerebellopontine angle. Only 3 reported cases did not have a clear association with neurofibromatosis type 2. We report a mixed tumor comprising schwannoma admixed with meningioma and ependymoma in the cervical spinal cord of a 22-year-old male. PMID:26316051

  20. Large retroperitoneal schwannoma mimicking a cystic ovarian mass in a patient with Hansen's disease.

    PubMed

    Surendrababu, Narayanam R S; Cherian, Sucy Rekha; Janakiraman, Rajinikanth; Walter, Noel

    2008-06-01

    We present a rare case of retroperitoneal cystic schwannoma of the pelvis in a patient with Hansen's disease that mimicked an ovarian cyst. Due to economic constraints and because the lesion was assumed to be of ovarian origin, the patient did not undergo any cross-sectional imaging other than sonography. Sonographically guided fine needle aspiration of the cystic lesion was inconclusive. A cystic schwannoma was diagnosed at laparotomy.

  1. Staging in giant vestibular schwannoma surgery: A two consecutive day technique for complete resection in basic neurosurgical setups

    PubMed Central

    Bandlish, Deepak; Biswas, Nilay; Deb, Sumit

    2014-01-01

    Introduction: Vestibular schwannomas constitute 8% of all intracranial tumors. A majority of vestibular schwannomas are sporadic and unilateral. Giant vestibular schwannomas are seen in our country due to the late diagnosis and long duration of symptoms before diagnosis. These giant schwannomas are challenging to manage as most of the patients are having brainstem compression. Materials and Methods: Twelve cases of a giant vestibular schwannoma were operated in our department between May 2011 and December 2012. Vestibular schwannomas with a maximal diameter of more than 4 cm were defined as a giant vestibular schwannoma. All the patients had a unilateral vestibular schwannoma. Performance status of all the patients were graded as per the Karnofsky performance score. Pre-operative assessment of 5th, 7th, 8th and lower cranial nerve status was done in all cases. Ventriculoperitoneal shunting was done pre-operatively in all cases. All patients were operated through retromastoid suboccipital craniectomy and retrosigmoid approach. These patients were operated in two stages in two consecutive days with overnight elective ventilation in ICU. Ultrasonic aspirator and nerve monitoring techniques were not used. Results: Giant acoustic schwannomas can be safely resected completely by a staged resection on two consecutive days without any increased morbidity or mortality. This technique may be employed to achieve complete resection of such lesions without deterioration of facial nerve function in institutions which do not have advanced facilities like nerve monitoring or ultrasonic aspirator. PMID:25002760

  2. Incidental sequence learning across the lifespan.

    PubMed

    Weiermann, Brigitte; Meier, Beat

    2012-06-01

    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 when the training sequences were removed, providing indirect evidence for sequence learning. This performance slowing was comparable between groups, indicating no age-related differences. However, when explicit sequence knowledge was considered, age effects were found. For both children and older adults with no or only little explicit knowledge, incidental sequence learning was largely reduced and statistically not significant. In contrast, young adults showed sequence learning irrespective of the amount of explicit knowledge. These results indicate that different learning processes are involved in incidental sequence learning depending on age.

  3. 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

  4. 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

  5. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis.

    PubMed

    Brown, Emma; Staines, Konrad

    2016-01-01

    We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. PMID:27022490

  6. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis

    PubMed Central

    Staines, Konrad

    2016-01-01

    We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. PMID:27022490

  7. Fractionated Stereotactic Radiotherapy of Vestibular Schwannomas Accelerates Hearing Loss

    SciTech Connect

    Rasmussen, Rune; Claesson, Magnus; Stangerup, Sven-Eric; Roed, Henrik; Christensen, Ib Jarle; Caye-Thomasen, Per; Juhler, Marianne

    2012-08-01

    Objective: To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hearing preservation was also investigated. Methods and Materials: Forty-two patients receiving FSRT between 1997 and 2008 with a minimum follow-up of 2 years were included. All patients received 54 Gy in 27-30 fractions during 5.5-6.0 weeks. Clinical and audiometry data were collected prospectively. From a 'wait-and-scan' group, 409 patients were selected as control subjects, matched by initial audiometric parameters. Radiation dose to the cochlea was measured using the original treatment plan and then related to changes in acoustic parameters. Results: Actuarial 2-, 4-, and 10-year tumor control rates were 100%, 91.5%, and 85.0%, respectively. Twenty-one patients had serviceable hearing before FSRT, 8 of whom (38%) retained serviceable hearing at 2 years after FSRT. No patients retained serviceable hearing after 10 years. At 2 years, hearing preservation rates in the control group were 1.8 times higher compared with the group receiving FSRT (P=.007). Radiation dose to the cochlea was significantly correlated to deterioration of the speech reception threshold (P=.03) but not to discrimination loss. Conclusion: FSRT accelerates the naturally occurring hearing loss in patients with vestibular schwannoma. Our findings, using fractionation of radiotherapy, parallel results using single-dose radiation. The radiation dose to the cochlea is correlated to hearing loss measured as the speech reception threshold.

  8. 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…

  9. From the cell of Schwann to schwannoma--a century's fruition.

    PubMed

    Sonig, Ashish; Gandhi, Viraj; Nanda, Anil

    2014-11-01

    The word "schwannoma" is pervasive throughout the neurosurgical community. However, little is known about the origin of the cell of "Schwann cell," the manifestation of the tumor's nomenclature, or the prominent physicians who studied its etiopathogenesis. Schwann was a founding father of cellular theory and one of the greatest scientists of the 19th century. He not only proposed cell theory but also discovered the "secondary" nerve cell and hypothesized its possible function in myelination. It took a century to confirm Schwann's hypothesis. In 1954, Geren, aided by the electron microscope, demonstrated that the cell of Schwann is responsible for nerve myelination. Concurrently, researchers worked to understand the etiology and pathogenesis of peripheral nerve neoplasms. Several attempts were made; Older, Virchow, and von Recklinghausen were the first pioneers who worked on the classification of these neoplasms. However, Masson first used the word "schwannoma" to describe peripheral nerve neoplasms other than neuromas. His French colleague Nageotte used the term "peripheral-glioma" to denote these tumors. These schwannomas were considered to have a malignant course. In 1932, Penfield attempted to classify peripheral nerve neoplasms into 3 categories: peripheral fibroblastoma, peripheral glioma, and neurofibroma of von Recklinghausen. He classified "Verocay's neurinoma," "Masson's schwannoma," and "cerebellopontine angle" tumors as perineural fibroblastoma. He believed that these tumors have a non-nerve cell, non-Schwann cell origin. He classified the tumors arising from the Schwann cell sheath as peripheral gliomas and articulated, "If any tumors are to be called schwannomas, these should be." The neurofibroma of von Recklinghausen was recognized as a separate entity, as described by von Recklinghausen himself. Murray and Stout proposed that schwannomas are essentially benign in nature clarifying the abstruseness of the benign or malignant nature of schwannoma

  10. From the cell of Schwann to schwannoma--a century's fruition.

    PubMed

    Sonig, Ashish; Gandhi, Viraj; Nanda, Anil

    2014-11-01

    The word "schwannoma" is pervasive throughout the neurosurgical community. However, little is known about the origin of the cell of "Schwann cell," the manifestation of the tumor's nomenclature, or the prominent physicians who studied its etiopathogenesis. Schwann was a founding father of cellular theory and one of the greatest scientists of the 19th century. He not only proposed cell theory but also discovered the "secondary" nerve cell and hypothesized its possible function in myelination. It took a century to confirm Schwann's hypothesis. In 1954, Geren, aided by the electron microscope, demonstrated that the cell of Schwann is responsible for nerve myelination. Concurrently, researchers worked to understand the etiology and pathogenesis of peripheral nerve neoplasms. Several attempts were made; Older, Virchow, and von Recklinghausen were the first pioneers who worked on the classification of these neoplasms. However, Masson first used the word "schwannoma" to describe peripheral nerve neoplasms other than neuromas. His French colleague Nageotte used the term "peripheral-glioma" to denote these tumors. These schwannomas were considered to have a malignant course. In 1932, Penfield attempted to classify peripheral nerve neoplasms into 3 categories: peripheral fibroblastoma, peripheral glioma, and neurofibroma of von Recklinghausen. He classified "Verocay's neurinoma," "Masson's schwannoma," and "cerebellopontine angle" tumors as perineural fibroblastoma. He believed that these tumors have a non-nerve cell, non-Schwann cell origin. He classified the tumors arising from the Schwann cell sheath as peripheral gliomas and articulated, "If any tumors are to be called schwannomas, these should be." The neurofibroma of von Recklinghausen was recognized as a separate entity, as described by von Recklinghausen himself. Murray and Stout proposed that schwannomas are essentially benign in nature clarifying the abstruseness of the benign or malignant nature of schwannoma.

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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

    ... one elephant seal has been observed at Pigeon Point. California Sea Lion California sea lions are not... to PISCO to take marine mammals incidental to these same proposed activities (77 FR 72327, December...

  18. 76 FR 6406 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ...; proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received an application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to construction activities as part of a pile replacement project....

  19. 76 FR 79409 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ...; proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received an application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to construction activities as part of a wharf construction...

  20. 77 FR 25408 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-30

    ...; proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received an application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to construction activities as part of a pile replacement project....

  1. 76 FR 4300 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ...; proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received an application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to pile driving activities as part of a test pile program. Pursuant to...

  2. Incidental Learning of Sex Role Characteristics.

    ERIC Educational Resources Information Center

    Kinsell-Rainey, Lynn W.

    The content and process of incidental learning of sex role related characteristics through play behavior was explored in a study of more than 6000 toys sold by Sears, Roebuck & Company between 1900 and 1970, as represented in their mail order catalogs. Sixty percent of all toys were sex typed by Sears. The nature of the play behavior associated…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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.

  8. 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…

  9. Mobile Schwannoma of the Lumbar Spine: A Case Report and Review of the Literature

    PubMed Central

    Toscano, Daniel T; Ryan, Joshua E; Sayah, Anousheh; Nair, Mani N

    2016-01-01

    Mobile schwannomas of the spine have been sparsely documented in the literature. In cases referred to in existing literature, the migratory schwannoma was documented to occur in the lumbar spine. We added another case to the small available literature. In our case report, the patient had a previously known lumbar schwannoma that was being managed conservatively. Due to an acute change in clinical symptoms, repeat imaging was performed. A magnetic resonance imaging (MRI) of his spine revealed migration of the schwannoma two levels rostral to his recent imaging from six weeks earlier. The patient underwent surgical resection of his lesion. During the operation, the ultrasound was utilized to confirm the lesion prior to dural opening. In this report, we attempt to provide further evidence of the utility of an intraoperative ultrasound for intradural lesions and intend to add to the published literature of mobile schwannomas of the spine

  10. Schwannoma in Sellar Region Mimics Invasive Pituitary Macroadenoma: Literature Review With One Case Report.

    PubMed

    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

    2016-03-01

    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. Mobile Schwannoma of the Lumbar Spine: A Case Report and Review of the Literature

    PubMed Central

    Toscano, Daniel T; Ryan, Joshua E; Sayah, Anousheh; Nair, Mani N

    2016-01-01

    Mobile schwannomas of the spine have been sparsely documented in the literature. In cases referred to in existing literature, the migratory schwannoma was documented to occur in the lumbar spine. We added another case to the small available literature. In our case report, the patient had a previously known lumbar schwannoma that was being managed conservatively. Due to an acute change in clinical symptoms, repeat imaging was performed. A magnetic resonance imaging (MRI) of his spine revealed migration of the schwannoma two levels rostral to his recent imaging from six weeks earlier. The patient underwent surgical resection of his lesion. During the operation, the ultrasound was utilized to confirm the lesion prior to dural opening. In this report, we attempt to provide further evidence of the utility of an intraoperative ultrasound for intradural lesions and intend to add to the published literature of mobile schwannomas of the spine PMID:27610287

  12. Ancient schwannoma arising from mental nerve. A case report and review.

    PubMed

    Subhashraj, Krishnaraj; Balanand, Subramanian; Pajaniammalle, Subhashraj

    2009-01-01

    Schwannoma is an intraoral rare, benign neoplasm derived from the nerve sheath of peripheral nerves. "Ancient schwannoma" shows histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. Ancient schwannoma of the head and neck region is relatively uncommon and very few cases had been reported in the oral cavity. We present a case of ancient schwannoma arising from the mental nerve in a 19 year old male which was of eight months duration. Examination revealed a 30 x 25 mm firm, strawberry-like mass in the periapical region of the left lower first premolar, extending anteriorly to the canine and posteriorly to the first molar, obliterating the buccal vestibule, with an intact overlying mucosa. Ultrasonography showed that the tumor was closely associated with the mental nerve on the left side, suggestive of a peripheral neural sheath tumor. Complete excision of the lesion was done under local anesthesia, preserving the mental nerve. The histological picture was strongly suggestive of ancient schwannoma (Antoni A type). There was no evidence of recurrence 18 months after excision. The clinicopathological aspects of this special case are discussed, and the literature regarding this entity is reviewed. PMID:19114949

  13. Statistical learning under incidental versus intentional conditions.

    PubMed

    Arciuli, Joanne; Torkildsen, Janne von Koss; Stevens, David J; Simpson, Ian C

    2014-01-01

    Statistical learning (SL) studies have shown that participants are able to extract regularities in input they are exposed to without any instruction to do so. This and other findings, such as the fact that participants are often unable to verbalize their acquired knowledge, suggest that SL can occur implicitly or incidentally. Interestingly, several studies using the related paradigms of artificial grammar learning and serial response time tasks have shown that explicit instructions can aid learning under certain conditions. Within the SL literature, however, very few studies have contrasted incidental and intentional learning conditions. The aim of the present study was to investigate the effect of having prior knowledge of the statistical regularities in the input when undertaking a task of visual sequential SL. Specifically, we compared the degree of SL exhibited by participants who were informed (intentional group) versus those who were uninformed (incidental group) about the presence of embedded triplets within a familiarization stream. Somewhat surprisingly, our results revealed that there were no statistically significant differences (and only a small effect size) in the amount of SL exhibited between the intentional versus the incidental groups. We discuss the ways in which this result can be interpreted and suggest that short presentation times for stimuli in the familiarization stream in our study may have limited the opportunity for explicit learning. This suggestion is in line with recent research revealing a statistically significant difference (and a large effect size) between intentional versus incidental groups using a very similar visual sequential SL task, but with longer presentation times. Finally, we outline a number of directions for future research. PMID:25071692

  14. Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report

    PubMed Central

    WANG, GUANGYAO; CHEN, PING; ZONG, LIANG; SHI, LEI; ZHAO, WEI

    2014-01-01

    Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm3 solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers. PMID:24396458

  15. An allograft mouse model for the study of hearing loss secondary to vestibular schwannoma growth.

    PubMed

    Bonne, Nicolas-Xavier; Vitte, Jérémie; Chareyre, Fabrice; Karapetyan, Gevorg; Khankaldyyan, Vazgen; Tanaka, Karo; Moats, Rex A; Giovannini, Marco

    2016-08-01

    Vestibular schwannoma is a benign neoplasm arising from the Schwann cell sheath of the auditory-vestibular nerve. It most commonly affects both sides in the genetic condition Neurofibromatosis type 2, causing progressive high frequency sensorineural hearing loss. Here, we describe a microsurgical technique and stereotactic coordinates for schwannoma cell grafting in the vestibular nerve region that recapitulates local tumor growth in the cerebellopontine angle and inner auditory canal with resulting hearing loss. Tumor growth was monitored by bioluminescence and MRI in vivo imaging, and hearing assessed by auditory brainstem responses. These techniques, by potentially enabling orthotopic grafting of a variety of cell lines will allow studies on the pathogenesis of tumor-related hearing loss and preclinical drug evaluation, including hearing endpoints, for NF2-related and sporadic schwannomas. PMID:27177628

  16. The molecular biology of vestibular schwannomas and its association with hearing loss: a review.

    PubMed

    Celis-Aguilar, Erika; Lassaletta, Luis; Torres-Martín, Miguel; Rodrigues, F Yuri; Nistal, Manuel; Castresana, Javier S; Gavilan, Javier; Rey, Juan A

    2012-01-01

    Hearing loss is the most common symptom in patients with vestibular schwannoma (VS). In the past, compressive mechanisms caused by the tumoral mass and its growth have been regarded as the most likely causes of the hearing loss associated with VS. Interestingly, new evidence proposes molecular mechanisms as an explanation for such hearing loss. Among the molecular mechanisms proposed are methylation of TP73, negative expression of cyclin D1, expression of B7-H1, increased expression of the platelet-derived growth factor A, underexpression of PEX5L, RAD54B, and PSMAL, and overexpression of CEA. Many molecular mechanisms are involved in vestibular schwannoma development; we review some of these mechanisms with special emphasis on hearing loss associated with vestibular schwannoma.

  17. Intramedullary schwannoma of the conus medullaris complicated by dense adhesion to neural tissue.

    PubMed

    Ohtonari, Tatsuya; Nishihara, Nobuharu; Ota, Taisei; Ota, Shinzo; Koyama, Tsunemaro

    2009-11-01

    A 29-year-old man presented with an intramedullary schwannoma of the conus medullaris manifesting as an 8-month history of mild bladder dysfunction, sexual impotence, and paresthesia in the buttocks. Subtotal removal of the lesion was achieved, as part of the tumor showed dense adhesion to the rostral neural tissue, with only postoperative transient deterioration of bladder dysfunction. Intramedullary schwannoma, especially involving the conus medullaris and the proximal spinal cord, is relatively rare and the pathogenesis and pathophysiology are unclear. Complete resection is often advised to avoid recurrence, but tumor adhesion to neural tissue sometimes renders complete resection difficult, and may create the risk of unacceptable operative morbidity. The present case shows that transient neurological deterioration may occur even with just subtotal removal, leaving the adherent part. Therefore, recognition of the particular features and the strategy for treatment in intramedullary schwannoma of the conus medullaris is essential for making appropriate decisions on the degree of removal.

  18. The Molecular Biology of Vestibular Schwannomas and Its Association with Hearing Loss: A Review

    PubMed Central

    Celis-Aguilar, Erika; Lassaletta, Luis; Torres-Martín, Miguel; Rodrigues, F. Yuri; Nistal, Manuel; Castresana, Javier S.; Gavilan, Javier; Rey, Juan A.

    2012-01-01

    Hearing loss is the most common symptom in patients with vestibular schwannoma (VS). In the past, compressive mechanisms caused by the tumoral mass and its growth have been regarded as the most likely causes of the hearing loss associated with VS. Interestingly, new evidence proposes molecular mechanisms as an explanation for such hearing loss. Among the molecular mechanisms proposed are methylation of TP73, negative expression of cyclin D1, expression of B7-H1, increased expression of the platelet-derived growth factor A, underexpression of PEX5L, RAD54B, and PSMAL, and overexpression of CEA. Many molecular mechanisms are involved in vestibular schwannoma development; we review some of these mechanisms with special emphasis on hearing loss associated with vestibular schwannoma. PMID:22567403

  19. Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss.

    PubMed

    Mandalà, Marco; Giannuzzi, Annalisa; Astore, Serena; Trabalzini, Franco; Nuti, Daniele

    2013-07-01

    We evaluated the incidence and characteristics of hyperventilation-induced nystagmus (HVN) in 49 patients with gadolinium-enhanced magnetic resonance imaging evidence of vestibular schwannoma and 53 patients with idiopathic unilateral sensorineural hearing loss and normal radiological findings. The sensitivity and specificity of the hyperventilation test were compared with other audio-vestibular diagnostic tests (bedside examination of eye movements, caloric test, auditory brainstem responses) in the two groups of patients. The hyperventilation test scored the highest diagnostic efficiency (sensitivity 65.3 %; specificity 98.1 %) of the four tests in the differential diagnosis of vestibular schwannoma and idiopathic unilateral sensorineural hearing loss. Small tumors with a normal caloric response or caloric paresis were associated with ipsilateral HVN and larger tumors and severe caloric deficits with contralateral HVN. These results confirm that the hyperventilation test is a useful diagnostic test for predicting vestibular schwannoma in patients with unilateral sensorineural hearing loss.

  20. Sciatica from a foraminal lumbar root schwannoma: case report and review of literature.

    PubMed

    Rustagi, Tarush; Badve, Siddharth; Parekh, Aseem N

    2012-01-01

    Sciatica is commonly caused by lumbar prolapsed intervertebral disc (PID) and other spinal lesions. Uncommon causes like nerve root schwannoma are rarely considered in the differential diagnosis of sciatica. Spinal schwannomas occur both sporadically and in association with neurofibromatosis type 1 (NF1; von Recklinghausen's disease). This case report describes lumbar foraminal schwannoma as an unusual cause of radiculopathy, presenting clinically as a lumbar disc prolapse. The diagnosis was confirmed on MRI scan. Patient had complete symptomatic recovery following surgical enucleation of the tumour mass from the L5 nerve root. This case report is of particular interest as it highlights the diagnostic confusion, which is bound to arise, because the clinical presentation closely mimics a lumbar PID. This often leads to delay in diagnosis and "failure of conservative treatment."

  1. Spinal Intradural Schwannoma with Acute Intratumoural Haemorrhage: Case Report and Review

    PubMed Central

    Kongwad, Lakshman I.; Valiathan, Manna G.

    2016-01-01

    Schwannomas account for around half of all intradural spinal tumours, with chronic progressive symptoms as the most common presenting features. Intratumoural haemorrhage as a presenting feature of spinal schwannoma is very rare and only 11 cases have been reported till date. Authors here report a previously asymptomatic 40-year-old male who presented with acute onset paraplegia 12 hours after a minor trauma. MR imaging revealed a C7-D3 intradural-extramedullary lesion with features of acute blood and showing no enhancement. Emergency laminectomy and complete removal of the mass was performed and histopathology revealed features of schwannoma with haemorrhage. Patient had modest improvement of his neurological deficits at a follow-up of 6 months. Pertinent literature is reviewed in brief. PMID:26894121

  2. Giant Spinal Schwannoma in a 76-year-old Woman--A Case Report.

    PubMed

    Zadro, Zvonko; Frketić, Ivan; Fudurić, Jurica; Zadro, Ana Sostarić; Skarica, Rade; Korusić, Anđelko; Zupcić, Miroslav; Nikolić, Igor; Jelec, Vjekoslav; Zupcić, Sandra Graf; Kolak, Toni

    2016-04-01

    A schwannoma is a benign nerve sheath tumor composed of Schwann cells. Spinal schwannoma originates from dorsal roots of the spinal cord, causing symptoms due to the compression of neighboring structures. We present a patient with a low back pain and left L2 and L3 radiculopathy. Neuroimaging techniques (CT, MRI) showed a large expansive mass in the left lumbar paraspinal area. The tumor was removed totally by the posterior approach and was verified to originate from the left L2 spinal nerve root. The histopathological examination revealed typical findings of a schwannoma. The pain was resolved promptly after the surgery, however the patient's neurological condition wasn't improved. Surgical treatment was a final treatment, and no additonal therapy was necessary. PMID:27301238

  3. Sciatica from a Foraminal Lumbar Root Schwannoma: Case Report and Review of Literature

    PubMed Central

    Rustagi, Tarush; Badve, Siddharth; Parekh, Aseem N.

    2012-01-01

    Sciatica is commonly caused by lumbar prolapsed intervertebral disc (PID) and other spinal lesions. Uncommon causes like nerve root schwannoma are rarely considered in the differential diagnosis of sciatica. Spinal schwannomas occur both sporadically and in association with neurofibromatosis type 1 (NF1; von Recklinghausen's disease). This case report describes lumbar foraminal schwannoma as an unusual cause of radiculopathy, presenting clinically as a lumbar disc prolapse. The diagnosis was confirmed on MRI scan. Patient had complete symptomatic recovery following surgical enucleation of the tumour mass from the L5 nerve root. This case report is of particular interest as it highlights the diagnostic confusion, which is bound to arise, because the clinical presentation closely mimics a lumbar PID. This often leads to delay in diagnosis and “failure of conservative treatment.” PMID:23259107

  4. The possibility of seeding vestibular schwannomas through surgery: Limited experience with two cases

    PubMed Central

    Roser, Florian; Ebner, Florian Heinrich; Skardelly, Marco

    2016-01-01

    Background: We present two exceptional cases of possible tumor seeding in benign vestibular schwannoma (VS) patients occurring years after initial microsurgical resection. Case Description: We retrospectively analyzed the surgical management, histology and documented the growth of new tumor occurrence in close vicinity of the original schwannomas by serial magnetic resonance imaging over a period of 10 years. None of the patients had stigmata of neurofibromatosis, making it a reasonable assumption that the second tumor was due to surgical seeding during the first surgery. Moreover, in the second case, a microsurgical re-exploration showed that the recurrent tumor did not show any adhesion or contact to the caudal cranial nerves as anticipated had this been a new cranial nerve schwannoma. Conclusions: Surgical seeding of VSs is a rare complication but can occur despite benign histology and generous irrigation during surgery. PMID:27217967

  5. Acute Presentation of Lumbar Spinal Schwannoma Due to Torsion: A Case Report

    PubMed Central

    Khanna, Ryan; Ortmeier, Thomas C; Tapia-Zegarra, Gino G; Lindley, Timothy E; Smith, Zachary A; Dahdaleh, Nader S

    2016-01-01

    Although schwannomas are common spinal tumors with insidious presentations, acute neurological deterioration is an extremely rare manifestation that can occur in the setting of tumor torsion and infarction. The present case reports an unusual presentation of a spinal schwannoma that underwent torsion and infarction. A 65-year-old male presented initially with acute radicular pain progressing to cauda equina syndrome and confusion. MRI of the lumbar spine revealed an intradural extramedullary lesion at the level of L1/L2 measuring 1.1x0.9 cm. Intraoperatively, a reddish mass was seen caudally twisted around itself. Gross total resection was achieved with a final diagnosis of schwannoma with areas of infarction. At his six week follow up clinical visit, the patient was asymptomatic and his neurological exam was normal. The neurosurgeon should be aware of such atypical radiographic and clinical presentation amongst the spectrum of clinical manifestation of these nerve sheath tumors.  PMID:27226945

  6. Head and Neck Schwannomas: 20-Year Experience of a Single Institution Excluding Cutaneous and Acoustic Sites.

    PubMed

    Butler, Randall T; Patel, Rajiv M; McHugh, Jonathan B

    2016-09-01

    While head and neck sites comprise the most common location of schwannomas, clinicopathologic data regarding those tumors occurring in non-acoustic and non-cutaneous locations are relatively sparse. In this study, therefore, we sought to examine retrospectively the clinical and pathologic features of head and neck schwannomas excised at our institution over a 20-year period. During this period, we identified a total cohort of 85 patients, which included 36 males (42.4 %) and 49 females with average age of 41.3 years, the majority of which presented asymptomatically with a mass. Localized symptoms were, however, associated with all of the schwannomas that arose in the oral cavity and larynx, while tumors within or adjacent to bone were often associated with neurologic complaints (7 of 15 such tumors [46.7 %]). Clinical follow-up data was available in 86.4 % of all cases and demonstrated no recurrences or mortality. Pathologically, the microscopic features were characteristic of those well-described for schwannomas in other sites, including alternating Antoni A and B areas and the presence of degenerative changes. Tumor encapsulation, however, was variable and was completely absent in schwannomas of the nasal cavity, paranasal sinuses, and larynx. Additionally, a significant minority of the tumors (28.2 %) exhibited foci that resembled neurofibroma. Non-acoustic, non-cutaneous schwannomas of the head and neck appear to have clinicopathologic features similar to their soft tissue counterparts with some subsite variation in presentation and/or microscopic features. PMID:26747460

  7. Schwannoma Showing Avid Uptake on 68Ga-PSMA-HBED-CC PET/CT.

    PubMed

    Kanthan, Gowri L; Izard, Michael A; Emmett, Louise; Hsiao, Edward; Schembri, Geoffrey Paul

    2016-09-01

    Ga prostate-specific membrane antigen (PSMA) PET/CT is a relatively new and highly sensitive imaging modality used in staging metastatic prostate cancer. We report a case of a 65-year-old man with newly diagnosed prostate carcinoma who had a PSMA PET/CT scan for staging of his disease. A PSMA-avid right pelvic mass was identified anterior to the sacrum. Surgical removal and histopathological examination of this lesion revealed the diagnosis of schwannoma. It is important to be aware that schwannoma may also show avid uptake on PSMA PET/CT scan and may potentially lead to an incorrect diagnosis of metastatic prostate carcinoma. PMID:27405039

  8. Caecal schwannoma: a rare cause of per rectal bleeding in a 72-year-old man

    PubMed Central

    Dickson-Lowe, Richard A; James, Christopher L; Bailey, Charles MH; Abdulaal, Yasser

    2014-01-01

    The presence of per rectal (PR) bleeding in elderly people usually alerts us to the possibility of colonic malignancy, particularly if a concomitant altered bowel habit is present, without a history of the symptom. We present a case where the cause of PR bleeding turned out to be a caecal schwannoma. Caecal schwannoma is a rare tumour of the gastrointestinal tract of mesenchymal origin and diagnosis prior to radical surgical resection is difficult. Endoscopic biopsy often fails to provide an adequate specimen and immunohistochemistry is essential to the diagnosis. PMID:25312892

  9. Diffuse Large B-Cell Lymphoma Mimicking Schwannoma of Lumbar Spine

    PubMed Central

    Kim, Seung-Kook; Lee, Sun-Ho; Kim, Eun-Sang

    2016-01-01

    A rare case of solitary diffuse large B-cell lymphoma arising from the lumbar spinal nerve root is reported. A 37-year-old man presented with a 3-month history of progressive numbness and paraparesis in both legs. The initial diagnosis was benign primary intradural extramedullary tumor including schwannoma and meningioma. Histopathological examination revealed diffuse large B-cell lymphoma. While a well-defined T1 isointense mass is common in primary spinal schwannoma, the present case was atypical and had a yellowish neural component. The pathogenesis and radiological findings of spinal diffuse large B-cell lymphoma are discussed and related literature is reviewed. PMID:27437017

  10. Benign neurilemmoma (schwannoma) masquerading as a pleomorphic adenoma of the submandibular salivary gland.

    PubMed

    Mair, S; Leiman, G

    1989-01-01

    A case of solitary benign neurilemmoma (schwannoma) arising in the submandibular region is presented. The tumor was mistaken clinically for an enlarged submandibular salivary gland. Fine needle aspiration cytology made an erroneous diagnosis of a pleomorphic adenoma, predominantly stromal in composition. Histology of the resection specimen resulted in the correct diagnosis of a benign schwannoma. Review of the needle aspirate demonstrated cytologic features that should enable both the correct diagnosis of this neoplasm and its distinction from pleomorphic adenoma, which it mimicked in this location.

  11. Incidentally discovered giant mucocele of the appendix.

    PubMed

    Harris, Syed Hasan; Khan, Roobina; Ansari, Maulana Mohammad; Maheshwari, Veena

    2014-11-01

    Mucocele of the appendix is a rare but well-recognized entity that can mimic several common clinical conditions or present as an incidental radiological or surgical finding at laparotomy. Mucoceles are characterized by distension of the lumen due to accumulation of mucoid substance. They can result from mucosal hyperplasia, mucinous cystadenoma, or mucinous cystadenocarcinoma. If untreated, they may rupture producing the potentially fatal entity Pseudomyxoma peritonei, which is difficult to treat both surgically or medically. Appendectomy is used for simple mucocele or for cystadenoma. Preoperative diagnosis of a mucocele is helpful at the time of surgical intervention with careful mobilization, particularly of large lesions reducing the possibility of rupture and complications. The authors report a case of a 65-year-old man presenting with peritonitis due to a pre-pyloric gastric perforation also having an incidental giant mucocele of the appendix.

  12. Prediction of Balance Compensation After Vestibular Schwannoma Surgery.

    PubMed

    Parietti-Winkler, Cécile; Lion, Alexis; Frère, Julien; Perrin, Philippe P; Beurton, Renaud; Gauchard, Gérome C

    2016-06-01

    Background Balance compensation after vestibular schwannoma (VS) surgery is under the influence of specific preoperative patient and tumor characteristics. Objective To prospectively identify potential prognostic factors for balance recovery, we compared the respective influence of these preoperative characteristics on balance compensation after VS surgery. Methods In 50 patients scheduled for VS surgical ablation, we measured postural control before surgery (BS), 8 (AS8) days after, and 90 (AS90) days after surgery. Based on factors found previously in the literature, we evaluated age, body mass index and preoperative physical activity (PA), tumor grade, vestibular status, and preference for visual cues to control balance as potential prognostic factors using stepwise multiple regression models. Results An asymmetric vestibular function was the sole significant explanatory factor for impaired balance performance BS, whereas the preoperative PA alone significantly contributed to higher performance at AS8. An evaluation of patients' balance recovery over time showed that PA and vestibular status were the 2 significant predictive factors for short-term postural compensation (BS to AS8), whereas none of these preoperative factors was significantly predictive for medium-term postoperative postural recovery (AS8 to AS90). Conclusions We identified specific preoperative patient and vestibular function characteristics that may predict postoperative balance recovery after VS surgery. Better preoperative characterization of these factors in each patient could inform more personalized presurgical and postsurgical management, leading to a better, more rapid balance recovery, earlier return to normal daily activities and work, improved quality of life, and reduced medical and societal costs.

  13. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage

    PubMed Central

    Dilwali, Sonam; Landegger, Lukas D.; Soares, Vitor Y. R.; Deschler, Daniel G.; Stankovic, Konstantina M.

    2015-01-01

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects’ degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs. PMID:26690506

  14. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.

    PubMed

    Dilwali, Sonam; Landegger, Lukas D; Soares, Vitor Y R; Deschler, Daniel G; Stankovic, Konstantina M

    2015-12-22

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects' degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs.

  15. Ruptured Pseudoaneurysm after Gamma Knife Surgery for Vestibular Schwannoma

    PubMed Central

    MURAKAMI, Mamoru; KAWARABUKI, Kentaro; INOUE, Yasuo; OHTA, Tsutomu

    2016-01-01

    Ruptured aneurysms of anterior inferior cerebellar artery (AICA) after radiotherapy for vestibular schwannoma (VS) are rare, and no definite treatment has been established for distal AICA pseudoaneurysms. We describe a 61-year-old man who underwent Gamma Knife surgery (GKS) for left VS. Follow-up magnetic resonance imaging (MRI) revealed partial regression of the tumor. Twelve years after GKS, he suffered from subarachnoid hemorrhage. Initial angiogram showed no vascular lesions; second left vertebral angiogram, 10 days after admission, demonstrated a pseudoaneurysm in the lateral pontine segment of the left AICA. The proximal portion of the AICA was occluded by a coil. Postoperative MRI revealed an infarction on the left side of the pons and brachium pontis. Although the patient suffered from mild postoperative cerebellar ataxia and facial and abducens nerve palsy, he was discharged 1 month postoperatively requiring no assistance with activities of daily living. Twelve months later, he recovered satisfactorily with a modified Rankin Scale grade of 1, and no recanalization of the aneurysm was found on MR angiography. Endovascular parent artery occlusion for ruptured aneurysms at distal AICA carries the risk of brain stem infarction, but should be considered when no other option is available such as after radiotherapy for VS. PMID:26667081

  16. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.

    PubMed

    Dilwali, Sonam; Landegger, Lukas D; Soares, Vitor Y R; Deschler, Daniel G; Stankovic, Konstantina M

    2015-01-01

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects' degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs. PMID:26690506

  17. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding. PMID:27200163

  18. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    PubMed

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  19. 12 CFR 721.2 - What is an incidental powers activity?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false What is an incidental powers activity? 721.2... INCIDENTAL POWERS § 721.2 What is an incidental powers activity? An incidental powers activity is one that is... activity meets the definition of an incidental power activity if the activity: (a) Is convenient or...

  20. Sex cord tumor with annular tubules: an incidental finding in an endometriotic cyst--the first known cooccurrence.

    PubMed

    Singh, Meeta; Mandal, Shramana; Majumdar, Kaushik

    2014-01-01

    Sex cord tumor with annular tubules (SCTATs) is a relatively rare ovarian neoplasm often having a syndromic association with Peutz-Jeghers syndrome (PJS). Other associations described with this rare neoplasm include adenoma malignum of cervix, Turners syndrome, dysgerminoma, gonadoblastoma, endometrial carcinoma, and endometriosis of fallopian tube. We describe for the first time to the best of our literature search the incidental detection of SCTAT coexisting with an endometriotic cyst of ovary. Meticulous histological scanning and awareness is mandatory for detection of such unusual incidental lesions. Non-PJS SCTATs tend to be larger and could be more prone to distant metastasis, warranting subsequent follow-up. PMID:25530972

  1. Incidental Prenatal Diagnosis of Sex Chromosome Aneuploidies: Health, Behavior, and Fertility

    PubMed Central

    Pieters, J. J. P. M.; Kooper, A. J. A.; van Kessel, A. Geurts; Braat, D. D. M.; Smits, A. P. T.

    2011-01-01

    Objective. To assess the diagnostic relevance of incidental prenatal findings of sex chromosome aneuploidies. Methods. We searched with medical subject headings (MeSHs) and keywords in Medline and the Cochrane Library and systematically screened publications on postnatally diagnosed sex chromosomal aneuploidies from 2006 to 2011 as well as publications on incidentally prenatally diagnosed sex chromosomal aneuploidies from 1980 to 2011. Results. Postnatally diagnosed sex chromosomal aneuploidies demonstrated three clinical relevant domains of abnormality: physical (22–100%), behavior (0–56%), and reproductive health (47–100%), while incidentally prenatally diagnosed sex chromosomal aneuploidies demonstrated, respectively, 0–33%, 0–40%, and 0–36%. Conclusion. In the literature incidental prenatal diagnosis of sex chromosomal aneuploidies is associated with normal to mildly affected phenotypes. This contrasts sharply with those of postnatally diagnosed sex chromosomal aneuploidies and highlights the importance of this ascertainment bias towards the prognostic value of diagnosis of fetal sex chromosomal aneuploidies. This observation should be taken into account, especially when considering excluding the sex chromosomes in invasive prenatal testing using Rapid Aneuploidy Detection. PMID:22191050

  2. Incidental Diagnosis of Diffuse Intrinsic Pontine Glioma in Children

    PubMed Central

    Wright, K. D.; Sabin, N. D.; Cheuk, D.; McNall-Knapp, R. Y.; Shurtleff, S. A.; Gajjar, A.; Broniscer, A.

    2014-01-01

    Children with diffuse intrinsic pontine glioma (DIPG) have a short onset, rapidly progressive neurologic decline before diagnosis. Therefore, incidental diagnosis of such an aggressive cancer is counterintuitive, yet our experience shows DIPG may occur as part of a spectrum of incidentally diagnosed pediatric brain cancers. Although children with incidentally diagnosed DIPG may experience a longer survival, it remains a potentially deadly cancer despite treatment with radiotherapy. Histologic confirmation is warranted when feasible in such patients to confirm diagnosis. Moreover, recent advances in genome-wide analyses may suggest incidentally diagnosed DIPGs are biologically distinct from the majority of these cancers. PMID:25598012

  3. Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma.

    PubMed

    Kocaoglu, M; Bulakbasi, N; Ucoz, T; Ustunsoz, B; Pabuscu, Y; Tayfun, C; Somuncu, I

    2003-07-01

    We compared contrast-enhanced T1-weighted and 3D constructive interference in steady state (CISS) sequences for demonstrating possible prognostic factors in hearing-preservation surgery for vestibular schwannoma. We studied 22 patients with vestibular schwannomas having hearing-preservation surgery. Postoperatively six (27%) had a facial palsy and eight (36%) had hearing loss. There was a significant correlation between the size of the tumour and facial palsy (r=-0.72). Both techniques adequately demonstrated all tumours. Involvement of the fundus of the internal auditory canal (IAC) and a small distance between the lateral border of the tumour and the fundus were correlated significantly with hearing loss (r=-0.81 and -0.75, respectively). The 3D-CISS sequence, by virtue of its high contrast resolution was superior to T1-weighted images ( P<0.05) for detection of the fundal involvement. The direction of displacement of the facial nerve did not correlate with facial palsy or hearing loss. We think that 3D-CISS images better show the features influencing surgical outcome, but that contrast-enhanced T1-weighted images are required for diagnosis. PMID:12802547

  4. Clinical and Radiographic Factors Predicting Hearing Preservation Rates in Large Vestibular Schwannomas.

    PubMed

    Mendelsohn, Daniel; Westerberg, Brian D; Dong, Charles; Akagami, Ryojo

    2016-06-01

    Objectives Postoperative hearing preservation rates for patients with large vestibular schwannomas range from 0 to 43%. The clinical and radiographic factors predicting hearing preservation in smaller vestibular schwannomas are well described; however, their importance in larger tumors is unclear. We investigated factors predicting hearing preservation in large vestibular schwannomas. Design Retrospective review. Setting Quaternary care academic center. Participants A total of 85 patients with unilateral vestibular schwannomas > 3 cm underwent retrosigmoid resections. Main Outcomes Measures Preoperative and postoperative serviceable hearing rates. Methods Clinical and radiographic data including preoperative and postoperative audiograms, preoperative symptoms, magnetic resonance imaging features, and postoperative facial weakness were analyzed. Results Hearing was preserved in 41% of patients (17 of 42) with preoperative serviceable hearing. Hypertension and diabetes increased the likelihood of preoperative hearing loss. Preoperative tinnitus predicted a lower likelihood of hearing preservation. No radiographic factors predicted hearing preservation; however, larger tumor size, smaller fourth ventricular width, and the presence of a cerebrospinal fluid cleft surrounding the tumor predicted postoperative facial weakness. Conclusion Systemic comorbidities may influence hearing loss preoperatively in patients with large vestibular schwannomas. The absence of tinnitus may reflect hearing reserve and propensity for hearing preservation. Preoperative radiographic features did not predict hearing preservation despite some associations with postoperative facial weakness. PMID:27175312

  5. Vestibular schwannoma and cell-phones. Results, limits and perspectives of clinical studies.

    PubMed

    Mornet, E; Kania, R; Sauvaget, E; Herman, P; Tran Ba Huy, P

    2013-11-01

    The widespread development of cell-phones entails novel user exposure to electromagnetic fields. Health impact is a public health issue and a source of anxiety in the population. Some clinical studies reported an association between cell and cordless phone use and vestibular schwannoma; others found none. A systematic review was performed of all published clinical studies (cohort, registry, case-control and validation studies), with analysis of results, to determine the nature of the association and the level of evidence. Cohort studies were inconclusive due to short exposure durations and poor representativeness. Registry studies showed no correlation between evolution of cell-phone use and incidence of vestibular schwannoma. Case-control studies reported contradictory results, with methodological flaws. Only a small number of subjects were included in long-term studies (>10 years), and these failed to demonstrate any indisputable causal relationship. Exposure assessment methods were debatable, and long-term assessment was lacking. An on-going prospective study should determine any major effect of electromagnetic fields; schwannoma being a rare pathology, absence of association will be difficult to prove. No clinical association has been demonstrated between cell and cordless phone use and vestibular schwannoma. Existing studies are limited by their retrospective assessment of exposure.

  6. Association between intraosseous schwannoma occurrence and the position of the intraosseous nutrient vessel: A case report

    PubMed Central

    SUZUKI, KAYO; YASUDA, TAKETOSHI; WATANABE, KENTA; KANAMORI, MASAHIKO; KIMURA, TOMOATSU

    2016-01-01

    Intraosseous schwannoma is a rare benign bone tumor that originates from Schwann cells of the nerve sheath. The majority of intraosseous schwannomas arise in the mandible and sacrum, but an intraosseous schwannoma involving the ulna is described in the present case report. Radiologically, the current case presented as a well-defined lytic lesion, with a pathological fracture and no intralesional calcification, in the proximal metaphysis of the left ulna. Using magnetic resonance imaging, an intraosseous mass spreading out from the cortical defect was observed. The lesion appeared isointense to skeletal muscle on T1-weighted images, and hyperintense or heterogeneous on T2-weighted images. The differential diagnosis comprised benign bone tumors, including bone cyst, aneurysmal bone cyst, giant cell tumor and fibrous dysplasia. Based on the results of a needle biopsy, a schwannoma involving the ulnar bone was diagnosed, and tumor marginal resection followed by artificial bone grafting and fixation was performed. A total of one year subsequent to surgery, the patient exhibits no symptoms, and there is no evidence of disease recurrence. PMID:27123086

  7. Extracranial Facial Nerve Schwannoma Treated by Hypo-fractionated CyberKnife Radiosurgery

    PubMed Central

    Miyazaki, Shinichiro; Hori, Tomokatsu

    2016-01-01

    Facial nerve schwannoma is a rare intracranial tumor. Treatment for this benign tumor has been controversial. Here, we report a case of extracranial facial nerve schwannoma treated successfully by hypo-fractionated CyberKnife (Accuray, Sunnyvale, CA) radiosurgery and discuss the efficacy of this treatment. A 34-year-old female noticed a swelling in her right mastoid process. The lesion enlarged over a seven-month period, and she experienced facial spasm on the right side. She was diagnosed with a facial schwannoma via a magnetic resonance imaging (MRI) scan of the head and neck and was told to wait until the facial nerve palsy subsides. She was referred to our hospital for radiation therapy. We planned a fractionated CyberKnife radiosurgery for three consecutive days. After CyberKnife radiosurgery, the mass in the right parotid gradually decreased in size, and the facial nerve palsy disappeared. At her eight-month follow-up, her facial spasm had completely disappeared. There has been no recurrence and the facial nerve function has been normal. We successfully demonstrated the efficacy of CyberKnife radiosurgery as an alternative treatment that also preserves neurofunction for facial nerve schwannomas. PMID:27774363

  8. Generation of Noninvasive, Quantifiable, Orthotopic Animal Models for NF2-Associated Schwannoma and Meningioma.

    PubMed

    Burns, Sarah S; Chang, Long-Sheng

    2016-01-01

    Schwannomas and meningiomas are nervous system tumors that can occur sporadically or in patients with neurofibromatosis type 2 (NF2). Mutations of the Neurofibromatosis 2 (NF2) gene are frequently observed in these tumors. Schwannomas and meningiomas cause significant morbidities, and an FDA-approved medical therapy is currently not available. The development of preclinical animal models that accurately capture the clinical characteristics of these tumors will facilitate the evaluation of novel therapeutic agents for the treatment of these tumors, ultimately leading to more productive clinical trials. Here, we describe the generation of luciferase-expressing NF2-deficient schwannoma and meningioma cells and the use of these cells to establish orthotopic tumor models in immunodeficient mice. The growth of these tumors and their response to treatment can be measured effectively by bioluminescence imaging (BLI) and confirmed by small-animal magnetic resonance imaging (MRI). These and other animal models, such as genetically-engineered models, should substantially advance the investigation of promising therapies for schwannomas and meningiomas. PMID:27259921

  9. Anterior fossa schwannoma mimicking an olfactory groove meningioma: case report and literature review.

    PubMed

    Sauvaget, F; François, P; Ben Ismail, M; Thomas, C; Velut, S

    2013-04-01

    Intracranial schwannomas not associated with cranial nerves account for less than 1% of surgically treated schwannomas of the central and peripheral nervous system. With only 45 cases reported to date, subfrontal schwannomas are very rare tumors, leaving the issue of their origin controversial. A 66-year-old woman presented with a 1-year history of progressive headaches. Clinical examination revealed hypoesthesia of the nasal tip. CT-scan and MRI studies revealed a large subfrontal tumor thought preoperatively to be a meningioma. Intraoperatively, a large extra-axial tumor arising from the floor of the right frontal fossa was encountered. Histopathology identified the tumor as a schwannoma. This current case gives strong clinical presumption of an origin from the anterior ethmoidal nerve. We reviewed the literature in order to establish the epidemiology of these tumors, from which there appear to be divergent profiles depending on tumor origin and histology. Despite close similarities with olfactory groove meningiomas, patient history and radiological findings provide substantial evidence for differential diagnosis.

  10. An Extremely Giant Lumbar Schwannoma: New Classification (Kotil) and Mini-Open Microsurgical Resection

    PubMed Central

    2014-01-01

    Purely extradural giant lumbar schwannomas are rare lesions. Classification of these tumors is performed according to the sizes and spills and is named the modified Sridhar's classification. The management of these tumors has traditionally been performed by combined antero-posterior large or two-stage exposures. This combined exposure has many disadvantages. Recent reports have demonstrated the safety and efficacy of removal of these tumors using mini-open micro surgical resection for the schwannomas, but the safety and efficacy have not been established for extremely large giant tumors. We report a case of a giant L4 dumb-bell schwannoma successfully resected through a mini-open micro surgical resection. These neoplasms can be safely and effectively treated with mini-open techniques. Reduction in blood loss, hospitalization, and tissue disruption may be potential benefits of this approach. We discuss the technical details of this surgical approach along with the limitations and possible complications. In addition, this study is included in the current schwannoma (Kotil) classification. PMID:25187870

  11. Plexiform schwannoma of the duodenum accompanying pyloric stenosis: report of a case.

    PubMed

    Aktekın, Ali; Özkara, Selvinaz; Merıç, Kaan; Günay Gürleyık, Meryem; Aker, Fügen; Sağlam, Abdullah

    2012-08-01

    Plexiform schwannoma is a benign peripheral nerve sheath tumor and is composed of Schwann cells arranged in a plexiform pattern. Most plexiform schwannomas are skin tumors, and there has been no case report of this tumor originating in the duodenum. We describe the first known case of plexiform schwannoma of the duodenum. A 60-year-old man presented with a short history of food intolerance, epigastric discomfort, fullness and bloatedness, sometimes vomiting, and weight loss, without any clinical picture of neurofibromatosis. Upper gastrointestinal endoscopy revealed pyloric stenosis with normal mucosal lining. The computed tomography demonstrated circumferentially and concentrically thickened pylorus up to 18 mm with narrowed lumen and limited contrast passage. Antrectomy and gastrojejunostomy were performed due to unknown etiology of the obstruction. The cut surface of the lesion revealed thickened pylorus up to 15 mm in a circumferential manner. It contained a 5 mm tumor consisted of multiple white nodules in the submucosal and subserosal layers with overlying duodenal mucosa. Microscopic examination revealed nodular structures composed of spindle cells within fascicular pattern without any atypia or mitosis. Immunohistochemical examination revealed that the cells diffusely and strongly expressed S100 proteins in a nuclear and cytoplasmic pattern, but not CD117, smooth muscle actin, desmin, or CD34, confirming plexiform schwannoma. PMID:22965512

  12. Surgical Approach to the Cavernous Sinus for a Trigeminal Schwannoma Resection: Technical Note and Case Report

    PubMed Central

    Caruso, Riccardo; Wierzbicki, Venceslao; Marrocco, Luigi; Piccione, Emanuele

    2016-01-01

    We report a rare case of schwannoma of the lateral wall of the cavernous sinus, an exceedingly rare lesion affecting this anatomical district, and discuss salient aspects of the surgical approach to the cavernous sinus, which are traditionally considered technically challenging due to the high risk of postoperative morbidity and mortality related to the presence of the cranial nerves and internal carotid artery.

  13. Minimally Invasive Surgery for Intracochlear Schwannoma Removal and Simultaneous Cochlear Implantation

    PubMed Central

    Bento, Ricardo Ferreira; Gebrim, Eloisa Maria Mello Santiago; Magalhães, Ana Tereza de Matos; Pereira, Larissa Vilela; Fonseca, Anna Carolina de Oliveira

    2016-01-01

    Introduction  Hearing preservation has not yet been reported in patients undergoing resection of intracochlear schwannomas. This study describes a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation that resulted in good hearing. Objective  This study aims to describe a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation. Data Synthesis  The technique described in this study was developed for a 55-year-old male with a 20-year history of bilateral progressive hearing loss and tinnitus that had a mass in the left apical turn of the cochlea measuring 0.3 cm. Surgery accessed the apical turn of the cochlea. We performed mastoidectomy and posterior tympanotomy and removed incus and tensor tympani muscle to expose the cochlear apex. The tumor was identified and completely resected. After the cochlea was anatomically preserved, it was implanted with a straight electrode via round window insertion. The histopathological examination confirmed intracochlear schwannoma. Speech perception test revealed 100% speech recognition with closed sentences and the average audiometric threshold (500 to 2000 Hz) was 23 dB. Conclusion  Our technique led to rehabilitation of the patient and improved hearing without damaging the intracochlear structure, making it possible to perform CI in the same procedure with good results. PMID:27413411

  14. [Retroperitoneal cystic schwannoma. Review of literature. A case report (author's transl)].

    PubMed

    Suhler, A; Blanchard, J

    One case of retroperitoneal cystic schwannoma (neurilemoma) in a 35 year old woman is described. With a review of literature are analysed the clinical and anatomo-pathological features of this uncommon tumour and the methods of diagnosis and surgical treatment.

  15. AR42, a novel histone deacetylase inhibitor, as a potential therapy for vestibular schwannomas and meningiomas

    PubMed Central

    Bush, Matthew L.; Oblinger, Janet; Brendel, Victoria; Santarelli, Griffin; Huang, Jie; Akhmametyeva, Elena M.; Burns, Sarah S.; Wheeler, Justin; Davis, Jeremy; Yates, Charles W.; Chaudhury, Abhik R.; Kulp, Samuel; Chen, Ching-Shih; Chang, Long-Sheng; Welling, D. Bradley; Jacob, Abraham

    2011-01-01

    Neurofibromatosis type 2 (NF2) is an autosomal-dominant disease that results in the formation of bilateral vestibular schwannomas (VSs) and multiple meningiomas. Treatment options for NF2-associated tumors are limited, and to date, no medical therapies are FDA approved. The ideal chemotherapeutic agent would inhibit both VS and meningiomas simultaneously. The objectives of this study are (1) to test the efficacy of AR42, a novel histone deacetylase inhibitor, to inhibit VS and meningioma growth and (2) to investigate this drug's mechanisms of action. Primary cultures of human VS and meningioma cells were established. Nf2-deficient mouse schwannoma and benign human meningioma Ben-Men-1 cells were also cultured. Cells were treated with AR42, and the drug's effects on proliferation and the cell cycle were analyzed using a methanethiosulfonate assay and flow cytometry, respectively. Human phospho-kinase arrays and Western blots were used to evaluate the effects of AR42 on intracellular signaling. The in vivo efficacy of AR42 was investigated using schwannoma xenografts. Tumor volumes were quantified using high-field, volumetric MRI, and molecular target analysis was performed using immunohistochemistry. AR42 inhibited the growth of primary human VS and Nf2-deficient mouse schwannoma cells with a half maximal inhibitory concentration (IC50) of 500 nM and 250–350 nM, respectively. AR42 also inhibited primary meningioma cells and the benign meningioma cell line, Ben-Men-1, with IC50 values of 1.5 µM and 1.0 µM, respectively. AR42 treatment induced cell-cycle arrest at G2 and apoptosis in both VS and meningioma cells. Also, AR42 exposure decreased phosphorylated Akt in schwannoma and meningioma cells. In vivo treatment with AR42 inhibited the growth of schwannoma xenografts, induced apoptosis, and decreased Akt activation. The potent growth inhibitory activity of AR42 in schwannoma and meningioma cells suggests that AR42 should be further evaluated as a potential

  16. Central pancreatectomy for pancreatic schwannoma: A case report and literature review

    PubMed Central

    Xu, Shao-Yan; Sun, Ke; Owusu-Ansah, Kwabena Gyabaah; Xie, Hai-Yang; Zhou, Lin; Zheng, Shu-Sen; Wang, Wei-Lin

    2016-01-01

    Schwannomas are mesenchymal tumors originating from Schwann cells in peripheral nerve sheaths. Although the tumor can be located in any part of the human body, the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are rare. To our knowledge, only 64 cases of pancreatic schwannoma have been reported in the English literature over the past 40 years. In this paper, we present a pancreatic schwannoma in a 59-year-old female. Ultrasound, computed tomography and magnetic resonance imaging revealed the tumor located in the pancreatic body; however, accurate diagnosis was hard to obtain preoperatively and a pancreatic cystadenoma was preliminarily considered. During laparotomy, the mass was found in the body of the pancreas. An enlarged gallbladder with multiple stones was also observed. We performed central pancreatectomy, end-to-side pancreaticojejunostomy and cholecystectomy. Notably, central pancreatectomy has been reported in only one case prior to this report. The gross specimen showed a mass with a thin capsule, 1.6 cm × 1.1 cm × 1.1 cm in size. Microscopic examination showed that the tumor was mainly composed of spindle-shaped cells with palisading arrangement and no atypia, which is consistent with a benign tumor. Both hypercellular and hypocellular areas were visible. Immunohistochemical staining revealed strongly positive results for protein S-100. Finally, the tumor was diagnosed as a schwannoma of the pancreatic body. Postoperatively, the patient recovered well and left the hospital 6 d later. During the 53-mo follow-up period, the patient remained well and free of complications. PMID:27729750

  17. Long-Term Results for Trigeminal Schwannomas Treated With Gamma Knife Surgery

    SciTech Connect

    Hasegawa, Toshinori Kato, Takenori; Iizuka, Hiroshi; Kida, Yoshihisa

    2013-12-01

    Purpose: Surgical resection is considered the desirable curative treatment for trigeminal schwannomas. However, complete resection without any complications remains challenging. During the last several decades, stereotactic radiosurgery (SRS) has emerged as a minimally invasive treatment modality. Information regarding long-term outcomes of SRS for patients harboring trigeminal schwannomas is limited because of the rarity of this tumor. The aim of this study was to evaluate long-term tumor control and functional outcomes in patients harboring trigeminal schwannomas treated with SRS, specifically with gamma knife surgery (GKS). Methods and Materials: Fifty-three patients harboring trigeminal schwannomas treated with GKS were evaluated. Of these, 2 patients (4%) had partial irradiation of the tumor, and 34 patients (64%) underwent GKS as the initial treatment. The median tumor volume was 6.0 cm{sup 3}. The median maximum and marginal doses were 28 Gy and 14 Gy, respectively. Results: The median follow-up period was 98 months. On the last follow-up image, 7 patients (13%) had tumor enlargement, including the 2 patients who had partial treatment. Excluding the 2 patients who had partial treatment, the actuarial 5- and 10-year progression-free survival (PFS) rates were 90% and 82%, respectively. Patients with tumors compressing the brainstem with deviation of the fourth ventricle had significantly lower PFS rates. If those patients with tumors compressing the brainstem with deviation of the fourth ventricle are excluded, the actuarial 5- and 10-year PFS rates increased to 95% and 90%, respectively. Ten percent of patients had worsened facial numbness or pain in spite of no tumor progression, indicating adverse radiation effect. Conclusions: GKS can be an acceptable alternative to surgical resection in patients with trigeminal schwannomas. However, large tumors that compress the brainstem with deviation of the fourth ventricle should be surgically removed first and then

  18. Preservation of auditory and vestibular function after surgical removal of bilateral vestibular schwannomas in a patient with neurofibromatosis type 2

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Brackmann, D. E.; Hitselberger, W. E.; Purdy, J.

    1995-01-01

    The outcome of acoustic neuroma (vestibular schwannoma) surgery continues to improve rapidly. Advances can be attributed to several fields, but the most important contributions have arisen from the identification of the genes responsible for the dominant inheritance of neurofibromatosis types 1 (NF1) and 2 (NF2) and the development of magnetic resonance imaging with gadolinium enhancement for the early anatomic confirmation of the pathognomonic, bilateral vestibular schwannomas in NF2. These advances enable early diagnosis and treatment when the tumors are small in virtually all subjects at risk for NF2. The authors suggest that advising young NF2 patients to wait until complications develop, especially hearing loss, before diagnosing and operating for bilateral eighth nerve schwannomas may not always be in the best interest of the patient. To the authors' knowledge, this is the first reported case of preservation of both auditory and vestibular function in a patient after bilateral vestibular schwannoma excision.

  19. 78 FR 18965 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... on OCS leases in the Chukchi Sea, Alaska, during the 2014 open-water season (78 FR 12542). NMFS... whether to issue an IHA. NMFS refers the reader to the February 22, 2013, Federal Register notice (78 FR... Specified Activities; Taking Marine Mammals Incidental to an Exploration Drilling Program in the Chukchi...

  20. 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

    ... Proposed IHA, initiating a 30- day public comment period, on February 22, 2013 (78 FR 12542). We then published a notice extending the comment period by 45 days on March 28, 2013 (78 FR 18965). On April 22... Specified Activities; Taking Marine Mammals Incidental to an Exploration Drilling Program in the Chukchi...

  1. 76 FR 4093 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... comment periods in the Federal Register on April 19, 2010 (74 FR 20482) for the Beaufort Sea request and May 7, 2010 (74 FR 25730) for the Chukchi Sea request. On May 27, 2010, following the April 20, 2010... Specified Activities; Taking Marine Mammals Incidental to Exploration Drilling Programs in the Chukchi...

  2. 77 FR 12246 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ... mammals incidental to black abalone (Haliotis cracherodii) research surveys. The first of five IHAs for the specified activities was issued to VanBlaricom on September 23, 2003 (68 FR 57427; October 3, 2003); the most recent of these was issued on January 18, 2008 (73 FR 4841; January 28, 2008),...

  3. 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

    ..., humpback, and fin whales, and is not likely to adversely affect sperm, sei, or blue whales and Kemp's..., and is not likely to adversely affect sperm, sei, or blue whales. National Environmental Policy Act... incidental harassment authorization for this activity pursuant to section 101(a)(5)(D) of the MMPA (74...

  4. 75 FR 24906 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ...: North Atlantic right whale; blue whale; fin whale; sei whale; minke whale; humpback whale; killer whale..., the North Atlantic right, blue, fin, sei, humpback, and sperm whales are all listed as endangered... the ``Estimated Take by Incidental Harassment'' section). Blue and sperm whales are not commonly......

  5. 78 FR 79403 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... proposal and preliminary determinations (78 FR 64918). The notice initiated a 30-day public comment period... incidental to these same proposed activities (77 FR 72327, December 5, 2012). That IHA expired on December 2... ADDRESSES) and the Notice of Proposed IHA (78 FR 64918, October 30, 2013). Community Structure...

  6. 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

    ... on monitoring of marine mammal reactions to rocket launches at Vandenberg Air Force Base. In those... Administration (NOAA), Commerce. ACTION: Notice; proposed incidental harassment authorization; request for... non-target species, if such an alternative action is chosen, during a proposed house mouse...

  7. 77 FR 67797 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... Administration (NOAA), Commerce. ACTION: Notice; issuance of an incidental harassment authorization. SUMMARY: In... Federal Register on August 27, 2012 (77 FR 51773), requesting comments from the public on the proposed... may be found in NMFS' Federal Register notice (77 FR 51773, August 27, 2012) and a summary is...

  8. 77 FR 59211 - Marine Mammals; Incidental Take During Specified Activities; Proposed Incidental Harassment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-26

    ... (Level A harassment) for cetaceans (70 FR 1871, January 11, 2005). In the absence of data on which to... and ramp-up procedures would prevent Level A harassment and limit the number of incidental takes by... measures are thus expected to prevent any Level A harassment and to minimize Level B harassment. It...

  9. 77 FR 27283 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ...) for the onset of Level B harassment from pulsed sound sources. The Notice of Proposed IHA (76 FR 68974... harassment. Bowheads may engage in avoidance behavior preventing their exposure to these levels of sound, and...; issuance of an incidental harassment authorization. SUMMARY: In accordance with the Marine...

  10. 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

    ... expertise among trappers and non-trappers that may provide other minimization and mitigation measures in... inform the decision making process. In the draft EA, we attempted to quantify the incidental take of non-target wildlife (species other than lynx) in traps. We are particularly interested in whether there...

  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

    ... Mexico Inc. (Shell) for an Incidental Harassment Authorization (IHA) to take marine mammals, by... not limited to, migration, breathing, nursing, breeding, feeding, or sheltering . Summary of Request.... For example, at the Guerreo Negro Lagoon in Baja California, Mexico, which is one of the...

  12. Incidental Warthin Tumor on Pertechnetate Scintigraphy.

    PubMed

    Kulkarni, Mukta; Shetkar, Shubhangi; Joshi, Prathamesh; Kasaliwal, Sanket; Chaudhari, Shrikant

    2016-09-01

    A 30-year-old woman underwent Tc-pertechnetate scintigraphy for evaluation of thyrotoxicosis. The scintigraphy revealed hypervascular thyroid gland with markedly increased trapping function in both the lobes suggesting diagnosis of Graves disease. Incidentally, a hypervascular and pertechnetate avid focus was seen along the lateral margin of the right parotid gland. Pertechnetate avidity and site of uptake suggested possibility of Warthin tumor. Clinical examination and ultrasonography revealed a well-defined lesion in the superficial lobe of the right parotid gland favoring diagnosis of benign lesion. Postsurgery specimen confirmed diagnosis of Warthin tumor. PMID:27405035

  13. 20 CFR 202.14 - Service incidental to railroad transportation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Service incidental to railroad transportation. 202.14 Section 202.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYERS UNDER THE ACT § 202.14 Service incidental to railroad transportation....

  14. 20 CFR 202.14 - Service incidental to railroad transportation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Service incidental to railroad transportation. 202.14 Section 202.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYERS UNDER THE ACT § 202.14 Service incidental to railroad transportation....

  15. 20 CFR 202.14 - Service incidental to railroad transportation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Service incidental to railroad transportation. 202.14 Section 202.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYERS UNDER THE ACT § 202.14 Service incidental to railroad transportation....

  16. 20 CFR 202.14 - Service incidental to railroad transportation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Service incidental to railroad transportation. 202.14 Section 202.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYERS UNDER THE ACT § 202.14 Service incidental to railroad transportation....

  17. 29 CFR 793.12 - Related and incidental work.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Related and incidental work. 793.12 Section 793.12 Labor... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS EXEMPTION OF CERTAIN RADIO AND TELEVISION... Requirements for Exemption § 793.12 Related and incidental work. An employee who is employed primarily in...

  18. 29 CFR 793.12 - Related and incidental work.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Related and incidental work. 793.12 Section 793.12 Labor... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS EXEMPTION OF CERTAIN RADIO AND TELEVISION... Requirements for Exemption § 793.12 Related and incidental work. An employee who is employed primarily in...

  19. 29 CFR 793.12 - Related and incidental work.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Related and incidental work. 793.12 Section 793.12 Labor... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS EXEMPTION OF CERTAIN RADIO AND TELEVISION... Requirements for Exemption § 793.12 Related and incidental work. An employee who is employed primarily in...

  20. 20 CFR 202.14 - Service incidental to railroad transportation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Service incidental to railroad transportation. 202.14 Section 202.14 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYERS UNDER THE ACT § 202.14 Service incidental to railroad transportation....

  1. 29 CFR 793.12 - Related and incidental work.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Related and incidental work. 793.12 Section 793.12 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL... Requirements for Exemption § 793.12 Related and incidental work. An employee who is employed primarily in...

  2. 29 CFR 793.12 - Related and incidental work.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Related and incidental work. 793.12 Section 793.12 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL... Requirements for Exemption § 793.12 Related and incidental work. An employee who is employed primarily in...

  3. Implications of an Incidental Pulmonary Arteriovenous Malformation

    PubMed Central

    Holden, Van K.; Shah, Nirav G.; Verceles, Avelino C.

    2016-01-01

    Introduction. Pulmonary arteriovenous malformations (PAVMs) have been associated with life-threatening complications, such as stroke and massive hemoptysis, thus posing significant morbidity if left untreated. We report a case of an incidental finding of a PAVM in a trauma patient newly recognized to have suspected hereditary hemorrhagic telangiectasia (HHT). Case Description. A 34-year-old man with a history of recurrent epistaxis presented with a sudden fall associated with seizure-like activity. Trauma imaging showed a large subdural hematoma and, incidentally, a serpiginous focus within the right upper lobe with a prominent feeding artery consistent with a PAVM. The patient was diagnosed with a simple PAVM related to possible or suspected HHT, an autosomal dominant trait with age-related penetrance. He underwent a pulmonary arteriography of the right upper and lower lobe with the use of a microcatheter system; however, the PAVM could not be visualized. Thus, he was managed medically. The patient was educated on the need for prophylactic antibiotics prior to dental procedures and surveillance imaging. Discussion. Our case highlights the importance of obtaining a complete past medical and family history in young patients with a history of recurrent epistaxis to elicit features of HHT. The diagnosis can be made clinically and directly affects family members, who would otherwise not receive appropriate screening. PMID:27027094

  4. Incidental Finding and Management of Mesenteric Fibromatosis

    PubMed Central

    Nicolas, Gregory; Kfoury, Tony; Shimlati, Rasha; Tohme, Maroon; Wakim, Raja

    2016-01-01

    Patient: Male, 45 Final Diagnosis: Mesenteric fibromatosis Symptoms: — Medication: — Clinical Procedure: Surgical removal of the mesenteric fibromatosis Specialty: Surgery Objective: Rare disease Background: Mesenteric fibromatosis, also known as mesenteric desmoids, is part of the clinical-pathologic spectrum of deep fibromatosis, which encompasses a group of benign fibro-proliferative processes that are locally aggressive and have the capacity to infiltrate or recur without metastasis. Case Report: Case of a 45-year-old man, with a history of hypertension and lung fibrosis, presenting for a left abdominal mass, which was found incidentally during his lung fibrosis imaging. He complained of constipation due to pressure upon his bowel leading to difficulty in defecation. Conclusions: Although there are many overlapping criteria between gastrointestinal stromal tumors and mesenteric fibromatosis, making it difficult to discriminate between the two, there are differences that are unique to mesenteric fibromatosis that should be noticed during the diagnosis. In this case, mesenteric fibromatosis was unusual as it is not associated with Gardner’s syndrome, desmoid tumors, nor familial adenomatous polyposis, but was an incidental finding. PMID:27279600

  5. Incidental statistical summary representation over time.

    PubMed

    Oriet, Chris; Hozempa, Kadie

    2016-01-01

    Information taken in by the human visual system allows individuals to form statistical representations of sets of items. One's knowledge of natural categories includes statistical information, such as average size of category members and the upper and lower boundaries of the set. Previous research suggests that when subjects attend to a particular dimension of a set of items presented over an extended duration, they quickly learn about the central tendency of the set. However, it is unclear whether such learning can occur incidentally, when subjects are not attending to the relevant dimension of the set. The present study explored whether subjects could reproduce global statistical properties of a set presented over an extended duration when oriented to task-irrelevant properties of the set. Subjects were tested for their memory of its mean, its smallest and largest exemplars, the direction of its skew, and the relative distribution of the items. Subjects were able to accurately recall the average size circle, as well as the upper and lower boundaries of a set of 4,200 circles displayed over an extended period. This suggests that even without intending to do so, they were encoding and updating a statistical summary representation of a task-irrelevant attribute of the circles over time. Such incidental encoding of statistical properties of sets is thus a plausible mechanism for establishing a representation of typicality in category membership. PMID:26830709

  6. 76 FR 41463 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ...NMFS has received an application from the University of Alaska Geophysics Institute (UAGI) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to conducting a marine geophysical seismic survey in the Arctic Ocean during September- October 2011. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to......

  7. 78 FR 29705 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-21

    ... application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals....noaa.gov/pr/permits/incidental.htm . Supplemental documents provided by the U.S. Navy may be found at..., (301) 427-8401. SUPPLEMENTARY INFORMATION: Background Sections 101(a)(5)(A) and (D) of the MMPA (16...

  8. Incidental emotions influence risk preference and outcome evaluation.

    PubMed

    Zhao, Ding; Gu, Ruolei; Tang, Ping; Yang, Qiwei; Luo, Yue-Jia

    2016-10-01

    Incidental emotions, which are irrelevant to the current decision, play a significant role in the decision-making process. In this study, to investigate the influence of incidental emotions on behavioral, psychological, and electrophysiological responses in the process of decision making, participants were required to perform a monetary gambling task. During the selection stage, an emotional picture, which was chosen from the Chinese Affective Picture System and fell into one of three categories: negative, neutral, and positive, was presented between two alternatives (small/large amount of bet). The pictures were provided to induce incidental emotions. ERPs and self-rating emotional experiences to outcome feedback were recorded during the task. Behavioral results showed that positive incidental emotions elicited risk preference, but emotional experiences to outcome feedback were not influenced by incidental emotions. The feedback-related negativity amplitudes were larger in the positive emotion condition than in the negative and neutral emotion conditions for small outcomes (including wins and losses), whereas there was no difference between the three conditions for large outcomes. In addition, the amplitudes of P3 were reduced overall in the negative emotion condition. We suggest that incidental emotions have modulated both the option assessment stage (manifested in behavioral choices) and the outcome evaluation stage (manifested in ERP amplitudes) of decision making unconsciously (indicated by unchanged subjective emotional experiences). The current findings have expanded our understanding of the role of incidental emotion in decision making.

  9. Incidental emotions influence risk preference and outcome evaluation.

    PubMed

    Zhao, Ding; Gu, Ruolei; Tang, Ping; Yang, Qiwei; Luo, Yue-Jia

    2016-10-01

    Incidental emotions, which are irrelevant to the current decision, play a significant role in the decision-making process. In this study, to investigate the influence of incidental emotions on behavioral, psychological, and electrophysiological responses in the process of decision making, participants were required to perform a monetary gambling task. During the selection stage, an emotional picture, which was chosen from the Chinese Affective Picture System and fell into one of three categories: negative, neutral, and positive, was presented between two alternatives (small/large amount of bet). The pictures were provided to induce incidental emotions. ERPs and self-rating emotional experiences to outcome feedback were recorded during the task. Behavioral results showed that positive incidental emotions elicited risk preference, but emotional experiences to outcome feedback were not influenced by incidental emotions. The feedback-related negativity amplitudes were larger in the positive emotion condition than in the negative and neutral emotion conditions for small outcomes (including wins and losses), whereas there was no difference between the three conditions for large outcomes. In addition, the amplitudes of P3 were reduced overall in the negative emotion condition. We suggest that incidental emotions have modulated both the option assessment stage (manifested in behavioral choices) and the outcome evaluation stage (manifested in ERP amplitudes) of decision making unconsciously (indicated by unchanged subjective emotional experiences). The current findings have expanded our understanding of the role of incidental emotion in decision making. PMID:27354122

  10. Giant Primary Schwannoma of the Left Nasal Cavity and Ethmoid Sinus

    PubMed Central

    Kong, Justin; Oh, Lawrence; Cox, Daniel; Forer, Martin

    2016-01-01

    A unilateral tumour in the nasal cavity or paranasal sinuses is commonly caused by polyps, cysts, and mucoceles, as well as invasive tumours such as papillomas and squamous cell carcinomas. Schwannomas, in contrast, are rare lesions in this area (Minhas et al., 2013). We present a case of a 52-year-old female who presented with a 4-year progressive history of mucous hypersecretion, nasal obstruction, pain, and fullness. Imaging of the paranasal sinuses showed complete opacification of the entire left nasal cavity and sinuses by a tumour causing subsequent obstruction of the frontal and maxillary sinuses. The tumour was completely excised endoscopically. Histopathology was consistent with that of a schwannoma. PMID:27379190

  11. [Oculomotor nerve schwannoma in a child: Case report and literature review].

    PubMed

    Jibia, A; Chenin, L; Lefranc, M; Peltier, J

    2015-08-01

    An isolated schwannoma of the oculomotor nerve is rare in children without an associated neurofibromatosis. A 13-year-old girl, with a previous medical history of migraine, was admitted for disabling ophthalmic migraine with oblique diplopia. The clinical examination showed a right incomplete ophthalmoplegia with reduced ipsilateral visual acuity (8/10). There was no particular skin reaction. The MRI revealed a right (isosignal-T1 and isosignal-T2) nodular schwannoma located within the cisternal segment of the oculomotor nerve. The angio-CT performed later confirmed the absence of any vascular malformation. The treatment consisted of analgesics and corticotherapy, with complete regression of symptoms three weeks later and a normal MRI follow-up. Therefore, radiosurgery was not performed. PMID:26071177

  12. Giant Primary Schwannoma of the Left Nasal Cavity and Ethmoid Sinus.

    PubMed

    Wong, Eugene; Kong, Justin; Oh, Lawrence; Cox, Daniel; Forer, Martin

    2016-01-01

    A unilateral tumour in the nasal cavity or paranasal sinuses is commonly caused by polyps, cysts, and mucoceles, as well as invasive tumours such as papillomas and squamous cell carcinomas. Schwannomas, in contrast, are rare lesions in this area (Minhas et al., 2013). We present a case of a 52-year-old female who presented with a 4-year progressive history of mucous hypersecretion, nasal obstruction, pain, and fullness. Imaging of the paranasal sinuses showed complete opacification of the entire left nasal cavity and sinuses by a tumour causing subsequent obstruction of the frontal and maxillary sinuses. The tumour was completely excised endoscopically. Histopathology was consistent with that of a schwannoma. PMID:27379190

  13. A report of three cases of surgical removal of esophageal schwannomas.

    PubMed

    Chen, Xiankai; Li, Yin; Liu, Xianben; Fu, Huaiping; Sun, Haibo; Zhang, Ruixiang; Wang, Zongfei; Zheng, Yan

    2016-05-01

    Esophageal schwannomas are rarely observed, and the most frequent presenting symptom is dysphagia. In such cases, esophageal endoscopy shows a mucosal protrusion with normal esophageal mucosa. Esophagography shows a protruding smooth mass in the middle thoracic esophagus. Both fluorodeoxyglucose (FDG) positron emission tomography (PET) and endoscopic ultrasonography-fine needle aspiration (EUS-FNA) are limited for diagnosing the case. Diagnosis of this condition before surgery is difficult. The most common and effective treatment is enucleation through surgery or endoscopy. Thoracoscopic surgery is gradually becoming used more often, and the prognosis is particularly good. In comparison, thoracoscopy surgery is less invasive, with a shorter length of hospital stay, and reduced pain at the surgical wound site. Extended lymph node dissection was not performed. The positive expression of S-100 on immunohistochemistry examination indicates the nature of the schwannoma. In the present cases, the postoperative course was uneventful, and no evidence of recurrence has been noted. PMID:27162699

  14. [Transmanubrial Osteomuscular-sparing Approach for Resection of Superior Mediastinal Schwannoma].

    PubMed

    Aragaki, Masato; Iimura, Yasuyuki; Sato, Nagato; Fukuda, Naoya; Miyazaki, Dai; Umemoto, Kazufumi; Yoshida, Yusuke; Hasegawa, Naoto

    2016-08-01

    Various approaches can be applied to resect superior mediastinal tumor. It is important to choose the procedure according to the location, size, and characteristics of the tumor in order to perform safe procedure surgery because of distinctive anatomy of this site. We hereby report on a case of Schwannoma of the superior mediastinum resected by the transmanubrial approach. A 67-year-old woman was referred to our department to examine an abnormal chest shadow found at a regular health checkup. Computed tomography revealed a tumor 58×52 mm in size extending from the left supraclavicular fossa to the upper border of the aortic arch. The surgery was performed under the diagnosis of neurogenic tumor using the transmanubrial approach. The tumor was resected safely and the pathological diagnosis was a Schwannoma. Transmanubrial approach was found to be quite useful in securing an adequate visual field and enabling the safe separation of blood vessels and nerves from the tumor. PMID:27476565

  15. A Case of Benign Esophageal Schwannoma Causing Life-threatening Tracheal Obstruction

    PubMed Central

    Nakamura, Tetsu; Otowa, Yasunori; Imanishi, Tatsuya; Tanaka, Yugo; Maniwa, Yoshimasa; Kakeji, Yoshihiro

    2015-01-01

    A 59-year-old woman presented with a 1-year history of dysphagia. She suffered from a large mediastinal mass obstructing trachea and bilateral main bronchus, which led to dyspnea and disturbed consciousness. Immediate intubation and surgery was required. A solid tumor that included esophagus and right vagal nerve, and adhered to the membranous part of the bronchus was found. However, the tumor could be resected en bloc and the patient has been free from recurrence. Pathologically, the tumor exhibited proliferative spindle cells and was diffusely positive for S-100 protein. It was therefore diagnosed as a benign esophageal schwannoma. To our knowledge, this is the first report of tracheal obstruction from a benign esophageal schwannoma, which we successfully treated with emergency subtotal esophagectomy. PMID:25740444

  16. Relevance of an incidental chest finding

    PubMed Central

    Cortés-Télles, Arturo; Mendoza, Daniel

    2012-01-01

    Solitary pulmonary nodule represents 0.2% of incidental findings in routine chest X-ray images. One of the main diagnoses includes lung cancer in which small-cell subtype has a poor survival rate. Recently, a new classification has been proposed including the very limited disease stage (VLD stage) or T1-T2N0M0 with better survival rate, specifically in those patients who are treated with surgery. However, current recommendations postulate that surgery remains controversial as a first-line treatment in this stage. We present the case of a 46-year-old female referred to our hospital with a preoperative diagnosis of a solitary pulmonary nodule. On initial approach, a biopsy revealed a small cell lung cancer. She received multimodal therapy with surgery, chemotherapy, and prophylactic cranial irradiation and is currently alive without recurrence on a 2-year follow-up. PMID:22345914

  17. 76 FR 79157 - Takes of Marine Mammals Incidental to Specified Activities; St. George Reef Light Station...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ...), for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment incidental to... SGRLPS to incidentally harass, by Level B harassment only, four species of marine mammals during the... Commerce to authorize, upon request, the incidental, but not intentional, taking by harassment of...

  18. SU-E-T-536: Inhomogeneity Correction in Planning of Gamma Knife Treatments for Acoustic Schwannoma

    SciTech Connect

    Lu, L; Gupta, N; Hessler, J; Liu, A; Weldon, M; McGregor, J; Ammirati, M; Guiou, M; Xia, F; Grecula, J

    2014-06-01

    Purpose: To find out the dose difference on targets and organs at risk for the treatment of acoustic schwannoma if the inhomogeneity correction (Convolution algorithm) is applied. Methods: Images of patients treated for acoustic schwannoma with Gamma Knife using TMR 10 algorithm were retrieved from database and replanned with Convolution and TMR 10 algorithm respectively. These patients were treated using a preplan scheme in following: (1) Before the actual treatment day, using the MRI image that was taken without a head frame on the patient's skull, a pre-treatment plan was made based on the default skull coordinates in the Gamma Knife treatment planning system (LGP); (2) then on treatment day, a head frame was placed on the patient's skull, and a CT image was taken. The CT image with head frame was registered and fused with the completed preplan; (3) the treatment plan was finalized and the treatment was delivered. To find out the dosimetry impact of inhomogeneity correction, we used the retrieved CT images to replan the treatment using Convolution algorithm in LGP software version 10.1.1. The dose distributions and the dose volume histograms for targets and OARs were compared for these two dose calculation algorithms. Results: The dose calculated with the Convolution algorithm in general is slightly lower than the one from TMR 10 around the boney area. The effect from the inhomogeneity correction is observable but not significant, and varies with the location of the tumor. Conclusion: Inhomogeneity correction slightly improve the dose accuracy for acoustic schwannoma Gamma Knife treatments although the correction may not be very significant. Our Result provides evidence for dose prescription adjustment to treat acoustic schwannoma. The actual clinical outcome of switching from using TMR10 to using Convolution needs to be further investigated.

  19. Natural Compounds as Potential Treatments of NF2-Deficient Schwannoma and Meningioma: Cucurbitacin D and Goyazensolide

    PubMed Central

    Spear, Samuel A.; Burns, Sarah S.; Oblinger, Janet L.; Ren, Yulin; Pan, Li; Kinghorn, A. Douglas; Welling, D. Bradley; Chang, Long-Sheng

    2015-01-01

    Hypothesis Cucurbitacin D and goyazensolide, two plant-derived natural compounds, possess potent growth-inhibitory activity in schwannoma and meningioma cells. Background Currently, no FDA-approved drugs are available for neurofibromatosis type 2 (NF2)-associated schwannomas and meningiomas. Selected natural compounds with antineoplastic activity, such as cucurbitacin and goyazensolide, may be developed as potential treatments for these tumors. Methods The Nf2-deficient mouse schwannoma Sch10545 and human benign meningioma Ben-Men-1 cells were treated with various concentrations of cucurbitacin D and goyazensolide. The effect on cell proliferation was determined using resazurin assays. Flow cytometry was used to assess the cell cycle profiles. Western blot analysis was performed to investigate the expression of various signal molecules related to the cell cycle and the AKT pathway. Results Cucurbitacin D inhibited proliferation of Sch10545 cells (IC50 ~0.75 μM) and Ben-Men-1 cells (IC50 ~0.2 μM). Goyazensolide also reduced cell proliferation of Sch10545 cells (IC50 ~0.9 μM) and Ben-Men-1 cells (IC50 ~1 μM). The G2/M population increased in both Sch10545 and Ben-Men-1 cells treated with cucurbitacin D or goyazensolide around the IC50. Cucurbitacin and goyazensolide substantially reduced the levels of cyclins E and A in treated Sch10545 and Ben-Men-1 cells. Cucurbitacin D also inhibited cyclin B, phospho-AKT and phospho-PRAS40 expression. In addition, goyazensolide reduced the levels of phospho-AKT and NFκB and increased the expression of pro-apoptotic Bim in Sch10545 and Ben-Men-1 cells. Conclusions Both cucurbitacin D and goyazensolide effectively inhibit proliferation of NF2-deficient schwannoma and meningioma cells, suggesting that these natural compounds should be further evaluated as potential treatments for NF2-related tumors. PMID:23928514

  20. The diagnostic dilemma of a parasympathetic schwannoma in the submandibular gland.

    PubMed

    Patel, M; Srinivasan, B; Sharma, S

    2015-03-01

    Schwannomas are benign soft tissue tumours that arise from nerve sheath cells. They are rare in the salivary glands and are thought to arise from the parasympathetic nerves. We report the case of a 69-year-old man who presented with a painless right submandibular mass that appeared to resemble a pleomorphic adenoma on ultrasonography and, on this basis, proceeded to surgical excision of the gland. We review the relevant literature and highlight the diagnostic pitfalls.

  1. Diffusion-weighted imaging in extracranial head and neck schwannomas: A distinctive appearance

    PubMed Central

    Das, Abanti; Bhalla, Ashu S; Sharma, Raju; Kumar, Atin; Thakar, Alok; Goyal, Ankur

    2016-01-01

    Purpose: To evaluate the diffusion weighted (DW) magnetic resonance imaging (MRI) features of the extracranial schwannomas of head and neck. Materials and Methods: The MRI (including DWI) of 12 patients with pathologically proven head and neck schwannomas (4 men, 8 women, with mean age of 32.6 years; age range 16–50 years) were retrospectively evaluated. Images were analyzed for signal intensity and morphology on conventional sequences followed by the qualitative evaluation of DW images (DWI) and measurement of apparent diffusion coefficient (ADC) values. Results: Majority of the tumors were located in the parapharyngeal space (8/12). All but one showed heterogeneous appearance, with 10 tumors showing scattered areas of hemorrhage. Eight out of 12 tumors showed intensely hyperintense core surrounded by intermediate signal intensity peripheral rim (reverse target sign) on T2-weighted (T2W) images. On DWI, these eight tumors showed a distinctive appearance, resembling target sign on trace DWI and reverse target on ADC map. Out of the remaining four tumors, one showed uniformly restricted diffusion whereas three showed free diffusion. Mean ADC value in the central area of free diffusion was 2.277 × 10−3 mm2/s (range of 1.790 × 10 −3 to 2.605 × 10−3 mm2/s) whereas in the peripheral area was 1.117 × 10−3 mm2/s (range of 0.656 × 10−3 to 1.701 × 10−3 mm2/s). Rest of the schwannomas showing free diffusion had a mean ADC value of 1.971 × 10−3 mm2/s. Conclusion: Majority of the head and neck schwannomas showed a characteristic appearance of free diffusion in the centre and restricted diffusion in the periphery of the mass. PMID:27413271

  2. Incidental gallbladder cancer after cholecystectomy: 1990 to 2014

    PubMed Central

    Dorobisz, Tadeusz; Dorobisz, Karolina; Chabowski, Mariusz; Pawłowski, Wiktor; Janczak, Dawid; Patrzałek, Dariusz; Janczak, Dariusz

    2016-01-01

    Introduction Cancer of the gallbladder is a serious diagnostic and therapeutic problem. According to the literature, 30% of cases are not confirmed before surgery. Other cases are detected incidentally by histopathology. Clinical trials and meta-analyses show that incidental gallbladder cancer (iGBC) occurs in 0.19%–2.8% of patients after cholecystectomy. The aim of this study was to analyze the incidence and severity of iGBC in cholecystectomy procedures performed in the surgical department at the 4th Military Teaching Hospital in Wroclaw during the years 1990–2014. Patients and methods In the years 1990–2014, a total of 7,314 cholecystectomies were performed in the surgical department because of cholecystolithiasis: 6,145 were performed using the laparoscopic approach (84.02%), 867 were performed as open surgery (11.8%), and 302 cases required conversion (5.1%). In this group, 5,214 of the patients were females (71.3%) and 2,100 were males (28.7%), with an average age of 54.7 years. Results We found 64 iGBC cases which were confirmed by histopathology. This represented 0.87% of all cases. In this group, 50 patients were females (78.1%) and 14 were males (21.8%), with an average age of 67.1 years. Of this group, 40 patients underwent a classic cholecystectomy, while 24 underwent laparoscopic procedures, out of which 13 cases ultimately required traditional surgery. The histopathology showed 15 carcinomas that were classified as G1 (23.4%), 28 were G2 (43.75%), and 21 were G3 (32.8%). Conclusion iGBC detected after a cholecystectomy due to cholecystolithiasis is a rare disease. We found iGBC in 0.87% of cases, which is on a comparable scale to the world literature. In the case of cancer, we frequently found it necessary to convert to an open surgical procedure. This cancer is more common in females and in people over 60 years of age. PMID:27540304

  3. Schwannoma of Upper Lip: Report of a Rare Case in a Rare Age Group

    PubMed Central

    Hajong, Debobratta; Naku, Narang; Sharma, Girish; Boruah, Manash

    2016-01-01

    Schwannoma is a benign, encapsulated perineural tumour originating from the schwann cells of the neural sheath of peripheral motor and sensory nerves. It may develop at any age but is extremely rare in paediatric age group. The tumour is frequently located on the head and neck region, the tongue being the most common site followed by the palate, floor of mouth, buccal mucosa, lips and jaws. Schwannomas rarely occur in the lip area and it is exceedingly rare in the upper lip. The lesion is usually solitary but can be multiple when associated with neurofibromatosis. The diagnosis is usually confirmed after biopsy and anti-S100 protein immuno-histochemical staining is usually used to identify the tumour. In the present study the patient was a 14-year-old young girl with the schwannoma on the upper lip which is probably the third such case in a paediatric age group being reported and was excised without any recurrence at 2 year after excision. PMID:27656503

  4. The clinical characteristics and treatment for sudden sensorineural hearing loss with vestibular schwannoma.

    PubMed

    Lin, Chang; Gong, Qilin; Zuo, Wenjing; Zhang, Rong; Zhou, Aidong

    2015-04-01

    The aim of this study is to analyze the clinical characteristics and treatment of sudden sensorineural hearing loss (SSNHL) patients with vestibular schwannoma (VS). The clinical features of the VS patients were explored by retrospectively analyzing the clinical data from 542 cases of SSNHL patients between January 2008 and March 2013. There were 10 cases (10 ears) diagnosed with VS in 542 cases of SSNHL patients (10 ears, 1.85 %), 3 males, 7 females, with a range of 28-57 years. Among all the cases, eight patients with abnormal ABR, ten with ear ipsilateral stapedius reflexes which were completely not elicited and seven patients with healthy ear contralateral stapedius reflexes which were completely not elicited. Neuromas were classified by Koos grades according to size (8 of grade I, 1 of grade II, 1 of grade IV). Eight small VS  patients were taken waiting and MRI therapy strategies. Meanwhile, we used glucocorticoid treatment and timely and short-term medication to improve the microcirculation of the inner ear for these patients. And four cases' hearing was improved. Some vestibular schwannomas have SSNHL as initial symptoms, especially the small ones in internal auditory canal. To prevent misdiagnosis or leak-diagnosis, MRI should be performed as a routine test for SSNHL, and ABR is sometimes necessary for SSNHL patients. It is also necessary to give appropriate treatment to protect hearing of the small vestibular schwannoma patients whose first symptoms are diagnosed as SSNHL in acute phase.

  5. Schwannoma of Upper Lip: Report of a Rare Case in a Rare Age Group.

    PubMed

    Hajong, Ranendra; Hajong, Debobratta; Naku, Narang; Sharma, Girish; Boruah, Manash

    2016-08-01

    Schwannoma is a benign, encapsulated perineural tumour originating from the schwann cells of the neural sheath of peripheral motor and sensory nerves. It may develop at any age but is extremely rare in paediatric age group. The tumour is frequently located on the head and neck region, the tongue being the most common site followed by the palate, floor of mouth, buccal mucosa, lips and jaws. Schwannomas rarely occur in the lip area and it is exceedingly rare in the upper lip. The lesion is usually solitary but can be multiple when associated with neurofibromatosis. The diagnosis is usually confirmed after biopsy and anti-S100 protein immuno-histochemical staining is usually used to identify the tumour. In the present study the patient was a 14-year-old young girl with the schwannoma on the upper lip which is probably the third such case in a paediatric age group being reported and was excised without any recurrence at 2 year after excision. PMID:27656503

  6. Lingual schwannoma involving the posterior lateral border of the tongue in a young individual: case report.

    PubMed

    Pereira, Luciano José; Pereira, Patrícia Peres Iucif; dos Santos, João de Paula; Reis Filho, Viator Ferreira; Dominguete, Paulo Roberto; Pereira, Alessandro A Costa

    2008-01-01

    A schwannoma, also called neurilemmoma, is a benign, encapsulated, slow growing tumor arising from the neural sheath's Schwann cells of the peripheral, cranial or autonomic nerves. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25-48% of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The current case reports a schwannoma of the tongue, found in a 12 year-old boy. The lesion was present for 6 months. The clinical examination revealed a 1.5x1.0 cm, sessile, rubbery, non-tender non-ulcerated mass on the right posterior lateral border of the tongue. An excisional biopsy was performed under local anesthesia. The histological sections showed a circumscribed submucosal nodule composed of spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence free after one year. PMID:19093653

  7. Cystic versus solid vestibular schwannomas: a series of 80 grade III-IV patients.

    PubMed

    Benech, Franco; Perez, Rosa; Fontanella, Marco Maria; Morra, Bruno; Albera, Roberto; Ducati, Alessandro

    2005-07-01

    Cystic acoustic neuromas are less frequent than solid ones and present different clinical and radiological features. Cystic schwannomas are larger, show a shorter clinical history and a different risk of postoperative complications. This study was designed to compare surgical results and complications of solid and cystic vestibular schwannomas of matching size operated upon via either a retrosygmoid or a translabyrinthine approach. The study included 80 patients presenting with grade III and IV acoustic vestibular schwannomas referred to the Neurosurgical and ENT team in the Department of Neuroscience of Torino, Italy. Twenty-six were cystic and 54 were solid tumours. Clinical history, surgical results and complications were compared between the two groups. In cystic tumors, rapid clinical worsening is common, due to sudden expansion of cystic elements. Tighter adherences are found between cystic tumours and nervous elements (particularly brainstem and possibly facial nerve), once compared to solid ones. Operative morbidity appears to be higher in cystic tumours. A wait and see policy should not to be applied to patients with cystic tumours. Careful technique, possibly sharp dissection, to divide the tumour adherences from the nervous tissue must be employed, in order to avoid lesions on brainstem veins and traction on a thin facial nerve. Severe complications may be caused by the excessive efforts to dissect brainstem adherences.

  8. Retroperitoneal schwannoma is characterized by a high incidence of cellular type and GFAP-immunoreactivity.

    PubMed

    Hirose, Takanori; Ishizawa, Keisuke; Sakaki, Mika; Fujii, Yoshiyuki

    2012-07-01

    To clarify the clinicopathologic characteristics of retroperitoneal schwannomas, which are sometimes confused with other spindle cell tumors, 27 cases were studied microscopically and immunohistochemically. The 27 cases consisted of 17 females and 10 males, the ages of whom ranged from 31-79 (mean 57.4) years. Gross examination revealed well-demarcated, encapsulated tumors, 3-15 cm (mean 8 cm) in diameter. Microscopic review divided them into 13 cases of cellular/fascicular, 3 of conventional, 6 of intermediate, and 5 of ancient type. Cellular/fascicular schwannomas were composed of cellular fascicles of spindle cells, in which nuclear palisading, Antoni B area and cyst were unclear, while numerous foamy cells were intermingled. Immunohistochemical investigation revealed diffuse, strong positivity for S-100 protein and Sox10 in all tumors studied. In addition, glial fibrillary acidic protein (GFAP) was extensively expressed in 92% of the cellular/fascicular type, while it was less prominent in others. The present study suggests that retroperitoneal schwannoma often occurs in the middle-aged woman, grows to a large size, exhibits cellular/fascicular microscopic features in half of the cases, and may arise from GFAP-positive Schwann cells. The presence of hyalinized vessels and dense infiltration of foamy macrophages as well as diffuse immunoreactivity for S-100 protein and Sox10 are helpful for the differential diagnosis.

  9. Malignant melanotic schwannian tumor: a clinicopathologic, immunohistochemical, and gene expression profiling study of 40 cases, with a proposal for the reclassification of "melanotic schwannoma".

    PubMed

    Torres-Mora, Jorge; Dry, Sarah; Li, Xinmin; Binder, Scott; Amin, Mitual; Folpe, Andrew L

    2014-01-01

    Melanotic schwannomas (MSs), variably associated with the Carney complex, are rare tumors that usually involve spinal nerve roots but may occur in other locations. Clinicopathologic evaluation poorly predicts the behavior of MS. Fewer than 200 cases have been reported. We report a series of 40 well-characterized MSs, one of the largest series to date. The tumors were comprehensively evaluated, and clinical follow-up was obtained. Immunohistochemistry for S100 protein, Melan-A, HMB45, tyrosinase, glial fibrillary acidic protein (GFAP), EMA, SMARCB1, Ki-67 antigen, ASMTL, and the Carney complex-associated PRKAR1A gene product was performed using commercially available antibodies and the Ventana Ultraview detection system. Gene microarray study was conducted on formalin-fixed, paraffin-embedded blocks from 10 MSs and the results compared with previous data from melanoma and schwannoma. Differentially expressed genes were selected at >3-fold and P<0.001. The Fisher exact test was used for statistical analysis. The tumors occurred in 18 male and 22 female patients (mean age 41 y; range, 11 to 84 y) and involved the paravertebral nerve roots (N=31), mediastinum (N=3), sacrum, cauda equina, para-aortic region, fifth cranial nerve, buttock, and cerebellum (N=1 each). Two patients had known Carney complex, and 1 patient also had a cutaneous myxoma, suggestive of Carney complex. The tumors expressed S100 protein (21/25, 84%), Melan-A (23/25, 92%), HMB45 (25/25, 100%), tyrosinase (25/25, 100%), GFAP (0/24, 0%), EMA (0/9, 0%), SMARCB1 (retained in 25/25, 100%), and ASMTL (5/19, 26%); PRKAR1A expression was lost in 7/20 cases (35%). Ki-67-labeling index was <5% in 23/25 cases (92%) and 5% to 10% in 2/25 cases (8%). Gene expression profiling showed significant differences between MS, melanoma, and conventional schwannoma. Clinical follow-up (26/40, 65%; mean 55 mo; range, 1 to 300 mo) showed local recurrences in 9/26 (35%) and metastases in 11/26 (44%) patients. Fourteen

  10. When Herbivores Eat Predators: Predatory Insects Effectively Avoid Incidental Ingestion by Mammalian Herbivores

    PubMed Central

    Ben-Ari, Matan; Inbar, Moshe

    2013-01-01

    The direct trophic links between mammalian herbivores and plant-dwelling insects have been practically ignored. Insects are ubiquitous on plants consumed by mammalian herbivores and are thus likely to face the danger of being incidentally ingested by a grazing mammal. A few studies have shown that some herbivorous hemipterans are able to avoid this peril by dropping to the ground upon detecting the heat and humidity on the mammal's breath. We hypothesized that if this risk affects the entire plant-dwelling insect community, other insects that share this habitat are expected to develop similar escape mechanisms. We assessed the ability of three species (adults and larvae) of coccinellid beetles, important aphid predators, to avoid incidental ingestion. Both larvae and adults were able to avoid incidental ingestion effectively by goats by dropping to the ground, demonstrating the importance of this behavior in grazed habitats. Remarkably, all adult beetles escaped by dropping off the plant and none used their functional wings to fly away. In controlled laboratory experiments, we found that human breath caused 60–80% of the beetles to drop. The most important component of mammalian herbivore breath in inducing adult beetles and larvae to drop was the combination of heat and humidity. The fact that the mechanism of dropping in response to mammalian breath developed in distinct insect orders and disparate life stages accentuates the importance of the direct influence of mammalian herbivores on plant-dwelling insects. This direct interaction should be given its due place when discussing trophic interactions. PMID:23424674

  11. The Radiological Prevalence of Incidental Kienböck Disease

    PubMed Central

    Golay, Saroj K.; Rust, Philippa; Ring, David

    2016-01-01

    Background: To determine the prevalence of incidental Kienböck disease. Methods: A retrospective analysis of 150,912 radiological reports or images obtained over a five year period was performed of 76,174 patients who underwent a radiograph or computed tomography scan which included the wrist, in Edinburgh and Lothian, UK. Results: There were 5 cases of incidental Kienböck disease and 13 cases of symptomatic Kienböck disease. There were no significant differences in age, sex, ethnicity, comorbidities, smoking status, excess alcohol use or Lichtman stage between the incidental and symptomatic Kienböck groups. Conclusion: The radiological prevalence of incidental Kienböck disease was 0.0066% or 7 in 100,000 patients. PMID:27517065

  12. Surgery for lumbar degenerative spondylolisthesis in SPORT: Does incidental durotomy affect outcome?

    PubMed Central

    Desai, Atman; Ball, Perry A.; Bekelis, Kimon; Lurie, Jon; Mirza, Sohail K.; Tosteson, Tor D.; Zhao, Wenyan; Weinstein, James N.

    2011-01-01

    Study Design Retrospective review of a prospectively collected multi-institutional database. Objective In the present analysis we investigate the impact of incidental durotomy on outcome in patients undergoing surgery for lumbar degenerative spondylolisthesis. Summary of Background Data Surgery for lumbar degenerative spondylolisthesis has several potential complications, one of the most common of which is incidental durotomy. The effect of incidental durotomy on outcome, however, remains uncertain. Methods Spine Patient Outcomes Research Trial cohort participants with a confirmed diagnosis of lumbar degenerative spondylolisthesis (DS) undergoing standard first-time open decompressive laminectomy, with or without fusion, were followed from baseline at 6 weeks, and 3, 6, 12 months and yearly thereafter, at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database was reviewed. As of May 2009, the mean (Standard Deviation) follow-up among all analyzed DS patients was 46.6 (13.1) months (No durotomy: 46.7 vs. Had durotomy: 45.2, p-value=0.49). The median (range) follow-up time among all analyzed DS patients was 47.6 (2.5, 84) months. Results A 10.5% incidence of durotomy was detected among the 389 patients undergoing surgery. No significant differences were observed with or without durotomy in age, race, the prevalence of smoking, diabetes and hypertension, decompression level, number of levels, or whether a fusion was performed. There were no differences in incidence of nerve root injury, post-op mortality, additional surgeries, SF-36 scores of body pain or physical function, or Oswestry disability index at 1, 2, 3 and 4 years. Conclusions Incidental durotomy during first time surgery for lumbar degenerative spondylolisthesis does not appear to impact outcome in affected patients. PMID:21971123

  13. Incidental Prostate Cancer at the Time of Cystectomy: The Incidence and Clinicopathological Features in Chinese Patients

    PubMed Central

    Sha, Jianjun; Yang, Hu; Xu, Fan; Xuan, Hanqing; Li, Dong; Huang, Yiran

    2014-01-01

    Objectives To evaluate the incidence and the clinicopathological features of incidental prostate cancer detected in radical cystoprostatectomy (RCP) specimens in Chinese men and to estimate the oncological risk of prostate apex-sparing surgery for such patients. Methods The clinical data and pathological feature of 504 patients who underwent RCP for bladder cancer from January 1999 to March 2013 were retrospectively reviewed. Whole mount serial section of the RCP specimens were cut transversely at 3–4 mm intervals and examined in same pathological institution. Results Thirty-four out of 504 patients (6.8%) had incidental prostate cancer with a mean age of 70.3 years. 12 cases (35.2%) were diagnosed as significant disease. 4 cases were found to have apex involvement of adenocarcinoma of the prostate while in 5 cases the prostate stroma invasion by urothelial carcinoma were identified (one involved prostate apex). The mean follow-up time was 46.4±33.8 months. Biochemical recurrence occurred in 3 patients but no prostate cancer-related death during the follow-up. There was no statistical significance in cancer specific survival between the clinically significant and insignificant cancer group. Conclusions The prevalence of incidental prostate cancer in RCP specimens in Chinese patients was remarkably lower than in western people. Most of the incidental prostate cancer was clinically insignificant and patient's prognosis was mainly related to the bladder cancer. Sparing the prostate apex was potentially associated with a 1.0% risk of leaving significant cancer of the prostate or urothelial carcinoma. PMID:24722643

  14. Incidental Superior Hypophygeal Artery Aneurysm Embedded within Pituitary Adenoma

    PubMed Central

    Choi, Hong-Seok; Kim, Min-Su; Jung, Young-Jin

    2013-01-01

    Intra-cranial aneurysm can be incidental findings in patients with pituitary adenomas, and are usually located outside the pituitary region. However, the coexistence of intrasellar (not intracranial) aneurysms with pituitary adenomas is extremely rare. We report a patient with an incidental superior hypophygeal aneurysm embedded within a non-functional pituitary adenoma which was treated by transsphenoidal surgery after endovascular coil embolization. PMID:24278658

  15. Incidental findings on MRI of the temporomandibular joint

    PubMed Central

    Makdissi, J; Pawar, R R; Radon, M; Holmes, S B

    2013-01-01

    Objectives: The aim of this study was to determine the prevalence of incidental findings in MRI of the temporomandibular joint (TMJ). Methods: MRI reports of 730 patients were assessed. The reports were analysed by one consultant and one clinical lecturer in dental and maxillofacial radiology. The prevalence of intracranial and extracranial incidental findings was recorded and categorized. Results: There were 53 (7.3%) incidental findings, of which 11 (1.5%) were intracranial and 42 (5.7%) were extracranial (divided into paranasal sinuses, mastoid air cells, muscle hypertrophy, lymphadenopathy and salivary glands). A total number of eight intracranial findings needed further dedicated imaging and/or specialist clinical opinion. Only one tumour (a meningioma) was found and required surgical intervention. Conclusions: Incidental findings on TMJ MRI are rare but not unheard of. The clinical relevance of incidental findings can be significant, and it is therefore important to ensure that the full data set of images is inspected, including any scout slices. A close working relationship between the areas of dental and maxillofacial radiology and neuroradiology is essential in expediting a second opinion relating to intracranial findings. All incidental findings should be communicated to referring clinicians in a timely manner, based on their urgency and clinical significance. PMID:24005059

  16. Incidental nest predation in freshwater turtles: inter- and intraspecific differences in vulnerability are explained by relative crypsis.

    PubMed

    Wirsing, Aaron J; Phillips, Julia R; Obbard, Martyn E; Murray, Dennis L

    2012-04-01

    There has long been interest in the influence of predators on prey populations, although most predator-prey studies have focused on prey species that are targets of directed predator searching. Conversely, few have addressed depredation that occurs after incidental encounters with predators. We tested two predictions stemming from the hypothesis that nest predation on two sympatric freshwater turtle species whose nests are differentially prone to opportunistic detection-painted turtles (Chrysemys picta) and snapping turtles (Chelydra serpentina)-is incidental: (1) predation rates should be density independent, and (2) individual predators should not alter their foraging behavior after encountering nests. After monitoring nest survival and predator behavior following nest depredation over 2 years, we confirmed that predation by raccoons (Procyon lotor), the primary nest predators in our study area, matched both predictions. Furthermore, cryptic C. picta nests were victimized with lower frequency than more detectable C. serpentina nests, and nests of both species were more vulnerable in human-modified areas where opportunistic nest discovery is facilitated. Despite apparently being incidental, predation on nests of both species was intensive (57% for painted turtles, 84% for snapping turtles), and most depredations occurred within 1 day of nest establishment. By implication, predation need not be directed to affect prey demography, and factors influencing prey crypsis are drivers of the impact of incidental predation on prey. Our results also imply that efforts to conserve imperiled turtle populations in human-modified landscapes should include restoration of undisturbed conditions that are less likely to expose nests to incidental predators. PMID:22009341

  17. Incidental Diagnosis in Healthy Clinical Trial Subjects

    PubMed Central

    Duncan, Christopher JA; Rowland, Rosalind; Lillie, Patrick J; Meyer, Joel; Sheehy, Susanne H; O'Hara, Geraldine A; Hamill, Matthew; Donaldson, Hannah; Dinsmore, Laura; Poulton, Ian D; Gilbert, Sarah C; McShane, Helen; Hill, Adrian VS

    2012-01-01

    Previously unrecognized medical conditions identified in volunteers for early phase clinical studies have significant clinical and ethical implications for the participant. It is therefore crucial that the potential for unexpected diagnosis is addressed during the informed consent process. But the frequency of incidental diagnosis in healthy volunteers who attend for clinical trial screening remains unclear. To assess this we retrospectively analyzed 1,131 independent screening visits for 990 volunteers at a single academic center over a 10-year period to describe the frequency and nature of new clinical findings. Overall 23 of 990 volunteers (2.3%) were excluded at screening for a newly diagnosed medical abnormality. Some clinically important conditions, such as nephrotic syndrome and familial hypercholesterolemia were identified. The frequency of abnormalities was associated with increasing age in males (p = 0.02 χ2 for trend) but not females (p = 0.82). These data will assist those planning and conducting phase I/II vaccine trials in healthy volunteers, and importantly should strengthen the informed consent of future trial participants. Clin Trans Sci 2012; Volume 5: 348–350 PMID:22883613

  18. Incidental sounds of locomotion in animal cognition.

    PubMed

    Larsson, Matz

    2012-01-01

    The highly synchronized formations that characterize schooling in fish and the flight of certain bird groups have frequently been explained as reducing energy expenditure. I present an alternative, or complimentary, hypothesis that synchronization of group movements may improve hearing perception. Although incidental sounds produced as a by-product of locomotion (ISOL) will be an almost constant presence to most animals, the impact on perception and cognition has been little discussed. A consequence of ISOL may be masking of critical sound signals in the surroundings. Birds in flight may generate significant noise; some produce wing beats that are readily heard on the ground at some distance from the source. Synchronization of group movements might reduce auditory masking through periods of relative silence and facilitate auditory grouping processes. Respiratory locomotor coupling and intermittent flight may be other means of reducing masking and improving hearing perception. A distinct border between ISOL and communicative signals is difficult to delineate. ISOL seems to be used by schooling fish as an aid to staying in formation and avoiding collisions. Bird and bat flocks may use ISOL in an analogous way. ISOL and interaction with animal perception, cognition, and synchronized behavior provide an interesting area for future study. PMID:21748447

  19. Incidental sounds of locomotion in animal cognition.

    PubMed

    Larsson, Matz

    2012-01-01

    The highly synchronized formations that characterize schooling in fish and the flight of certain bird groups have frequently been explained as reducing energy expenditure. I present an alternative, or complimentary, hypothesis that synchronization of group movements may improve hearing perception. Although incidental sounds produced as a by-product of locomotion (ISOL) will be an almost constant presence to most animals, the impact on perception and cognition has been little discussed. A consequence of ISOL may be masking of critical sound signals in the surroundings. Birds in flight may generate significant noise; some produce wing beats that are readily heard on the ground at some distance from the source. Synchronization of group movements might reduce auditory masking through periods of relative silence and facilitate auditory grouping processes. Respiratory locomotor coupling and intermittent flight may be other means of reducing masking and improving hearing perception. A distinct border between ISOL and communicative signals is difficult to delineate. ISOL seems to be used by schooling fish as an aid to staying in formation and avoiding collisions. Bird and bat flocks may use ISOL in an analogous way. ISOL and interaction with animal perception, cognition, and synchronized behavior provide an interesting area for future study.

  20. Clinical approach to incidental pancreatic cysts

    PubMed Central

    Chiang, Austin L; Lee, Linda S

    2016-01-01

    The approach to incidentally noted pancreatic cysts is constantly evolving. While surgical resection is indicated for malignant or higher risk cysts, correctly identifying these highest risk pancreatic cystic lesions remains difficult. Using parameters including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines have sought to identify the higher risk patients who would benefit from further evaluation using endoscopic ultrasound (EUS). Not only can EUS help further assess the presence of solid component and nodules, but also fine needle aspiration of cyst fluid aids in diagnosis by obtaining cellular, molecular, and genetic data. The impact of new endoscopic innovations with novel methods of direct visualization including confocal endomicroscopy require further validation. This review also highlights the differences between the 2012 IAP and 2015 AGA guidelines, which include the thresholds for sending patients for EUS and surgery and methods, interval, and duration of surveillance for unresected cysts. PMID:26811661

  1. Incidentally diagnosed pulmonary nodule: a diagnostic algorithm.

    PubMed

    Dziedzic, Robert; Rzyman, Witold

    2014-12-01

    Asymptomatic solitary pulmonary nodules incidentally revealed by computed tomography has become a serious medical problem. Depending on their diameter, solid, part-solid, or pure ground-glass pulmonary nodules may be observed, diagnosed radiologically/invasively, or resected in accordance with international guidelines. Pure ground-glass nodules, semi-solid lesions, or solid lesions smaller than 8 mm should be monitored by serial low-dose computed tomography. In the case of solid nodules greater than 8 mm, the assessment of the risk of malignancy is recommended. Patients at high risk of lung cancer with pulmonary lesions should undergo diagnostic investigation, or the nodule should be resected. If the risk of lung cancer is low, the patients may be monitored. Needle aspiration biopsy is the most important invasive method of tumor diagnosis. Cytological or histopathological diagnosis is helpful in appropriate clinical decision making that reduces the risk of unnecessary surgery, decreasing the rate of benign nodule resections and thus reducing the costs of medical treatment.

  2. Microarray analysis of gene expression in vestibular schwannomas reveals SPP1/MET signaling pathway and androgen receptor deregulation

    PubMed Central

    TORRES-MARTIN, MIGUEL; LASSALETTA, LUIS; SAN-ROMAN-MONTERO, JESUS; DE CAMPOS, JOSE M.; ISLA, ALBERTO; GAVILAN, JAVIER; MELENDEZ, BARBARA; PINTO, GIOVANNY R.; BURBANO, ROMMEL R.; CASTRESANA, JAVIER S.; REY, JUAN A.

    2013-01-01

    Vestibular schwannomas are benign neoplasms that arise from the vestibular nerve. The hallmark of these tumors is the biallelic inactivation of neurofibromin 2 (NF2). Transcriptomic alterations, such as the neuregulin 1 (NRG1)/ErbB2 pathway, have been described in schwannomas. In this study, we performed a whole transcriptome analysis in 31 vestibular schwannomas and 9 control nerves in the Affymetrix Gene 1.0 ST platform, validated by quantitative real-time PCR (qRT-PCR) using TaqMan Low Density arrays. We performed a mutational analysis of NF2 by PCR/denaturing high-performance liquid chromatography (dHPLC) and multiplex ligation-dependent probe amplification (MLPA), as well as a microsatellite marker analysis of the loss of heterozygosity (LOH) of chromosome 22q. The microarray analysis demonstrated that 1,516 genes were deregulated and 48 of the genes were validated by qRT-PCR. At least 2 genetic hits (allelic loss and/or gene mutation) in NF2 were found in 16 tumors, seven cases showed 1 hit and 8 tumors showed no NF2 alteration. MET and associated genes, such as integrin, alpha 4 (ITGA4)/B6, PLEXNB3/SEMA5 and caveolin-1 (CAV1) showed a clear deregulation in vestibular schwannomas. In addition, androgen receptor (AR) downregulation may denote a hormonal effect or cause in this tumor. Furthermore, the osteopontin gene (SPP1), which is involved in merlin protein degradation, was upregulated, which suggests that this mechanism may also exert a pivotal role in schwannoma merlin depletion. Finally, no major differences were observed among tumors of different size, histological type or NF2 status, which suggests that, at the mRNA level, all schwannomas, regardless of their molecular and clinical characteristics, may share common features that can be used in their treatment. PMID:23354516

  3. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI.

    PubMed

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta

    2016-08-01

    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients.

  4. Combined endoscopic-microscopic approach for vestibular schwannoma removal: outcomes in a cohort of 81 patients.

    PubMed

    Presutti, L; Magnaguagno, F; Pavesi, G; Cunsolo, E; Pinna, G; Alicandri-Ciufelli, M; Marchioni, D; Prontera, A; Gioacchini, F M

    2014-12-01

    Patients affected by vestibular schwannomas typically report a number of symptoms and minor disabilities after surgery. Therefore, surgeons dealing with this pathology should also try to achieve a good QoL for patients who have undergone tumour removal. The aim of this study was to analyse QoL in subjects undergoing surgery for vestibular schwannomas and to try to establish a relationship with both the tumour size and post-surgical alterations (e.g. facial motor dysfunctions, difficulties in balance, persistence of headache and tinnitus). A retrospective analysis was performed on a consecutive series of 81 patients affected by vestibular schwannomas and treated by a combined microscopic-endoscopic approach. Three groups of patients were identified on the basis of tumour size. Group 1 (lesions < 25 mm) with 31 patients (38%); Group 2 (lesions > 26 mm and < 40 mm) with 39 patients (48%); Group 3 (lesions > 41 mm) with 11 patients (14%). Data obtained with the Short Form Questionnaire showed a statistically significant difference in QoL in those undergoing intervention compared with a control group of healthy subjects. The Glasgow Benefit Inventory Questionnaire showed that 25 (31%) patients felt better, 11 (14%) felt similarly, and 45 (55%) felt poorer health conditions in comparison to the pre-surgical period. Concerning the relationship between preservation of facial nerve function and QoL, using the Glasgow Health Status Inventory, it appeared that only 34% of subjects with good facial nerve function (RGS grade I-II) complained of worsening of QoL, while 45% of those with serious facial nerve injury (RGS grade IV-V) referred poorer QoL. Moreover, the possibility of recovery of facial nerve function during the months following surgery was clearly highlighted by our analysis. Our study confirmed the close relation between tumour size and post-surgical QoL, which is worse for patients affected by larger lesions.

  5. A Structured approach to incidental take decision making

    USGS Publications Warehouse

    McGowan, Conor P.

    2013-01-01

    Decision making related to incidental take of endangered species under U.S. law lends itself well to a structured decision making approach. Incidental take is the permitted killing, harming, or harassing of a protected species under the law as long as that harm is incidental to an otherwise lawful activity and does not “reduce appreciably the probability of survival and recovery in the wild.” There has been inconsistency in the process used for determining incidental take allowances across species and across time for the same species, and structured decision making has been proposed to improve decision making. I use an example decision analysis to demonstrate the process and its applicability to incidental take decisions, even under significant demographic uncertainty and multiple, competing objectives. I define the example problem, present an objectives statement and a value function, use a simulation model to assess the consequences of a set of management actions, and evaluate the tradeoffs among the different actions. The approach results in transparent and repeatable decisions.

  6. A Structured Approach to Incidental Take Decision Making

    NASA Astrophysics Data System (ADS)

    McGowan, Conor P.

    2013-01-01

    Decision making related to incidental take of endangered species under U.S. law lends itself well to a structured decision making approach. Incidental take is the permitted killing, harming, or harassing of a protected species under the law as long as that harm is incidental to an otherwise lawful activity and does not "reduce appreciably the probability of survival and recovery in the wild." There has been inconsistency in the process used for determining incidental take allowances across species and across time for the same species, and structured decision making has been proposed to improve decision making. I use an example decision analysis to demonstrate the process and its applicability to incidental take decisions, even under significant demographic uncertainty and multiple, competing objectives. I define the example problem, present an objectives statement and a value function, use a simulation model to assess the consequences of a set of management actions, and evaluate the tradeoffs among the different actions. The approach results in transparent and repeatable decisions.

  7. Stereotactic radiosurgery in the management of vestibular schwannoma and glomus jugulare: indications, techniques, and results.

    PubMed

    Jacob, Jeffrey T; Pollock, Bruce E; Carlson, Matthew L; Driscoll, Colin L W; Link, Michael J

    2015-06-01

    Gamma Knife stereotactic radiosurgery (GKS) has become an important management strategy for an increasing number of patients with skull base tumors. For select patients with lateral skull base disorders, given the proximity to sensitive critical structures such as the brainstem, cranial nerves, and cochlea, this technology has emerged as a first-line treatment to achieve the paramount goals of long-term tumor control and maintenance of existing neurologic function. This article reviews the indications, technique, and results of GKS for the treatment of vestibular schwannoma and glomus jugulare tumors, and highlights our experience in treating these tumors at the Mayo Clinic. PMID:25873444

  8. Non-invasive, serum DNA pregnancy testing leading to incidental discovery of cancer: a good thing?

    PubMed

    Prasad, Vinay

    2015-11-01

    Cell-free DNA for perinatal screening is a growing industry. Non-invasive prenatal testing (NIPT) is based on the premise that foetal DNA is able to cross the placental barrier and enter the mother's circulation, where it can be examined for chromosomal abnormalities, such as trisomy 13, 18 or 21. Such tests are expected to be widely used by pregnant women, with the annual market expected to surpass $1 billion. Recently, a number of case reports have emerged in the haematology-oncology literature. The routine use of NIPT has led to the discovery of maternal neoplasms. Most writers have concluded that this is yet another benefit of the test; however, a closer examination of the cases reveals that this incidental detection may not improve patient outcomes. In some cases, early detection provides lead time bias, but does not change the ultimate clinical outcome, and in other cases, detection constitutes earlier knowledge of a cancer whose natural history cannot be altered. Here, we explore in detail cases where cancer was incidentally discovered among women undergoing routine non-invasive pregnancy testing, and investigate whether or not these women were benefitted by the discovery.

  9. Non-invasive, serum DNA pregnancy testing leading to incidental discovery of cancer: a good thing?

    PubMed

    Prasad, Vinay

    2015-11-01

    Cell-free DNA for perinatal screening is a growing industry. Non-invasive prenatal testing (NIPT) is based on the premise that foetal DNA is able to cross the placental barrier and enter the mother's circulation, where it can be examined for chromosomal abnormalities, such as trisomy 13, 18 or 21. Such tests are expected to be widely used by pregnant women, with the annual market expected to surpass $1 billion. Recently, a number of case reports have emerged in the haematology-oncology literature. The routine use of NIPT has led to the discovery of maternal neoplasms. Most writers have concluded that this is yet another benefit of the test; however, a closer examination of the cases reveals that this incidental detection may not improve patient outcomes. In some cases, early detection provides lead time bias, but does not change the ultimate clinical outcome, and in other cases, detection constitutes earlier knowledge of a cancer whose natural history cannot be altered. Here, we explore in detail cases where cancer was incidentally discovered among women undergoing routine non-invasive pregnancy testing, and investigate whether or not these women were benefitted by the discovery. PMID:26278647

  10. 75 FR 20344 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Rocket Launches from...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ... Marine Mammals Incidental to Rocket Launches from Kodiak, AK AGENCY: National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Commerce. ACTION: Notice; Issuance of a Letter of... (Eumetopias jubatus) and Pacific harbor seals (Phoca vitulina richardsi) incidental to rocket launches...

  11. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease.

    PubMed

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-05-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status.

  12. Occurrence of Optic Neuritis and Cervical Cord Schwannoma with Charcot-Marie-Tooth Type 4B1 Disease

    PubMed Central

    Scott, Patrick; Bruwer, Zandre; Al-Kharusi, Khalsa; Meftah, Douja; Al-Murshedi, Fathiya

    2016-01-01

    Charcot-Marie-Tooth neuropathy type 4B1 (CMT4B1) disease is a rare subtype of CMT4 with reported association of facial weakness, vocal cord paresis, chest deformities, and claw hands. We report the unusual occurrence of optic neuritis and cervical cord schwannoma in a male individual with confirmed CMT4B1 disease. Sequencing of the MTMR2 gene revealed a novel nonsense homozygous mutation c.1768C>T (p.Gln590*). The mutation was identified in affected relatives of the proband and a second, apparently unrelated, family. The rare association of optic neuritis or schwannoma with genetically confirmed CMT1A has been individually observed, but never with recessive CMT. To the best of our knowledge, the occurrence of optic neuritis and cervical cord schwannoma in the same patient has never been reported with any form of CMT including CMT4B1. In similar cases, we recommend immediate medical attention to rule out the possibility of schwannomas in patients with all demyelinating CMT subtypes in case of the development of focal neurological signs or acute worsening of clinical status. PMID:27162595

  13. Germline loss-of-function mutations in LZTR1 predispose to an inherited disorder of multiple schwannomas

    PubMed Central

    Piotrowski, Arkadiusz; Xie, Jing; Liu, Ying F; Poplawski, Andrzej B; Gomes, Alicia R; Madanecki, Piotr; Fu, Chuanhua; Crowley, Michael R; Crossman, David K; Armstrong, Linlea; Babovic-Vuksanovic, Dusica; Bergner, Amanda; Blakeley, Jaishri O; Blumenthal, Andrea L; Daniels, Molly S; Feit, Howard; Gardner, Kathy; Hurst, Stephanie; Kobelka, Christine; Lee, Chung; Nagy, Rebecca; Rauen, Katherine A; Slopis, John M; Suwannarat, Pim; Westman, Judith A; Zanko, Andrea; Korf, Bruce R; Messiaen, Ludwine M

    2015-01-01

    Constitutional SMARCB1 mutations at 22q11.23 have been found in ~50% of familial and <10% of sporadic schwannomatosis cases1. We sequenced highly conserved regions along 22q from eight individuals with schwannomatosis whose schwannomas involved somatic loss of one copy of 22q, encompassing SMARCB1 and NF2, with a different somatic mutation of the other NF2 allele in every schwannoma but no mutation of the remaining SMARCB1 allele in blood and tumor samples. LZTR1 germline mutations were identified in seven of the eight cases. LZTR1 sequencing in 12 further cases with the same molecular signature identified 9 additional germline mutations. Loss of heterozygosity with retention of an LZTR1 mutation was present in all 25 schwannomas studied. Mutations segregated with disease in all available affected first-degree relatives, although four asymptomatic parents also carried an LZTR1 mutation. Our findings identify LZTR1 as a gene predisposing to an autosomal dominant inherited disorder of multiple schwannomas in ~80% of 22q-related schwannomatosis cases lacking mutation in SMARCB1. PMID:24362817

  14. Low-dose bevacizumab induces radiographic regression of vestibular schwannomas in neurofibromatosis type 2: A case report and literature review

    PubMed Central

    LIU, PENGFEI; YAO, QINGYU; LI, NA; LIU, YONGLIANG; WANG, YUGUO; LI, MENG; LI, ZEFU; LI, JIANMIN; LI, GANG

    2016-01-01

    The current case study aimed to explore the efficacy of a low-dose bevacizumab regimen in inhibiting tumor growth and minimizing adverse effects. A 55-year-old man with neurofibromatosis type 2 (NF2) suffered bilateral vestibular schwannomas (VS) measuring 5.25 and 2.54 cm3 on the left and right, respectively. His capacity for bilateral language recognition was impaired. However, the patient refused microsurgical tumor resection and gamma knife therapy. Low-dose bevacizumab regimen (3.3–2.2 mg/kg every 2–4 weeks) was administered by intravenous injection for ~1.5 years to inhibit tumor growth and avoid further deterioration of hearing. Compared with baseline measurements prior to treatment, the bilateral VS regressed to 3.59 cm3 (68%) and 2.08 cm3 (82%) on the left and right, respectively. No hearing improvement was detected; however, the patient subjectively experienced a significant hearing improvement as his ability to communicate with people and distinguish voices was restored. No adverse effects were observed. Bevacizumab provides an alternative treatment option for those who refuse surgical intervention. Given the adverse effects commonly induced by bevacizumab, the use of a low-dose regimen would appear to be promising with regard to tumor regression and hearing preservation for patients with VS in NF2. However, the minimum dose required to sustain a response to bevacizumab in NF2 patients remains unknown. Finding the minimum effective dose sufficient to sustain hearing and/or volumetric response for individual patients is required. PMID:27123050

  15. 75 FR 81972 - Taking of Threatened or Endangered Marine Mammals Incidental to Commercial Fishing Operations...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    .... stock of Steller sea lions incidental to commercial fishing will have a negligible impact on these... lions, and Eastern U.S. Steller sea lions incidental to commercial fishing will have a negligible impact... Mammals Incidental to Commercial Fishing Operations; Issuance of Permit AGENCY: National Marine...

  16. 76 FR 61670 - Receipt of an Application for Incidental Take Permit (16230)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... the conservation plan would allow for the incidental take of specified numbers of sea turtles... monitor, minimize, and mitigate the incidental take of ESA-listed sea turtles. The conservation plan... application is for the incidental take of ESA- listed adult and juvenile sea turtles associated with...

  17. 78 FR 1838 - Takes of Marine Mammals Incidental to Specified Activities; St. George Reef Light Station...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... ] (Society), for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment... Harassment Authorization to the Society to incidentally harass, by Level B harassment only, four species of... limited to harassment. We shall grant authorization for the incidental taking of small numbers of...

  18. 75 FR 80471 - Takes of Marine Mammals Incidental to Specified Activities; St. George Reef Light Station...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ...), for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment incidental to... incidentally harass, by Level B harassment only, four species of marine mammals during the specified activity... intentional, taking by harassment of small numbers of marine mammals of a species or population stock,...

  19. A Review of Effect of Different Tasks on Incidental Vocabulary Acquisition

    ERIC Educational Resources Information Center

    Liu, Chen L.

    2015-01-01

    Studies of incidental vocabulary acquisition in second language learning have got more and more attention both at home and abroad. By first introducing the definition and theoretical foundations of incidental vocabulary acquisition, this paper reviews empirical studies of effect of different tasks on incidental vocabulary acquisition and points…

  20. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas. PMID:27695545

  1. Non psammomatous melanocytic schwannoma presenting as a subcutaneous nodule: A rare presentation of a rare lesion

    PubMed Central

    Gulati, Harveen Kaur; Joshi, Avinash R.; Anand, Mani; Deshmukh, S. D.

    2016-01-01

    Melanocytic schwannoma (MS) is an extremely rare soft tissue tumor accounting for less than 1% of all primitive nerve sheath tumors, with a predilection for spinal nerve involvement. To date, only 20 cases of cutaneous/subcutaneous MS have been described in literature. Here, we describe a case of MS presenting as a subcutaneous nodule in a 22-year-old male in right thigh. On examination, the nodule measured 2.5 × 2.0 × 1.5 cm with overlying skin showing a bluish hue and an ulcer. With a preoperative diagnosis of hemangioma, the patient was taken up for wide local excision and was diagnosed as a case of non psammomatous melanocytic schwannoma based on clinical, histological, and immunohistochemical studies. Immunohistochemistry revealed positivity with S-100, HMB-45, and Melan A with pericellular Laminin positivity. Carney's syndrome was ruled out. MS needs to be differentiated from other pigmented lesions like pigmented neurofibroma, Bednar tumor, cellular blue neavus, and especially malignant melanoma, which has an obvious ominous prognosis. Since MS can show unpredictable behavior especially in absence of overt malignant features, a long term follow up with or without radiotherapy is recommended. PMID:27366278

  2. Multimodal visualization of 3D enhanced MRI and CT of acoustic schwannoma and related structures

    NASA Astrophysics Data System (ADS)

    Kucharski, Tomasz; Kujawinska, Malgorzata; Niemczyk, Kazimierz; Marchel, Andrzej

    2005-09-01

    According to the necessity of supporting vestibular schwannoma surgery, there is a demand to develop a convenient method of medical data visualization. The process of making choice of optimal operating access way has been uncomfortable for a surgeon so far, because there has been a necessity of analyzing two independent 3D images series (CT -bone tissues visible, MRI - soft tissues visible) in the region of ponto-cerebellar angle tumors. The authors propose a solution that will improve this process. The system used is equipped with stereoscopic helmet mounted display. It allows merged CT and MRI data representing tissues in the region of of ponto-cerebellar angle to be visualized in stereoscopic way. The process of data preparation for visualization includes: -automated segmentation algorithms, -different types of 3D images (CT, MRI) fusion. The authors focused on the development of novel algorithms for segmentation of vestibular schwannoma. It is important and difficult task due to different types of tumors and their inhomogeneous character dependent on growth models. The authors propose algorithms based on histogram spectrum and multimodal character of MRI imaging (T1 and T2 modes). However due to a variety of objects the library of algorithms with specific modifications matching to selected types of images is proposed. The applicability and functionality of the algorithms and library was proved on the series of data delivered by Warsaw Central Medical University Hospital.

  3. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas.

    PubMed

    Carney, J A

    1995-06-01

    The complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas (the Carney complex) is a multisystem tumorous disorder that is transmitted as a mendelian autosomal dominant trait. Approximately 150 affected patients are known worldwide. The myxomas, which tend to be multiple in the involved organ, affect the heart, skin and breast. Typical sites for the skin myxomas are the eyelids, external ear canal, and nipples. The lesions commonly recur after excision. The spotty skin pigmentation includes lentigines and blue nevi, but ephelides and junctional and compound nevi also occur. The lentigines are widespread and typically involve the centrofacial area, including the vermilion border of the lips, and the conjunctiva, especially the lacrimal caruncle and the conjunctival semilunar fold. One or more intraoral pigmented spots are seen occasionally. The blue nevi occur on the face, trunk, and limbs, but not the hands and feet. Endocrine overactivity includes Cushing's syndrome (caused by primary pigmented nodular adrenocortical disease), acromegaly (caused by growth hormone-producing pituitary adenoma), and sexual precocity (caused by large-cell calcifying Sertoli cell tumor). The schwannomas are a special histological type, featuring psammoma bodies and melanin. Most commonly, they affect the upper gastrointestinal tract and sympathetic nerve chains, but a few have occurred in the skin. The most serious component of the Carney complex is cardiac myxoma. Patients suspected of having the syndrome (and their primary relatives) should be examined for this neoplasm.

  4. Surgical Planning by 3D Printing for Primary Cardiac Schwannoma Resection.

    PubMed

    Son, Kuk Hui; Kim, Kun-Woo; Ahn, Chi Bum; Choi, Chang Hu; Park, Kook Yang; Park, Chul Hyun; Lee, Jae-Ik; Jeon, Yang Bin

    2015-11-01

    We report herein a case of benign cardiac schwannoma in the interatrial septum. A 42-year-old woman was transferred from a clinic because of cardiomegaly as determined by chest X-ray. A transthoracic echocardiography and chest computed tomography examination revealed a huge mass in the pericardium compressing the right atrium, superior vena cava (SVC), left atrium, and superior pulmonary vein. To confirm that the tumor originated from either heart or mediastinum, cine magnetic resonance imaging was performed, but the result was not conclusive. To facilitate surgical planning, we used 3D printing. Using a printed heart model, we decided that tumor resection under cardiopulmonary bypass (CPB) through sternotomy would be technically feasible. At surgery, a huge tumor in the interatrial septum was confirmed. By incision on the atrial roof between the aorta and SVC, tumor enucleation was performed successfully under CPB. Pathology revealed benign schwannoma. The patient was discharged without complication. 3D printing of the heart and tumor was found to be helpful when deciding optimal surgical approach.

  5. Surgical Planning by 3D Printing for Primary Cardiac Schwannoma Resection

    PubMed Central

    Son, Kuk Hui; Kim, Kun-Woo; Ahn, Chi Bum; Choi, Chang Hu; Park, Kook Yang; Park, Chul Hyun

    2015-01-01

    We report herein a case of benign cardiac schwannoma in the interatrial septum. A 42-year-old woman was transferred from a clinic because of cardiomegaly as determined by chest X-ray. A transthoracic echocardiography and chest computed tomography examination revealed a huge mass in the pericardium compressing the right atrium, superior vena cava (SVC), left atrium, and superior pulmonary vein. To confirm that the tumor originated from either heart or mediastinum, cine magnetic resonance imaging was performed, but the result was not conclusive. To facilitate surgical planning, we used 3D printing. Using a printed heart model, we decided that tumor resection under cardiopulmonary bypass (CPB) through sternotomy would be technically feasible. At surgery, a huge tumor in the interatrial septum was confirmed. By incision on the atrial roof between the aorta and SVC, tumor enucleation was performed successfully under CPB. Pathology revealed benign schwannoma. The patient was discharged without complication. 3D printing of the heart and tumor was found to be helpful when deciding optimal surgical approach. PMID:26446661

  6. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas.

  7. Triological Society Thesis Preclinical Validation of AR42, a Novel Histone Deacetylase Inhibitor, as Treatment for Vestibular Schwannomas

    PubMed Central

    Jacob, Abraham; Oblinger, Janet; Bush, Matthew L.; Brendel, Victoria; Santarelli, Griffin; Chaudhury, Abhik R.; Kulp, Samuel; La Perle, Krista M. D.; Chen, Ching-Shih; Chang, Long-Sheng; Welling, D. Bradley

    2012-01-01

    Objective/Hypothesis Recent studies indicate that vestibular schwannomas (VS) rely on PI3-kinase/AKT activation to promote cell proliferation and survival; therefore, targeting AKT may provide new therapeutic options. We have previously shown that AR42, a novel histone deacetylase inhibitor, potently suppresses VS growth in vitro at doses correlating with AKT inactivation. The objectives of the current study were translational: 1) to examine the end biologic effects of AR42 on tumor growth in vivo, 2) to validate AKT as its in vivo molecular target, 3) to determine whether AR42 penetrates the blood brain barrier (BBB), and 4) to study AR42’s pharmacotoxicity profile. Study Design In vivo mouse studies Methods AR42 was dosed orally in murine schwannoma allografts and human vestibular schwannoma xenografts. MRI was used to quantify changes in tumor volume while intracellular molecular targets were analyzed using immunohistochemistry. Blood-brain barrier (BBB) penetration was assayed, and both blood chemistry measurements and histology studies were used to evaluate toxicity. Results Growth of schwannoma implants was dramatically decreased by AR42 at doses correlating with AKT dephosphorylation, cell cycle arrest, and apoptosis. AR42 penetrated the BBB, and wild-type mice fed AR42 for 6-months behaved normally and gained weight appropriately. Blood chemistry studies and organ histology performed after 3- and 6-months of AR42 treatment demonstrated no clinically significant abnormalities. Conclusions AR42 suppresses schwannoma growth at doses correlating with AKT pathway inhibition. This orally bioavailable drug penetrates the BBB, is well tolerated, and represents a novel candidate for translation to human VS clinical trials. PMID:22109824

  8. Effects of Animated Visuals on Incidental Learning and Motivation.

    ERIC Educational Resources Information Center

    Rieber, Lloyd P.

    This study examined the effects of animated presentations on intentional and incidental learning and the degree to which computer practice activities contained intrinsically motivating characteristics as measured by continuing motivation. A total of 70 fourth graders participated in an introductory lesson on Newton's laws of motion. Two levels of…

  9. Guidance of Spatial Attention by Incidental Learning and Endogenous Cuing

    ERIC Educational Resources Information Center

    Jiang, Yuhong V.; Swallow, Khena M.; Rosenbaum, Gail M.

    2013-01-01

    Our visual system is highly sensitive to regularities in the environment. Locations that were important in one's previous experience are often prioritized during search, even though observers may not be aware of the learning. In this study we characterized the guidance of spatial attention by incidental learning of a target's spatial probability,…

  10. Is Incidental Vocabulary Acquisition Feasible to EFL Learning?

    ERIC Educational Resources Information Center

    Luo, Jian-ping

    2013-01-01

    For learning English as a foreign language, the efficiency of the approach of incidental vocabulary acquisition depends on the word frequency and text coverage. However, the statistics of English corpus reveals that English is a language that has a large vocabulary size but a low word frequency as well as text coverage, which is obviously not in…

  11. Strategy Training: An Incidental Learning Model for CAI.

    ERIC Educational Resources Information Center

    Derry, Sharon J.

    Attempts to train learning strategies have not produced marked or lasting increases in academic IQ, probably because current training models fail to recognize the evolutionary nature of strategies acquisition. Empirical and theoretical evidence supports an incidental learning model, which engineers the instructional environment following study…

  12. Representations of an Incidental Learning Framework to Support Mobile Learning

    ERIC Educational Resources Information Center

    Scanlon, Eileen; Gaved, Mark; Jones, Ann; Kukulska-Hulme, Agnes; Paletta, Lucas; Dunwell, Ian

    2014-01-01

    This paper discusses how the particular features of mobile learning can be harnessed to provide new informal learning opportunities in relation to context aware and location based learning. The MASELTOV project is developing representations of an incidental learning framework to enable software developers and researchers to both design and analyse…

  13. Incidental Learning of Geospatial Concepts across Grade Levels: Map Overlay

    ERIC Educational Resources Information Center

    Battersby, Sarah E.; Golledge, Reginald G.; Marsh, Meredith J.

    2006-01-01

    In this paper, the authors evaluate map overlay, a concept central to geospatial thinking, to determine how it is naively and technically understood, as well as to identify when it is leaner innately. The evaluation is supported by results from studies at three grade levels to show the progression of incidentally learned geospatial knowledge as…

  14. An Analysis of Adult Interaction Styles and Children's Incidental Imitation.

    ERIC Educational Resources Information Center

    Sharkey, Robert W.; Morris, Edward K.

    This paper describes two experiments designed to determine whether traditional effects of adult nurturance on children's incidental imitation could be obtained using a within-subject design and a functional (rather than operational) definition of nurturance. Four preschool children served as subjects, with four others serving as cross-sex…

  15. Incidental Vocabulary Acquisition from Reading an Authentic Text

    ERIC Educational Resources Information Center

    Daskalovska, Nina

    2014-01-01

    A number of studies have demonstrated that second/foreign language learners can acquire vocabulary from reading. This study was designed to examine whether advanced EFL learners can acquire vocabulary incidentally from reading an authentic text. Eighteen first year English major students read and listened to the first eight chapters of Pride and…

  16. Reviewing Theory and Research on Informal and Incidental Learning

    ERIC Educational Resources Information Center

    Marsick, Victoria J.; Watkins, Karen E.; Callahan, Mary Wilson; Volpe, Marie

    2006-01-01

    Leaders and employees of today's organizations typically assume increasing responsibility for their own and their organization's learning. Much of that learning is informal or incidental. This article reviews theory and research to update that model and identify future research challenges. Through this review, groundwork will be laid for…

  17. Concurrent Movement Impairs Incidental but Not Intentional Statistical Learning

    ERIC Educational Resources Information Center

    Stevens, David J.; Arciuli, Joanne; Anderson, David I.

    2015-01-01

    The effect of concurrent movement on incidental versus intentional statistical learning was examined in two experiments. In Experiment 1, participants learned the statistical regularities embedded within familiarization stimuli implicitly, whereas in Experiment 2 they were made aware of the embedded regularities and were instructed explicitly to…

  18. 75 FR 42121 - Marine Mammals; Incidental Take During Specified Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... sea otters are listed as threatened under the ESA (42 FR 2965; January 14, 1977) and, because of their... applicant to incidentally take, by harassment, small numbers of southern sea otters for a period of 6 months... does not apply to southern sea otters. Section 101(a)(5)(D) of the MMPA established an...

  19. Incidental Language Learning in Foreign Language Content Courses

    ERIC Educational Resources Information Center

    Rodgers, Daryl M.

    2015-01-01

    This study examined the extent to which 40 students enrolled in upper level foreign language literary/cultural studies content courses showed evidence of incidental language learning over the course of a semester. Students completed a cloze passage and provided both writing and speaking samples at the beginning and end of the semester. In…

  20. Playground Exploration: An Opportunity for Incidental Learning of Mechanical Principles

    ERIC Educational Resources Information Center

    Lyons, Brian

    2005-01-01

    Play involves unstructured activity that is freely entered into and intrinsically rewarding. When children engage in play there is little intentional learning. There are no lesson plans. There are no daily objectives or specific learning outcomes. Incidental learning can cause relatively permanent changes in the way one thinks; accidental learning…

  1. 78 FR 42508 - Notice of Availability of Draft Environmental Assessment on the Effects of Issuing an Incidental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ..., minimize, and mitigate the incidental take of ESA-listed sea turtles. The conservation plan includes... incidental take of threatened and endangered sea turtles during management of North Carolina inshore gillnet... incidental take permits (ITP's) to NCDMF for the incidental take of sea turtles in inshore gillnet...

  2. 77 FR 39485 - Incidental Taking of Marine Mammals; Taking of Marine Mammals Incidental to the Explosive Removal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    ..., 2008 (73 FR 34875), and remain in effect through July 19, 2013. For detailed information on this action.... Under the MMPA, the term ``take'' means to harass, hunt, capture, or kill or to attempt to harass, hunt, capture, or kill any marine mammal. Authorization for incidental taking, in the form of annual LOAs,...

  3. 77 FR 45341 - Incidental Taking of Marine Mammals; Taking of Marine Mammals Incidental to the Explosive Removal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-31

    ..., 2008 (73 FR 34875), and remain in effect through July 19, 2013. For detailed information on this action... issued. Under the MMPA, the term ``take'' means to harass, hunt, capture, or kill or to attempt to harass, hunt, capture, or kill any marine mammal. Authorization for incidental taking, in the form of...

  4. 78 FR 22517 - Incidental Taking of Marine Mammals; Taking of Marine Mammals Incidental to the Explosive Removal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-16

    ..., 2008 (73 FR 34875), and remain in effect through July 19, 2013. For detailed information on this action... the MMPA, the term ``take'' means to harass, hunt, capture, or kill or to attempt to harass, hunt, capture, or kill any marine mammal. Authorization for incidental taking, in the form of annual LOAs,...

  5. 78 FR 30273 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... potential area of effect for this project (London, 2006; see Figure 4-1 of the Navy's application.... waters and just south of the U.S.-Mexico border, and animals belonging to this population may be found... application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine...

  6. 76 FR 12070 - Incidental Taking of Marine Mammals; Taking of Marine Mammals Incidental to the Explosive Removal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... EROS were published on June 19, 2008 (73 FR 34875), and remain in effect through July 19, 2013. For... of Marine Mammals Incidental to the Explosive Removal of Offshore Structures in the Gulf of Mexico... removal of offshore oil and gas structures (EROS) in the Gulf of Mexico. DATES: These authorizations...

  7. 78 FR 56659 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-13

    ... U.S. waters and just south of the U.S.-Mexico border, and animals belonging to this population may... from the U.S. Navy (Navy) for authorization to take marine mammals incidental to construction..., NMFS, (301) 427-8401. SUPPLEMENTARY INFORMATION: Availability A copy of the Navy's application and...

  8. Morphometric analysis of posterior fossa in Indian CP angle acoustic schwannoma patients

    PubMed Central

    Patibandla, Mohana Rao; Panigrahi, Manas K.; Gurram, Paniraj L.; Thotakura, Amit Kumar; Kulkarni, Dilip

    2016-01-01

    Aim: To study the morphometry of posterior fossa in Indian CP angle schwannoma patients in order to know its influence on the extent of excision of the CP angle acoustic schwannomas. Materials and Methods: One hundred cases of cerebellopontine angle schwannomas treated surgically by the senior author and 20 controls between January 2006 and June 2011 were consecutively investigated with computed tomography (CT) using the high-resolution CT bone windows before surgery. Evaluation of anatomic parameters of the petrous bone and posterior fossa cavity were done in all patients and controls. Data were entered in Excel software and were analyzed using NCSS software. All possible regression analysis was done to select the important variables to be included in the model to predict the excision of tumor with these variables. A prediction model was developed defining the binary outcome as total excision or subtotal excision as dependent variable and the morphometric data and grading of tumor as independent variables. Results: Interpetrous distance (IP) is the distance between the two petrous apices. Sigmoid distance (IS) distance is the distance between the two sigmoid points. Sigmoid point is the point at which the scalloped impression of the sigmoid sinus straightens to join the occipital bone posteriorly. SAG is the distance between the mid IP point and the mid-point on the inner wall of the occipital bone. The PM angle was 47.8±4.14 degrees (38-58), the PA angle was 42.68±4.47 degrees (34-53), the IP distance was 2.07±0.13 cm (1.5-2.8), the sagittal diameter of posterior fossa was 6.22±0.73 cm (5.1-9.8) and the intersigmoid distance was 9.45±0.73 cm (7.4-11). There was no significant gender difference in the posterior fossa morphometry between patients and controls. Inter-sigmoid distance and the petrous-apex angle were more in the Indians when compared to the European population mentioned in the Mathies and Samii study. Conclusions: The posterior fossa

  9. Anaesthesia Management of a Patient with Incidentally Diagnosed Diaphragmatic Hernia During Laparoscopic Surgery

    PubMed Central

    Özdemir, Mehtap; Yanlı, Pınar Yonca; Tomruk, Şenay Göksu; Bakan, Nurten

    2015-01-01

    Diaphragmatic hernia is usually congenital. However, it is rarely traumatic and can stay asymptomatic. In this report, we aimed to present the anaesthetic management of a patient with diaphragmatic hernia due to previous trauma (14 years ago), which was diagnosed incidentally during surgery for rectal cancer. The patient (53 years, 56 kg, 165 cm, American Society of Anaesthesiologist (ASA) II), to whom laparoscopic surgery was planned because of rectal cancer, had a history of falling from a height 14 years ago. Preoperatively, the patient did not have any sign except small right diaphragmatic elevation on the chest x-ray. After induction, maintenance of anaesthesia was continued with sevoflurane and O2/N2O. The patient was given a 30° Trendelenburg position. When the trochars were inserted by the surgeon, the diaphragmatic hernia was seen on the right part of the diaphragm, which was hidden by the liver. The surgery was continued laparoscopically but with low pressure (12 mmHg), because the patient did not have any haemodynamic and respiratory instability. The patient, who had stable haemodynamic parameters and no respiratory complications during the operation, was transferred to the ward for monitorised care. Traumatic diaphragmatic hernias can be detected incidentally after a long period of acute event. In our case, it was diagnosed during laparoscopic surgery. The surgery was completed with appropriate and careful haemodynamic monitoring and low intra-abdominal pressure under inhalational anaesthesia without any impairment in the patient’s haemodynamic and respiratory parameters. PMID:27366465

  10. The friendly incidental portal vein thrombus in liver transplantation.

    PubMed

    Koh, Peng Soon; Chan, See Ching; Chok, Kenneth Siu-Ho; Sharr, William Wei; Wong, Tiffany Cho-Lam; Sin, Sui Ling; Lo, Chung Mau

    2015-07-01

    Improved outcomes have been shown in liver transplantation (LT) with portal vein thrombosis (PVT). However, PVT is still discovered incidentally during surgery despite careful preoperative imaging. Data are limited comparing the outcomes of incidental PVT with PVT diagnosed via preoperative imaging before LT. This study aims to compare the overall outcomes of patients with PVT. From 2008 to 2012, 369 patients had LT, and 58 patients with PVT were identified. They were divided into those with non-PVT (group 0; n = 311), preoperatively identified PVT (group 1; n = 28), and incidental PVT (group 2; n = 30). The demographics, characteristics, preoperative assessment, and postoperative outcomes were compared. A survival analysis was also performed. Baseline characteristics and preoperative evaluations of all 3 groups were comparable (P > 0.05) except for Model for End-Stage Liver Disease score, tumor status, platelet levels, and serum bilirubin. A multivariate analysis only showed a high serum bilirubin level to be a predictor of PVT (P = 0.004; odds ratio, 3.395; 95% confidence interval, 1.467-7.861). Postoperative outcomes were also comparable (P > 0.05). Compared to group 2, group 1 had more patients with a Yerdel classification of 3 or 4 with more extensive surgical intervention required (P = 0.02). The survival analysis in all 3 groups was comparable with 5-year survival rate of 87.4%, 84.6%, and 91.8% in group 0, 1, and 2, respectively (P = 0.66). In conclusion, recipients with PVT undergoing LT can have similar outcomes as the non-PVT patients even if PVTs were discovered incidentally. Discovery of incidental PVT only requires thrombectomy with no substantial change of treatment strategy, and the outcome is not adversely affected because most incidental PVTs are of a lower Yerdel grade. Preoperative imaging is useful to identify those with a higher Yerdel grade to allow planning of surgical strategy during transplantation.

  11. The friendly incidental portal vein thrombus in liver transplantation.

    PubMed

    Koh, Peng Soon; Chan, See Ching; Chok, Kenneth Siu-Ho; Sharr, William Wei; Wong, Tiffany Cho-Lam; Sin, Sui Ling; Lo, Chung Mau

    2015-07-01

    Improved outcomes have been shown in liver transplantation (LT) with portal vein thrombosis (PVT). However, PVT is still discovered incidentally during surgery despite careful preoperative imaging. Data are limited comparing the outcomes of incidental PVT with PVT diagnosed via preoperative imaging before LT. This study aims to compare the overall outcomes of patients with PVT. From 2008 to 2012, 369 patients had LT, and 58 patients with PVT were identified. They were divided into those with non-PVT (group 0; n = 311), preoperatively identified PVT (group 1; n = 28), and incidental PVT (group 2; n = 30). The demographics, characteristics, preoperative assessment, and postoperative outcomes were compared. A survival analysis was also performed. Baseline characteristics and preoperative evaluations of all 3 groups were comparable (P > 0.05) except for Model for End-Stage Liver Disease score, tumor status, platelet levels, and serum bilirubin. A multivariate analysis only showed a high serum bilirubin level to be a predictor of PVT (P = 0.004; odds ratio, 3.395; 95% confidence interval, 1.467-7.861). Postoperative outcomes were also comparable (P > 0.05). Compared to group 2, group 1 had more patients with a Yerdel classification of 3 or 4 with more extensive surgical intervention required (P = 0.02). The survival analysis in all 3 groups was comparable with 5-year survival rate of 87.4%, 84.6%, and 91.8% in group 0, 1, and 2, respectively (P = 0.66). In conclusion, recipients with PVT undergoing LT can have similar outcomes as the non-PVT patients even if PVTs were discovered incidentally. Discovery of incidental PVT only requires thrombectomy with no substantial change of treatment strategy, and the outcome is not adversely affected because most incidental PVTs are of a lower Yerdel grade. Preoperative imaging is useful to identify those with a higher Yerdel grade to allow planning of surgical strategy during transplantation. PMID

  12. Malignant psammomatous melanotic schwannoma of the spine: A component of Carney complex

    PubMed Central

    Shields, Lisa B. E.; Glassman, Steven D.; Raque, George H.; Shields, Christopher B.

    2011-01-01

    Background: Psammomatous melanotic schwannomas (PMS) of the spine may be a component of the Carney complex in 50% of cases and is inherited in an autosomal dominant manner. Most PMS are benign and frequently associated with lentiginous pigmentation; cardiac, cutaneous, or breast myxomas; endocrine overactivity; and cutaneous blue nevi. These tumors are characterized by melanin containing cells having ultrastructural characteristics of Schwann cells. Case Description: Two patients had spinal PMS that were surgically resected with adjacent local radiotherapy, followed by local recurrence and metastasis. The aggressive nature of this tumor is reported. Conclusion: Spinal PMS are rarely malignant with local recurrence and distal metastases. Inquiry into the patient's and family members’ hereditary background for the Carney complex is important to avoid overlooking potential lethal associated abnormalities. PMID:22059131

  13. Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function.

    PubMed

    Akard, William; Tubbs, R Shane; Seymour, Zachary A; Hitselberger, William E; Cohen-Gadol, Aaron A

    2009-04-01

    The current state of surgery for vestibular schwannomas (VSs) is the result of a century of step-by-step technical progress by groundbreaking surgeons who transformed the procedure from its hazardous infancy and high mortality rate to its current state of safety and low morbidity rate. Harvey Cushing advocated bilateral suboccipital decompression and developed the method of intracapsular tumor enucleation. Walter Dandy supported the unilateral suboccipital approach and developed the technique of gross-total tumor resection. Microsurgical techniques revolutionized VS surgery to its current status. In this article, the authors review the early history of surgery for VSs with an emphasis on contributions from pioneering surgeons. The authors examined the Cushing Brain Tumor Registry for clues regarding the bona fide intention of Cushing for the resection of these tumors. PMID:18991500

  14. Surgical management of Giant Lumbar Extradural Schwannoma: Report of 3 cases

    PubMed Central

    Srikantha, Umesh

    2015-01-01

    Standard surgical approach for extradural paraspinal tumours has been through a unilateral facetectomy, inter-transverse or retroperitoneal approach. Some of these approaches destabilise the spine and consequently require a fusion procedure. Access to these tumours through a minimal access route can decrease tissue damage, fasten post-operative recovery and obviate the need for a concomitant fusion procedure. However, proper case selection and adequate pre-operative planning are important in choosing cases for a minimally invasive approach. We discuss three cases of giant extradural, paraspinal schwannomas. One case that was associated with listhesis along with the tumour situated more anteriorly and embedded in the psoas muscle was managed by lateral retroperitoneal route with simultaneous interbody graft followed by posterior interspinous stabilising device. The other two cases were managed by minimal access route using a 22mm fixed tubular retractor, one by a paramedian approach and one by far lateral approach. The technique and merits of the procedure are discussed. PMID:26114087

  15. Schwannomas: a pitfall in the diagnosis of pleomorphic adenomas on fine-needle aspiration cytology.

    PubMed

    Kapila, Kusum; Mathur, Sandeep; Verma, Kusum

    2002-07-01

    Fine-needle aspiration cytology (FNAC) is being employed with increasing frequency for the preoperative diagnostic workup of salivary gland lesions. Although most cases show morphologic features very characteristic of specific entities, few lesions, both benign and malignant, can cause problems in interpretation. We report four cases initially diagnosed on FNA as spindle-cell tumors, possibly benign nerve sheath tumors (BNST) in the salivary gland region. These cases were later diagnosed on histologic examination as schwannoma (two cases) and as pleomorphic adenoma (two cases). Review of the cytomorphology of these four cases enabled the correct diagnosis of pleomorphic adenoma in the two cases misinterpreted as BNST. Benign peripheral nerve sheath tumors should always be considered in the differential diagnosis of pleomorphic adenoma. A diligent search for epithelial elements is recommended prior to diagnosing BNST in the head and neck region.

  16. Predicting Nonauditory Adverse Radiation Effects Following Radiosurgery for Vestibular Schwannoma: A Volume and Dosimetric Analysis

    SciTech Connect

    Hayhurst, Caroline; Monsalves, Eric; Bernstein, Mark; Gentili, Fred; Heydarian, Mostafa; Tsao, May; Schwartz, Michael; Prooijen, Monique van; Millar, Barbara-Ann; Menard, Cynthia; Kulkarni, Abhaya V.; Laperriere, Norm; Zadeh, Gelareh

    2012-04-01

    Purpose: To define clinical and dosimetric predictors of nonauditory adverse radiation effects after radiosurgery for vestibular schwannoma treated with a 12 Gy prescription dose. Methods: We retrospectively reviewed our experience of vestibular schwannoma patients treated between September 2005 and December 2009. Two hundred patients were treated at a 12 Gy prescription dose; 80 had complete clinical and radiological follow-up for at least 24 months (median, 28.5 months). All treatment plans were reviewed for target volume and dosimetry characteristics; gradient index; homogeneity index, defined as the maximum dose in the treatment volume divided by the prescription dose; conformity index; brainstem; and trigeminal nerve dose. All adverse radiation effects (ARE) were recorded. Because the intent of our study was to focus on the nonauditory adverse effects, hearing outcome was not evaluated in this study. Results: Twenty-seven (33.8%) patients developed ARE, 5 (6%) developed hydrocephalus, 10 (12.5%) reported new ataxia, 17 (21%) developed trigeminal dysfunction, 3 (3.75%) had facial weakness, and 1 patient developed hemifacial spasm. The development of edema within the pons was significantly associated with ARE (p = 0.001). On multivariate analysis, only target volume is a significant predictor of ARE (p = 0.001). There is a target volume threshold of 5 cm3, above which ARE are more likely. The treatment plan dosimetric characteristics are not associated with ARE, although the maximum dose to the 5th nerve is a significant predictor of trigeminal dysfunction, with a threshold of 9 Gy. The overall 2-year tumor control rate was 96%. Conclusions: Target volume is the most important predictor of adverse radiation effects, and we identified the significant treatment volume threshold to be 5 cm3. We also established through our series that the maximum tolerable dose to the 5th nerve is 9 Gy.

  17. Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma

    PubMed Central

    Plotkin, Scott R.; Halpin, Chris; Blakeley, Jaishri O.; Slattery, William H.; Welling, D. Bradley; Chang, Susan M.; Loeffler, Jay S.; Harris, Gordon J.; Sorensen, A. Gregory; McKenna, Michael J.

    2014-01-01

    Neurofibromatosis type 2 (NF2) is a tumor suppressor gene syndrome characterized by multiple schwannomas, especially vestibular schwannomas (VS), and meningiomas. Anticancer drug trials are now being explored, but there are no standardized endpoints in NF2. We review the challenges of NF2 clinical trials and suggest possible response criteria for use in initial phase II studies. We suggest two main response criteria in such trials. Objective radiographic response is defined as a durable 20% or greater reduction in VS volume based on postcontrast T1-weighted MRI images collected with 3 mm or finer cuts through the internal auditory canal. Hearing response is defined as a statistically significant improvement in word recognition scores using 50-word recorded lists in audiology. A possible composite endpoint incorporating both radiographic response and hearing response is outlined. We emphasize pitfalls in response assessment and suggest guidelines to minimize misinterpretations of response. We also identify research goals in NF2 to facilitate future trial conduct, such as identifying the expectations for time to tumor progression and time to measurable hearing loss in untreated NF2-related VS, and the relation of both endpoints to patient prognostic factors (such as age, baseline tumor volume, and measures of disease severity). These data would facilitate future use of endpoints based on stability of tumor size and hearing, which might be more appropriate for testing certain drugs. We encourage adoption of standardized endpoints early in the development of phase II trials for this population to facilitate comparison of results across trials of different agents. PMID:19430883

  18. Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review

    PubMed Central

    Yoon, Sun; Park, Hunho; Lee, Kyu-Sung; Park, Seoung Woo

    2016-01-01

    Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions. We removed the tumor with a left lateral suboccipital craniectomy with laminectomy only at C1 and without any subsequent surgery-related neurologic deficits. However, this technique requires meticulous preoperative evaluation on existence of Cerebrospinal fluid (CSF) cleft between the tumor and spinal cord on magnetic resonance imaging, of tumor origin located at the upper cervical root, and of detachment of tumor from the origin site. PMID:27800002

  19. Incidental and intentional encoding in young and elderly adults.

    PubMed

    Téllez-Alanís, Bernarda; Cansino, Selene

    2004-08-01

    Event-related potentials (ERPs) were recorded in young and elderly adults during the performance of an incidental encoding task (subjects were unexpectedly given a recognition test) followed by an intentional task (subjects expected the recognition test). Both tasks consisted of an encoding stage in which subjects classified words (natural/artificial) and a recognition stage in which they indicated whether the words were old (presented during the encoding stage) or new. In both groups and tasks, the ERPs, during encoding, differed as a function of subsequent recognition: the old words correctly recognized generated greater amplitude potentials than the incorrect ones. The memory processes expressed by these ERPs are preserved in elderly adults, independently of whether the information is incidentally or intentionally encoded. PMID:15257155

  20. Triggering memory recovery: effects of direct and incidental cuing.

    PubMed

    Handy, Justin D; Smith, Steven M

    2012-12-01

    The present study examined forgetting and recovery of narrative passages varying in emotional intensity, using what we refer to as the "dropout" method. Previous studies of this dropout procedure have used word lists as to-be-remembered material, but the present experiments used brief story vignettes with one-word titles (e.g., "Torture", "Insects"). These vignettes showed a strong dropout forgetting effect in free recall. Both text and picture cues from the vignettes eliminated the forgetting effect on a subsequent cued recall test. Vignette-related pictures in an incidental picture naming task, however, triggered little recovery of initially forgotten vignettes, as shown on a post-test. The results extend findings of large forgetting and memory recovery effects to materials that are more naturalistic than word lists. The findings also show that picture cues, which trigger strong memory recovery effects on a direct test of memory, had little effect on recovery when cues were encountered incidentally. PMID:23123684

  1. Concurrent movement impairs incidental but not intentional statistical learning.

    PubMed

    Stevens, David J; Arciuli, Joanne; Anderson, David I

    2015-07-01

    The effect of concurrent movement on incidental versus intentional statistical learning was examined in two experiments. In Experiment 1, participants learned the statistical regularities embedded within familiarization stimuli implicitly, whereas in Experiment 2 they were made aware of the embedded regularities and were instructed explicitly to learn these regularities. Experiment 1 demonstrated that while the control group were able to learn the statistical regularities, the resistance-free cycling group and the exercise group did not demonstrate learning. This is in contrast with the findings of Experiment 2, where all three groups demonstrated significant levels of learning. The results suggest that the movement demands, rather than the physiological stress, interfered with statistical learning. We suggest movement activates the striatum, which is not only responsible for motor control but also plays a role in incidental learning.

  2. Incidental finding of a microsporidian parasite from an AIDS patient.

    PubMed Central

    McDougall, R J; Tandy, M W; Boreham, R E; Stenzel, D J; O'Donoghue, P J

    1993-01-01

    Light microscopic examination of feces from a human immunodeficiency virus-positive patient with chronic diarrhea, anorexia, and lethargy revealed the presence of numerous refractile bodies resembling microsporidian spores. They were subsequently identified as belonging to the genus Nosema on the basis of their ultrastructural characteristics. However, the microsporidia were enclosed within striated muscle cells, suggesting that they were probably ingested in food; thus, this represented an incidental finding rather than a true infection. Images PMID:8432833

  3. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    PubMed Central

    Balalis, Dimitrios; Soulou, Vasiliki N.; Korkolis, Dimitrios P.; Plataniotis, Georgios; Gontikakis, Emmanouil

    2016-01-01

    Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia), pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy), and biochemical (serum calcium and phosphate levels) factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p = 0.003). Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p = 0.49). Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  4. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences.

    PubMed

    Manatakis, Dimitrios K; Balalis, Dimitrios; Soulou, Vasiliki N; Korkolis, Dimitrios P; Plataniotis, Georgios; Gontikakis, Emmanouil

    2016-01-01

    Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia), pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy), and biochemical (serum calcium and phosphate levels) factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p = 0.003). Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p = 0.49). Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors. PMID:27635137

  5. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    PubMed Central

    Balalis, Dimitrios; Soulou, Vasiliki N.; Korkolis, Dimitrios P.; Plataniotis, Georgios; Gontikakis, Emmanouil

    2016-01-01

    Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia), pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy), and biochemical (serum calcium and phosphate levels) factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p = 0.003). Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p = 0.49). Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors. PMID:27635137

  6. Minimally Invasive Resection of an Extradural Far Lateral Lumbar Schwannoma with Zygapophyseal Joint Sparing: Surgical Nuances and Literature Review

    PubMed Central

    Gonçalves, Vítor M.; Santiago, Bruno; Ferreira, Vítor C.; Cunha e Sá, Manuel

    2014-01-01

    Introduction. Spinal schwannomas are benign nerve sheath tumors. Completely extradural schwannomas of the lumbar spine are extremely rare lesions, accounting for only 0,7–4,2% of all spinal NSTs. Standard open approaches have been used to treat these tumors, requiring extensive muscle dissection, laminectomy, radical foraminotomy, and facetectomy. In this paper the authors present the case of a minimally invasive resection of a completely extradural schwannoma. Operative technique literature review is presented. Material & Methods. A 50-year-old woman presented with progressive complains of chronic right leg pain and paresthesia. The magnetic resonance imaging revealed a giant well-encapsulated dumbbell-shaped extradural lesion at the L3-L4 level. The patient underwent a minimally invasive gross total resection of the tumor using a tubular expandable retractor system. Results. The patient had complete resolution of radiculopathy in the immediate postoperative period and she was discharged home, neurologically intact, on the second postoperative day. Postoperative MRI demonstrated no evidence of residual tumor. At latest follow-up (18 months) the patient remains asymptomatic. Conclusion. Although challenging, this minimally invasive procedure is safe and effective, being an appropriate alternative, with many potential advantages, to the open approach. PMID:25328530

  7. Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas.

    PubMed

    Lau, Ryan P; Melamed, Jonathan; Yee-Chang, Melissa; Marcus, Sonya; Givi, Babak; Zamuco, Ronaldo

    2016-09-01

    Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract, rarely involving the head/neck region. This is the first reported case involving the submandibular gland. We present a case in a 34 year old man with 4.5 cm submandibular mass. Fine needle aspiration suggested a spindle cell lesion. Frozen section evaluation raised the possibility of mucoepidermoid carcinoma. Resection showed a well circumscribed mass with a mucoid appearance. Histologic findings include a lobular architecture with fibrous septa, a lympho-plasmacytic infiltrate, and scattered lymphoid aggregates at the periphery. There are two distinct histologic patterns with solid areas of spindle cells and areas of spindle/ovoid cells with a microcystic pattern in a myxoid background. The tumor has a pushing border, with extension into adipose and adjacent parenchyma, without cytologic atypia or necrosis. Immunohistochemical stains are positive for S-100 and CD34, and negative for calponin, mammoglobin, ALK1, p63, ER, GFAP, SMA, desmin, cytokeratin 7, cytokeratin AE1/AE3, and C-Kit. Mucicarmine stain is negative. Recognition of this benign unusual variant of schwannoma is paramount for appropriate conservative treatment due to the morphologic and immunohistochemical overlap with primary salivary gland carcinomas.

  8. Outcome on hearing and facial nerve function in microsurgical treatment of small vestibular schwannoma via the middle cranial fossa approach.

    PubMed

    Ginzkey, Christian; Scheich, Matthias; Harnisch, Wilma; Bonn, Verena; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Mlynski, Robert; Hagen, Rudolf

    2013-03-01

    Encouraging results regarding hearing preservation and facial nerve function as well as increasing understanding of the natural behaviour of vestibular schwannomas have led to the recommendation of an early treatment in small VS. The aim of the present study was to evaluate current data on functional outcome of patients with small VS treated by middle cranial fossa (MCF) approach. A retrospective chart study of all cases treated by MCF approach between October 2007 and September 2011 was performed. Records were analyzed regarding demographical data, tumor size, hearing status, vestibular function and facial nerve function. Facial nerve function was classified according to the House-Brackmann scale (HB). Hearing status was classified according to the American Association of Otolaryngology-Head and Neck Surgery (AAO-HNS) and a modified classification of Gardner and Robertson (GR). Eighty-nine patients were included in the study; 41 % of VS was classified as intracanalicular (stage 1) and 59 % as stage 2. From 65 patients with a preoperative hearing status according to AAO-HNS A or B, 74 % still presented with A or B after surgery. Using a modified GR classification, from 70 patients categorized as class I or II prior to surgery, 70 % were still class I or II. Looking to the facial nerve function 1 week after surgery, 82 % of patients presented with HB 1 or 2. Three to twelve months later, 96 % demonstrated HB 1 or 2. A persisting facial palsy was recorded in four patients. Preoperative hearing status was evaluated as a prognostic factor for postoperative hearing, whereas no influence was detected in ABR, vestibular function and tumor length. Early diagnosis of small VS due to high-sensitive MRI requires the management of this tumor entity. Natural behaviour of VS in many cases demonstrates an increase of tumor size over time with deterioration of hearing status. The presented data underline the recommendation of an early surgical treatment in small VS as a valuable

  9. Central/incidental recall and selective attention in young and elderly adults.

    PubMed

    Mergler, N L; Dusek, J B; Hoyer, W J

    1977-01-01

    Central and incidental recall of young (Mean age=28.4) and elderly (Mean age=70.9) men and women was examined. As expected, statistically significant age differences were found for both central and incidental recall. For the eight items mean central recall (5.72) was significantly higher than mean incidental recall (2.56) at both age levels; mean incidental recall was significantly greater than chance for both age groups. Lack of an age X central/incidental interaction was interpreted as supporting a general recall deficit. No evidence was found to suggest an attentional focusing difference between young and elderly adults. Verbal labeling of the central stimuli had no effect on recall scores. Differential recall for each of eight positions of stimuli was also examined. Both age groups exhibited a spatial primacy-recency effect for central but not incidental recall. No support was obtained for an attentional interpretation of age-associated differences in learning.

  10. Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States.

    PubMed

    Carlson, Matthew L; Glasgow, Amy E; Grossardt, Brandon R; Habermann, Elizabeth B; Link, Michael J

    2016-09-01

    The management of small- to medium-sized vestibular schwannoma (VS) remains controversial. Despite a lack of compelling evidence supporting one treatment modality over others, many providers and institutions remain highly biased toward one particular therapy-microsurgery, radiation, or primary observation. The objective of the current study was to estimate the impact of geography on disease presentation and initial treatment of VS in the United States. An analysis of the Surveillance, Epidemiology, and End Results (SEER) database identified 9761 patients with VS that were managed across the 16 SEER geographic registry areas. Univariate analyses demonstrated strong associations between geographic location and tumor size at diagnosis (P < 0.0001). When analyzing the 6115 subjects with tumors between 0 and 3 cm in size, multivariable models identified strong associations between place of residence and treatment modality (P < 0.0001). These multivariable models demonstrated that in many cases the impact of place of residence on treatment selection was greater than other established variables such as tumor size and age. To our knowledge, this is the first study to evaluate geographic trends in VS patient demographics, tumor size and management in the United States. These data suggest that disease presentation and treatment modality are significantly influenced by regional referral patterns, provider or institutional treatment preferences, and regional availability of subspecialty expertise. Understanding geographic bias is important for patients, referring physicians, and treatment providers alike. Until there is clear evidence supporting one therapy over others, multidisciplinary consultation with a minimum of a neurotologist, neurosurgeon, and radiation oncologist or radiosurgeon should be offered in order to provide balanced counseling and accurate informed consent. PMID:27334903

  11. Ectopic Liver Tissue on the Gallbladder: An Incidental Mass in Laparoscopy.

    PubMed

    Karaca, Gökhan; Özden, Hüseyin; Pehlivanlı, Faruk; Pekcici, M Recep; Yıldırım, Yeşim

    2016-01-01

    Ectopic liver is a rare developmental abnormality. It is often asymptomatic and could be determined during the surgery. AIthough it could be detected in different areas of the body either below or above of the diaphragm, ectopic liver is usually found on the wall of the gallbladder. The importance of the ectopic liver came from the elevated risk of development of hepatocellulary carcinoma from ectopic tissue. Ectopic liver tissue could also mimic malign masses in radiographic studies. Ultrasound-guided percutaneous biopsies could be helpful for preoperative diagnosis. Recently, widespread usage of laparoscopic techniques caused an increase on the description of ectopic liver tissues located on the gallbladder. Due to the potential risk of developing malignancy the resection of the mass should be the preferred approach for an incidentally or intraoperatively diagnosed ectopic liver tissue.

  12. 31 CFR 539.403 - Transactions incidental to a licensed transaction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE CONTROL REGULATIONS Interpretations § 539.403 Transactions incidental to a licensed transaction....

  13. Counseling Challenges with Variants of Uncertain Significance and Incidental Findings in Prenatal Genetic Screening and Diagnosis

    PubMed Central

    Westerfield, Lauren; Darilek, Sandra; van den Veyver, Ignatia B.

    2014-01-01

    Prenatal genetic screening and testing provides prospective parents information about the health of their fetus. It is offered to find or address an increased risk for chromosomal abnormalities or other genetic conditions in the fetus or to identify the cause of fetal structural abnormalities detected by prenatal imaging. Genome-wide tests, such as the already widely-used chromosomal microarray analysis and emerging diagnostic whole exome and whole genome sequencing, have improved the ability to detect clinically significant findings, but have also increased the chance of detecting incidental findings and variants of uncertain significance. There is an extensive ongoing discussion about optimal strategies for diagnostic laboratories to report such findings and for providers to communicate them with patients. While consensus opinions and guidelines are beginning to appear, they often exclude the prenatal setting, due to its unique set of challenging considerations. These include more limited knowledge of the impact of genetic variants when prospectively detected in an ongoing pregnancy, the absence or limitations of detecting clinically recognizable phenotypes at the time of testing and the different decision-making processes that will ensue from testing. In this review, we examine these challenges within the medical ethical framework unique to prenatal care. PMID:26237491

  14. Global expression profile in low grade meningiomas and schwannomas shows upregulation of PDGFD, CDH1 and SLIT2 compared to their healthy tissue

    PubMed Central

    TORRES-MARTIN, MIGUEL; LASSALETTA, LUIS; ISLA, ALBERTO; DE CAMPOS, JOSE M.; PINTO, GIOVANNY R.; BURBANO, ROMMEL R.; CASTRESANA, JAVIER S.; MELENDEZ, BARBARA; REY, JUAN A.

    2014-01-01

    Schwannomas and grade I meningiomas are non-metastatic neoplasms that share the common mutation of gene NF2. They usually appear in neurofibromatosis type 2 patients. Currently, there is no drug treatment available for both tumors, thus the use of wide expression technologies is crucial to identify therapeutic targets. Affymetrix Human Gene 1.0 ST was used to test global gene expression in 22 meningiomas, 31 schwannomas and, as non-tumoral controls, 3 healthy meningeal tissues, 8 non-tumoral nerves and 1 primary Schwann cell culture. A non-stringent P-value cut-off and fold change were used to establish deregulated genes. We identified a subset of genes that were upregulated in meningiomas and schwannomas when compared to their respectively healthy tissues, including PDGFD, CDH1 and SLIT2. Thus, these genes should be thoroughly studied as targets in a possible combined treatment. PMID:25333347

  15. Global expression profile in low grade meningiomas and schwannomas shows upregulation of PDGFD, CDH1 and SLIT2 compared to their healthy tissue.

    PubMed

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

    2014-12-01

    Schwannomas and grade I meningiomas are non‑metastatic neoplasms that share the common mutation of gene NF2. They usually appear in neurofibromatosis type 2 patients. Currently, there is no drug treatment available for both tumors, thus the use of wide expression technologies is crucial to identify therapeutic targets. Affymetrix Human Gene 1.0 ST was used to test global gene expression in 22 meningiomas, 31 schwannomas and, as non-tumoral controls, 3 healthy meningeal tissues, 8 non-tumoral nerves and 1 primary Schwann cell culture. A non-stringent P-value cut-off and fold change were used to establish deregulated genes. We identified a subset of genes that were upregulated in meningiomas and schwannomas when compared to their respectively healthy tissues, including PDGFD, CDH1 and SLIT2. Thus, these genes should be thoroughly studied as targets in a possible combined treatment. PMID:25333347

  16. Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients.

    PubMed

    Zhang, Z; Nguyen, Y; De Seta, D; Russo, F Y; Rey, A; Kalamarides, M; Sterkers, O; Bernardeschi, D

    2016-09-06

    La gestione dello schwannoma vestibolare (SV) sporadico si è gradualmente evoluta negli ultimi decenni. Lo scopo di questo studio è di analizzare l’evoluzione negli esiti chirurgici dell’exeresi di queste lesioni, realizzata da un team neurotologico tra il 1990 e il 2006, attraverso differenti approcci. È stata eseguita una revisione retrospettica monocentrica dei dati clinici di 1006 pazienti. Al fine di valutare eventuali modifiche e progressi, il periodo di 17 anni è stato diviso in tre periodi, ciascuno comprendente rispettivamente 268 SV (1990- 1996), 299 SV (1997-2001), e 439 SV (2002-2006). Il follow-up medio è stato di 5,9 ± 2,4 anni. Complessivamente l’asportazione totale è stata ottenuta nel 99,4% dei casi. Il tasso di mortalità è stato dello 0,3%, la meningite e la perdita di liquido cefalo rachidiano (LCR) sono stati osservati nel 1,2% e il 9% dei casi, rispettivamente. La frequenza della perdita di LCR è diminuita dal 11,6% al 7,1% tra il primo e dell’ultimo periodo (p < 0,01) e la revisione chirurgica dal 3,4% al 0,9% (p < 0,05). Il nervo facciale è stato anatomicamente conservato nel 97,7% dei casi. Ad un anno, una buona funzione del nervo facciale è stata osservata nel 85,1% dei pazienti (I e II grado House- Brackmann), con una variazione tra il primo e l’ultimo periodo che andava dal 78,4% al 87,6% (p < 0,05). Ad un anno post-operatorio la conservazione dell’udito è stata ottenuta nel 61,6% dei pazienti, passando dal 50,9% del primo periodo, al 69,0% del periodo piú recente (p < 0,05) (classe A + B + C dalla classificazione AAO-HNS). L’udito utile (classe A + B) è stato conservato nel 33,5% dei casi complessivamente, con percentuali comprese tra il 21,8% e 42% nel primo e nell’ultimo periodo rispettivamente (p < 0,01). Gli esiti chirurgici dell’asportazion dello schwannoma vestibolare sporadico sono migliorati negli anni per quanto riguarda i risultati funzionali del nervo facciale, la conservazione dell’udito, le

  17. Outcomes after incidental durotomy during first-time lumbar discectomy

    PubMed Central

    Desai, Atman; Ball, Perry A.; Bekelis, Kimon; Lurie, Jon; Mirza, Sohail K.; Tosteson, Tor D.; Weinstein, James N.

    2015-01-01

    Introduction Incidental durotomy is an infrequent but well-recognized complication during lumbar disc surgery. The effect of a durotomy on long-term outcomes is however, controversial. We sought to examine whether the occurrence of durotomy during surgery impacts long-term clinical outcome. Methods Spine Patient Outcomes Research Trial (SPORT) cohort participants with a confirmed diagnosis of intervertebral disc herniation (IDH) undergoing standard first-time open discectomy were followed from baseline at 6 weeks, 3, 6, and 12 months, and yearly thereafter, at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database was reviewed. As of May 2009, the mean (SD) follow-up among all analyzed IDH patients was 41.5 (14.5) months (No durotomy: 41.4 vs. Had durotomy: 40.2, p-value<0.68). The median (range) follow-up time among all analyzed IDH patients was 47 (1 to 95) months. Results 799 patients underwent first-time lumbar discectomy. There was an incidental durotomy in 25 (3.1%) of these patients. There were no significant differences with or without durotomy in age, sex, race, body mass index, the prevalence of smoking, diabetes, hypertension, or herniation level or type. When outcome differences between the groups were analyzed, the durotomy group was found to have significantly increased operative duration, operative blood loss and inpatient stay. However, there were no differences in incidence of nerve root injury, post-op mortality, additional surgeries or SF-36 scores of bodily pain or physical function, or Oswestry Disability Index at 1, 2, 3 or 4 years. Conclusions Incidental durotomy during first time lumbar discectomy does not appear to impact long-term outcome in affected patients. PMID:21375385

  18. Paleoindian unifacial stone tool 'spurs': intended accessories or incidental accidents?

    PubMed

    Eren, Metin I; Jennings, Thomas A; Smallwood, Ashley M

    2013-01-01

    Paleoindian unifacial stone tools frequently exhibit distinct, sharp projections, known as "spurs". During the last two decades, a theoretically and empirically informed interpretation-based on individual artifact analysis, use-wear, tool-production techniques, and studies of resharpening-suggested that spurs were sometimes created intentionally via retouch, and other times created incidentally via resharpening or knapping accidents. However, more recently Weedman strongly criticized the inference that Paleoindian spurs were ever intentionally produced or served a functional purpose, and asserted that ethnographic research "demonstrates that the presence of so called 'graver' spurs does not have a functional significance." While ethnographic data cannot serve as a direct test of the archaeological record, we used Weedman's ethnographic observations to create two quantitative predictions of the Paleoindian archaeological record in order to directly examine the hypothesis that Paleoindian spurs were predominantly accidents occurring incidentally via resharpening and reshaping. The first prediction is that the frequency of spurs should increase as tool reduction proceeds. The second prediction is that the frequency of spurs should increase as tool breakage increases. An examination of 563 unbroken tools and 629 tool fragments from the Clovis archaeological record of the North American Lower Great Lakes region showed that neither prediction was consistent with the notion that spurs were predominately accidents. Instead, our results support the prevailing viewpoint that spurs were sometimes created intentionally via retouch, and other times, created incidentally via resharpening or knapping accidents. Behaviorally, this result is consistent with the notion that unifacial stone tools were multifunctional implements that enhanced the mobile lifestyle of Pleistocene hunter-gatherers.

  19. The role of biopsy in incidental renal tumours☆

    PubMed Central

    Al-Marhoon, Mohammed S.

    2011-01-01

    Purpose Historically, the biopsy of renal masses was not advocated, and to date there remains some controversy on the role of biopsy for renal masses in making treatment decisions. With the widespread use of imaging methods, the incidental diagnosis of renal masses has increased, necessitating renal biopsies to better plan the management of these tumours. Here I review previous reports to define the role of biopsy in incidental renal tumours. Methods Data were obtained from English-language studies listed in PubMed on the use of renal biopsy for evaluating incidental solid small renal tumours. Results The biopsy of small renal tumours is increasingly accepted due to: the increase in the incidence of small renal tumours; the finding that a significant number of these tumours are benign; the availability of new management options, such as ablative therapy and surveillance strategies; that imaging alone is unable to predict the biological behaviour of these tumours; and advances in the pathological evaluation of the biopsies. The biopsy procedure has an acceptable complication rate but is not free of limitations. The current recommendations for the use of renal biopsy in small renal tumours are: to help in differentiating benign from malignant renal tumours; before or during ablative therapies and during the follow-up after ablative therapies, for defining treatment success or failure; and to exclude nonrenal cell primary tumours (metastasis and lymphoma) or benign conditions (abscess), which may not require surgery. Conclusions The biopsy of small renal tumours is a safe and accurate procedure, and can help in the planning of definitive patient management. PMID:26579260

  20. Incidental Intravascular Lipoleiomyomatosis in A Hysterectomy Specimen: How To Manage?

    PubMed Central

    Aslanova, Rakhshanda; Can, Nuray; Okten, Sabri Berkem; Aslan, Mehmet Musa

    2015-01-01

    Leiomyomas are common benign tumors in female gynaecologic surgery. They are originated from smooth muscle cells of the uterus and/or sometimes of the uterine vessels. Intravascular lipoleiomyomatosis is a very rare form of leiomyomas which grow within veins and can extend up to vena cava inferior and right heart chamber with cardiac symptoms and is diagnosed by cardiovascular surgeons. We report a case of incidental intravascular lipoleiomyomatosis which was confined to the uterus being diagnosed after a total abdominal hysterectomy by pathology and its management strategy. PMID:25738043

  1. A Unique Incidental Finding in Two Young Dancers

    PubMed Central

    Miller, Marshal N.; Close, Jeremy D.

    2015-01-01

    Dancers frequently present to the sports medicine clinic with a variety of lower extremity complaints ranging from acute and traumatic injuries to more chronic, overuse injuries. This case series depicts a similar and unique incidental radiographic finding found in 2 young dancers seen at the same sports medicine clinic. While the findings are likely benign and unrelated to both patients’ initial presentation, the finding of acroosteolysis can be found in more serious systemic and genetic processes as well an early finding in repetitive trauma. PMID:26502417

  2. Multifocal peritoneal calcifying fibrous tumour: incidental finding at cholecystectomy

    PubMed Central

    Gatt, Noel; Falzon, Sharon; Ratynska, Marzena

    2011-01-01

    Calcifying fibrous tumour (CFT) is a benign tumour of elusive aetiology and a potential for local recurrence. Despite its peculiar histological characteristics it can still be confused with interrelated differential diagnosis like inflammatory myofibroblastic tumour (IMT) or solitary fibrous tumours. The clinical differential diagnosis is however much wider. To date seven cases of multiple peritoneal CFTs are on record. The authors present a case discovered incidentally during laparoscopic cholecystectomy, with no previous history and no radiological diagnosis achieved despite having undergone magnetic resonance cholangiopancreatography (MRCP) and normal routine perioperative investigation. The patient is disease-free 12 months after diagnosis. The case report is followed by a detailed literature review. PMID:22689663

  3. [Fundus albipunctatus incidentally discovered in a black African man].

    PubMed

    Kouassi, F X; Koffi, K V; Safede, K; Daccache, W; Cochener, B

    2006-05-01

    Fundus albipunctatus is a recessive autosomal disease classified as one of the causes of congenital stationary night blindness. It is characterized by early hemeralopia beginning in infancy. We report the incidental discovery of the disease in a 23-year-old black African man with late hemeralopia onset. During the 4 years of follow-up, visual acuity, ERG, and visual field remained normal. We underline the possibility of late hemeralopia onset and discuss the possible progressive features of this disease. Progression may be conditioned by the mutation of the RDH5 gene, which codes for retinol dehydrogenase-5.

  4. 77 FR 61017 - Draft Habitat Conservation Plan and Application for an Incidental Take Permit, Yamhill County, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ...'' of the endangered Fender's blue butterfly incidental to otherwise lawful activities associated with... and mitigate the impacts of incidental take of the Fender's blue butterfly caused by covered... regulatory assurances for potential impacts on the Fender's blue butterfly (Icaricia icarioides...

  5. The Effects of Distance Education and Student Involvement on Incidental Learning

    ERIC Educational Resources Information Center

    Konetes, George D.

    2011-01-01

    Incidental learning is an occurrence that is not generally accounted for using the traditional methods of instructional objectives and outcomes assessment. This type of learning occurs in part as a product of social interaction and active involvement in both online and onsite courses. This study examines various incidental learning outcomes and…

  6. 46 CFR 276.1 - Partial repayment-incidental domestic trading.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Partial repayment-incidental domestic trading. 276.1 Section 276.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING...—incidental domestic trading. In every instance where a vessel, with respect to which a...

  7. 19 CFR 148.17 - Declaration on arrival incidental to further foreign travel.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... foreign travel. 148.17 Section 148.17 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... § 148.17 Declaration on arrival incidental to further foreign travel. (a) Declaration on incidental arrival. A resident who enters the United States merely as an incident of foreign travel and who...

  8. 29 CFR 793.13 - Limitation on related and incidental work.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Limitation on related and incidental work. 793.13 Section... AND TELEVISION STATION EMPLOYEES FROM OVERTIME PAY REQUIREMENTS UNDER SECTION 13(b)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.13 Limitation on related and incidental work....

  9. 29 CFR 793.13 - Limitation on related and incidental work.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Limitation on related and incidental work. 793.13 Section... AND TELEVISION STATION EMPLOYEES FROM OVERTIME PAY REQUIREMENTS UNDER SECTION 13(b)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.13 Limitation on related and incidental work....

  10. 29 CFR 793.13 - Limitation on related and incidental work.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Limitation on related and incidental work. 793.13 Section... AND TELEVISION STATION EMPLOYEES FROM OVERTIME PAY REQUIREMENTS UNDER SECTION 13(b)(9) OF THE FAIR LABOR STANDARDS ACT Requirements for Exemption § 793.13 Limitation on related and incidental work....

  11. 19 CFR 148.17 - Declaration on arrival incidental to further foreign travel.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... foreign travel. 148.17 Section 148.17 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... § 148.17 Declaration on arrival incidental to further foreign travel. (a) Declaration on incidental arrival. A resident who enters the United States merely as an incident of foreign travel and who...

  12. 19 CFR 148.17 - Declaration on arrival incidental to further foreign travel.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... foreign travel. 148.17 Section 148.17 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... § 148.17 Declaration on arrival incidental to further foreign travel. (a) Declaration on incidental arrival. A resident who enters the United States merely as an incident of foreign travel and who...

  13. 76 FR 71940 - Takes of Marine Mammals Incidental to Specified Activities; Physical Oceanographic Studies in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ...NMFS has received an application from the United States Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to conducting physical oceanographic studies in the southwest Indian Ocean, January through February, 2012. Pursuant to the Marine Mammal Protection Act (MMPA), NMFS is requesting comments on its proposal to issue an IHA to the......

  14. Incidental Focus on Form in Teacher-Learner and Learner-Learner Interactions

    ERIC Educational Resources Information Center

    Zhao, Susan Yuqin; Bitchener, John

    2007-01-01

    Current attention in L2 acquisition research focuses on the integration of message-focused and form-focused instruction. One way to accomplish this is through the incidental focus on form during meaning-focused activities. Some studies have investigated incidental focus on form in different contexts and shown that it exists in L2 classes and…

  15. 50 CFR 18.24 - Taking incidental to commercial fishing operations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Taking incidental to commercial fishing... commercial fishing operations. Persons may take marine mammals incidental to commercial fishing operations... of marine mammals permitted in the course of commercial fishing operations be reduced...

  16. 50 CFR 18.24 - Taking incidental to commercial fishing operations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Taking incidental to commercial fishing... commercial fishing operations. Persons may take marine mammals incidental to commercial fishing operations... of marine mammals permitted in the course of commercial fishing operations be reduced...

  17. 50 CFR 18.24 - Taking incidental to commercial fishing operations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Taking incidental to commercial fishing... commercial fishing operations. Persons may take marine mammals incidental to commercial fishing operations... of marine mammals permitted in the course of commercial fishing operations be reduced...

  18. 50 CFR 18.24 - Taking incidental to commercial fishing operations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Taking incidental to commercial fishing... commercial fishing operations. Persons may take marine mammals incidental to commercial fishing operations... of marine mammals permitted in the course of commercial fishing operations be reduced...

  19. 50 CFR 18.24 - Taking incidental to commercial fishing operations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Taking incidental to commercial fishing... commercial fishing operations. Persons may take marine mammals incidental to commercial fishing operations... of marine mammals permitted in the course of commercial fishing operations be reduced...

  20. 29 CFR 793.13 - Limitation on related and incidental work.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements. One limitation is that the work must be an incident to the employee's primary occupation. The... 29 Labor 3 2011-07-01 2011-07-01 false Limitation on related and incidental work. 793.13 Section... LABOR STANDARDS ACT Requirements for Exemption § 793.13 Limitation on related and incidental work....

  1. Involvement in Traditional Cultural Practices and American Indian Children's Incidental Recall of a Folktale

    ERIC Educational Resources Information Center

    Tsethlikai, Monica; Rogoff, Barbara

    2013-01-01

    This study examined incidental recall of a folktale told to 91 Tohono O'odham American Indian children (average age 9 years) who either were directly addressed or had the opportunity to overhear the telling of the folktale. Learning from surrounding incidental events contrasts with learning through direct instruction common in Western schooling,…

  2. 31 CFR 537.516 - Importation of Burmese-origin articles and incidental transactions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Importation of Burmese-origin articles and incidental transactions. 537.516 Section 537.516 Money and Finance: Treasury Regulations... Importation of Burmese-origin articles and incidental transactions. (a) The importation of an article that...

  3. 31 CFR 537.516 - Importation of Burmese-origin articles and incidental transactions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Importation of Burmese-origin articles and incidental transactions. 537.516 Section 537.516 Money and Finance: Treasury Regulations Relating... Burmese-origin articles and incidental transactions. (a) The importation of an article that is a...

  4. 31 CFR 537.516 - Importation of Burmese-origin articles and incidental transactions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Importation of Burmese-origin articles and incidental transactions. 537.516 Section 537.516 Money and Finance: Treasury Regulations Relating... Burmese-origin articles and incidental transactions. (a) The importation of an article that is a...

  5. 31 CFR 537.516 - Importation of Burmese-origin articles and incidental transactions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Importation of Burmese-origin articles and incidental transactions. 537.516 Section 537.516 Money and Finance: Treasury Regulations Relating... Burmese-origin articles and incidental transactions. (a) The importation of an article that is a...

  6. 77 FR 65864 - Receipt of an Application for Incidental Take Permit (16230)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... monitor, minimize, and mitigate the incidental take of ESA-listed sea turtles. The conservation plan... permit application is for the incidental take of ESA-listed adult and juvenile sea turtles associated... (Dermochelys coriacea), hawksbill (Eretmochelys imbricata), and Kemp's ridley (Lepidochelys kempii) sea...

  7. 77 FR 23463 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Space Vehicle and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-19

    ... Marine Mammals Incidental to Space Vehicle and Missile Launch Operations at Kodiak Launch Complex, Alaska... two species of pinnipeds incidental to space vehicle and missile launch operations at the Kodiak... launch operations at the KLC, were issued on March 22, 2011 (76 FR 16311, March 23, 2011), and remain...

  8. 78 FR 78824 - Takes of Marine Mammals Incidental to Specified Activities; Rockaway Delivery Lateral Project off...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... proposes to expand its pipeline system to meet immediate and future demand for natural gas in the New York... have received an application from Transcontinental Gas Pipe Line Company, LLC (Transco) for an Incidental Harassment Authorization to take marine mammals, by harassment, incidental to expanding a...

  9. 19 CFR 148.17 - Declaration on arrival incidental to further foreign travel.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... foreign travel. 148.17 Section 148.17 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... § 148.17 Declaration on arrival incidental to further foreign travel. (a) Declaration on incidental arrival. A resident who enters the United States merely as an incident of foreign travel and who...

  10. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal extraction incidental to the extraction of... ENFORCEMENT, DEPARTMENT OF THE INTERIOR INDIAN LANDS PROGRAM REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other...

  11. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal extraction incidental to the extraction of... ENFORCEMENT, DEPARTMENT OF THE INTERIOR INDIAN LANDS PROGRAM REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other...

  12. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal extraction incidental to the extraction of... ENFORCEMENT, DEPARTMENT OF THE INTERIOR INDIAN LANDS PROGRAM REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other...

  13. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal extraction incidental to the extraction of... ENFORCEMENT, DEPARTMENT OF THE INTERIOR INDIAN LANDS PROGRAM REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other...

  14. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal extraction incidental to the extraction of... ENFORCEMENT, DEPARTMENT OF THE INTERIOR INDIAN LANDS PROGRAM REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other...

  15. 78 FR 63489 - Endangered and Threatened Wildlife and Plants; Receipt of Application for Incidental Take Permit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... Incidental Take Permit; Availability of Proposed Low- Effect Habitat Conservation Plan; Clermont Land... application for incidental take permit (ITP). Clermont Land Development, LLC requests a 10-year ITP under the Endangered Species Act of 1973, as amended (Act). We request public comment on the permit application...

  16. An "Adventure" of MBA Students in Europe: How Volcanic Ash Produced an Incidental Learning Experience

    ERIC Educational Resources Information Center

    Vazquez, Ana Claudia Souza; Ruas, Roberto Lima; Cervo, Clarissa S.; Hutz, Claudio Simon

    2013-01-01

    Because the volcanic ash that affected air travel in Western Europe in 2010 was considered as one of the most meaningful learning experiences by a group of MBA students, this article aims to outline the main aspects of an incidental learning situation, rarely described on management education literature. Incidental learning is an unsystematic…

  17. 76 FR 67419 - Takes of Marine Mammals Incidental to Specified Activities; Piling and Structure Removal in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... affected species or stocks, NMFS considers a number of criteria regarding the impact of the proposed action... Natural Resources (DNR) to incidentally harass, by Level B harassment only, small numbers of harbor seals... Commerce to authorize, upon request, the incidental, but not intentional, taking of small numbers of...

  18. 30 CFR 921.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 921.702 Section 921.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of the chapter, Exemption for Coal Extraction Incidental to the Extraction...

  19. 30 CFR 905.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 905.702 Section 905.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction...

  20. 30 CFR 933.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 933.702 Section 933.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction...

  1. 30 CFR 947.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 947.702 Section 947.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction...

  2. 30 CFR 937.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 937.702 Section 937.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  3. 30 CFR 941.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 941.702 Section 941.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction...

  4. 30 CFR 912.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 912.702 Section 912.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  5. 30 CFR 910.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 910.702 Section 910.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  6. 30 CFR 942.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 942.702 Section 942.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  7. 30 CFR 939.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 939.702 Section 939.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction...

  8. 30 CFR 903.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 903.702 Section 903.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  9. 30 CFR 922.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the extraction of other minerals. 922.702 Section 922.702 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION... minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  10. Incidental Vocabulary Learning in Second Language Acquisition: A Literature Review (Aprendizaje incidental de vocabulario en la adquisición de una segunda lengua: una revisión de literatura)

    ERIC Educational Resources Information Center

    Restrepo Ramos, Falcon Dario

    2015-01-01

    This literature review aims to analyze previous studies that address the incidental learning of vocabulary in second language acquisition. The articles included in this literature review look into the understanding of vocabulary learning through incidental means, the relationship of reading and incidental vocabulary learning, and the strategies…

  11. Neurite-promoting factor in conditioned medium from RN22 Schwannoma cultures: bioassay, fractionation, and properties.

    PubMed

    Manthorpe, M; Varon, S; Adler, R

    1981-09-01

    On polyornithine (PORN) substrata dissociated 8-day chick embryo ciliary ganglionic neurons will survive if the culture medium is supplemented with Ciliary neuronotrophic Factor. However, neuritic growth will not occur unless the substratum is derivatized with a PORN-bindable Neurite Promoting Factor (PNPF). In this preliminary study we report that soluble PNPF can be (1) assayed by a convenient in vitro system; (2) obtained in relatively large amounts from serum-free media conditioned over RN22 Schwannoma cultures; (3) concentrated by using Amicon XM100 ultrafiltration; and (4) separated from nearly all of the non-active protein by using ion-exchange chromatography. The partially purified PNPF can be concentrated using XM100 and is heat- and protease-sensitive. In the course of these fractionation studies we observed in some cases a concentration-dependent interference with the expression of PNPF activity in the bioassay; we propose graphical methods to permit the simultaneous determination of PNPF and the extent of such interference. Different treatments that affected the interference property did not always affect PNPF activity in a reciprocal manner, leaving open the possibility that the interference with PNPF activity results from reversible alteration of the PNPF molecule, or that there exists a separate interfering agent.

  12. Endoscopic-Assisted Middle Fossa Craniotomy for Resection of Vestibular Schwannoma

    PubMed Central

    Chen, Brian S.; Roberts, Daniel S.; Lekovic, Gregory P.

    2015-01-01

    Background Rates of hearing preservation following surgery via middle fossa craniotomy in patients harboring tumors with unfavorable characteristics are significantly lower than for those patients with “favorable” tumors. Objectives We will present two cases both with unfavorable conditions, which underwent endoscopic-assisted middle fossa craniotomy (MFC) resection of intracanalicular vestibular schwannomas with preserved postoperative hearing. Methods Chart reviews were conducted on both patients. Their presentation, intraoperative details, and techniques, pre- and postoperative audiograms, and facial nerve outcomes are presented. Results Patient A had 5.6 × 6.8 × 13.2 mm intracanalicular tumor with unserviceable hearing (pure tone audiometry [PTA], 41; speech determination score [SDS], 47%; class D) but was blind so hearing preservation was attempted. Postoperative hearing was preserved (PTA, 47; SDS, 60%; class B). Patient B had a 5 mm round intracanalicular tumor immediately adjacent to the vestibule and cochlea without any fundal fluid present. Preoperative audiogram showed serviceable hearing (PTA, 48; SDS, 88%; class B). Postoperatively, aidable hearing was preserved (PTA, 51; SDS, 76%; class C). Conclusion Hearing preservation surgery via MFC can be enhanced with endoscopic-assisted dissection, especially in the lateral internal auditory canal. The superior optical view allows for preservation of cochlear nerve function and removal of residual tumor not otherwise seen on microscopy. PMID:26929894

  13. Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

    PubMed

    Scheich, Matthias; Ginzkey, Christian; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Hagen, Rudolf

    2016-10-01

    Microsurgery is one of the primary current standard options for the treatment of vestibular schwannoma (VS). Especially the middle cranial fossa (MCF) approach is a safe and efficacious technique for the preservation of hearing and facial nerve function in small VS. Postoperative complications are rare, although a leakage of cerebrospinal fluid (CSF) is common. The aim of this study was to analyze postoperative CSF leaks and to describe strategies for postoperative treatment. Between October 2005 and May 2012, 148 patients suffering from VS and selected for microsurgery via the MCF approach were treated in our department. Postoperative CSF leakage occurred in 19 patients. We found a leakage via the Eustachian tube into the nasopharynx in 18 patients and one case of incisional leakage. In 13 cases leaking stopped within 5 days by conservative management including bed rest and intravenous (i.v) antibiotics. Five patients needed lumbar drainage (LD) and only two patients had to undergo revision surgery to seal and pack the mastoid. Analyzed risk factors were age, gender, tumor size and pneumatization of the mastoid. Only the latter showed a significant influence on CSF leakage. We could demonstrate that a stepwise strategy is needed for successful treatment of CSF leaks. PMID:26749560

  14. Anti-VEGF treatment improves neurological function and augments radiation response in NF2 schwannoma model.

    PubMed

    Gao, Xing; Zhao, Yingchao; Stemmer-Rachamimov, Anat O; Liu, Hao; Huang, Peigen; Chin, ShanMin; Selig, Martin K; Plotkin, Scott R; Jain, Rakesh K; Xu, Lei

    2015-11-24

    Hearing loss is the main limitation of radiation therapy for vestibular schwannoma (VS), and identifying treatment options that minimize hearing loss are urgently needed. Treatment with bevacizumab is associated with tumor control and hearing improvement in neurofibromatosis type 2 (NF2) patients; however, its effect is not durable and its mechanism of action on nerve function is unknown. We modeled the effect anti-VEGF therapy on neurological function in the sciatic nerve model and found that it improves neurological function by alleviating tumor edema, which may further improve results by decreasing muscle atrophy and increasing nerve regeneration. Using a cranial window model, we showed that anti-VEGF treatment may achieve these effects via normalizing the tumor vasculature, improving vessel perfusion, and delivery of oxygenation. It is known that oxygen is a potent radiosensitizer; therefore, we further demonstrated that combining anti-VEGF with radiation therapy can achieve a better tumor control and help lower the radiation dose and, thus, minimize radiation-related neurological toxicity. Our results provide compelling rationale for testing combined therapy in human VS. PMID:26554010

  15. Corneal infection by Pseudomonas stutzeri following excision of trigeminal nerve schwannoma.

    PubMed

    Kalra, Deepak; Sati, Alok; Shankar, Sandeep; Jha, Ashok

    2015-01-01

    A 25-year-old woman underwent intracranial surgery for trigeminal nerve schwannoma (TGNS) with persistent left-sided facial hypoaesthesia. Two months later, she developed a central corneal ulceration. Scraping of the corneal lesion revealed Gram-negative bacilli. Genus level identification was achieved using standard techniques and species level identification, revealing Pseudomonas stutzeri, was aided by a VITEK 2 compact system. Broad-spectrum fortified antibiotics were initially started followed by species-sensitive fortified antibiotics. Ocular surface toxicity developed a week later; this was managed with a non-fortified antibiotic. The epithelial defect healed in 3 weeks with subsequent corneal scar formation. Visual rehabilitation was achieved with deep anterior lamellar keratoplasty. Six months following surgery, the patient had a visual acuity of 20/40 with -1.25 170° -0.5 refractive correction and a clear graft. This case report, for the first time, highlights P. stutzeri, an aetiological agent of corneal ulcer following excision of TGNS and its successful management.

  16. Hearing Outcomes After Stereotactic Radiosurgery for Unilateral Intracanalicular Vestibular Schwannomas: Implication of Transient Volume Expansion

    SciTech Connect

    Kim, Young-Hoon; Kim, Dong Gyu; Han, Jung Ho; Chung, Hyun-Tai; Kim, In Kyung; Song, Sang Woo; Park, Jeong-Hoon; Kim, Jin Wook; Kim, Yong Hwy; Park, Chul-Kee; Kim, Chae-Yong; Paek, Sun Ha; Jung, Hee-Won

    2013-01-01

    Purpose: We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials: Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 {+-} 0.03 cm{sup 3} (range, 0.03-1.00 cm{sup 3}), and the mean marginal dose was 12.2 {+-} 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results: The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of {>=}20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average {>=}20 dB) (odds ratio = 7.638; 95% confidence interval, 2.317-25.181; P=.001 and odds ratio = 3.507; 95% confidence interval, 1.228-10.018; P=.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions: Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

  17. Role of intracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery

    SciTech Connect

    Massager, Nicolas . E-mail: nmassage@ulb.ac.be; Nissim, Ouzi; Delbrouck, Carine; Devriendt, Daniel; David, Philippe; Desmedt, Francoise; Wikler, David; Hassid, Sergio; Brotchi, Jacques; Levivier, Marc

    2006-04-01

    Purpose: To analyze the relationship between hearing preservation after gamma knife radiosurgery (GKR) for vestibular schwannoma (VS) and some volumetric and dosimetric parameters of the intracanalicular components of VS. Methods and Materials: This study included 82 patients with a VS treated by GKR; all patients had no NF2 disease, a Gardner-Robertson hearing class 1-4 before treatment, a marginal dose of 12 Gy, and a radiologic and audiologic follow-up {>=}1 year post-GKR. The volume of both the entire tumor and the intracanalicular part of the tumor and the mean and integrated dose of these two volumes were correlated to the auditory outcomes of patients. Results: At last hearing follow-up, 52 patients had no hearing worsening, and 30 patients had an increase of {>=}1 class on Gardner-Robertson classification. We found that hearing preservation after GKR is significantly correlated with the intracanalicular tumor volume, as well as with the integrated dose delivered to the intracanalicular tumor volume. Conclusions: Some volumetric and dosimetric parameters of the intracanalicular part of the tumor influence hearing preservation after GKR of VS. Consequently, we advise the direct treatment of patients with preserved functional hearing and a VS including a small intracanalicular volume.

  18. Anti-VEGF treatment improves neurological function and augments radiation response in NF2 schwannoma model

    PubMed Central

    Gao, Xing; Zhao, Yingchao; Stemmer-Rachamimov, Anat O.; Liu, Hao; Huang, Peigen; Chin, ShanMin; Selig, Martin K.; Plotkin, Scott R.; Jain, Rakesh K.; Xu, Lei

    2015-01-01

    Hearing loss is the main limitation of radiation therapy for vestibular schwannoma (VS), and identifying treatment options that minimize hearing loss are urgently needed. Treatment with bevacizumab is associated with tumor control and hearing improvement in neurofibromatosis type 2 (NF2) patients; however, its effect is not durable and its mechanism of action on nerve function is unknown. We modeled the effect anti-VEGF therapy on neurological function in the sciatic nerve model and found that it improves neurological function by alleviating tumor edema, which may further improve results by decreasing muscle atrophy and increasing nerve regeneration. Using a cranial window model, we showed that anti-VEGF treatment may achieve these effects via normalizing the tumor vasculature, improving vessel perfusion, and delivery of oxygenation. It is known that oxygen is a potent radiosensitizer; therefore, we further demonstrated that combining anti-VEGF with radiation therapy can achieve a better tumor control and help lower the radiation dose and, thus, minimize radiation-related neurological toxicity. Our results provide compelling rationale for testing combined therapy in human VS. PMID:26554010

  19. Neurite-promoting factor in conditioned medium from RN22 Schwannoma cultures: bioassay, fractionation, and properties.

    PubMed

    Manthorpe, M; Varon, S; Adler, R

    1981-09-01

    On polyornithine (PORN) substrata dissociated 8-day chick embryo ciliary ganglionic neurons will survive if the culture medium is supplemented with Ciliary neuronotrophic Factor. However, neuritic growth will not occur unless the substratum is derivatized with a PORN-bindable Neurite Promoting Factor (PNPF). In this preliminary study we report that soluble PNPF can be (1) assayed by a convenient in vitro system; (2) obtained in relatively large amounts from serum-free media conditioned over RN22 Schwannoma cultures; (3) concentrated by using Amicon XM100 ultrafiltration; and (4) separated from nearly all of the non-active protein by using ion-exchange chromatography. The partially purified PNPF can be concentrated using XM100 and is heat- and protease-sensitive. In the course of these fractionation studies we observed in some cases a concentration-dependent interference with the expression of PNPF activity in the bioassay; we propose graphical methods to permit the simultaneous determination of PNPF and the extent of such interference. Different treatments that affected the interference property did not always affect PNPF activity in a reciprocal manner, leaving open the possibility that the interference with PNPF activity results from reversible alteration of the PNPF molecule, or that there exists a separate interfering agent. PMID:7276956

  20. Nonsteroidal anti-inflammatory medications are cytostatic against human vestibular schwannomas.

    PubMed

    Dilwali, Sonam; Kao, Shyan-Yuan; Fujita, Takeshi; Landegger, Lukas D; Stankovic, Konstantina M

    2015-07-01

    Vestibular schwannomas (VSs) are the most common tumors of the cerebellopontine angle. Significant clinical need exists for pharmacotherapies against VSs. Motivated by previous findings that immunohistochemical expression of cyclooxygenase 2 (COX-2) correlates with VS growth rate, we investigated the role of COX-2 in VSs and tested COX-2 inhibiting salicylates against VSs. COX-2 was found to be aberrantly expressed in human VS and primary human VS cells in comparison with control human nerve specimens and primary Schwann cells (SCs), respectively. Furthermore, levels of prostaglandin E2, the downstream enzymatic product of COX-2, were correlated with primary VS culture proliferation rate. Because COX-2 inhibiting salicylates such as aspirin are well tolerated and frequently clinically used, we assessed their repurposing for VS. Changes in proliferation, cell death, and cell viability were analyzed in primary VS cultures treated with aspirin, sodium salicylate, or 5-aminosalicylic acid. These drugs neither increased VS cell death nor affected healthy SCs. The cytostatic effect of aspirin in vitro was in concurrence with our previous clinical finding that patients with VS taking aspirin demonstrate reduced tumor growth. Overall, this work suggests that COX-2 is a key modulator in VS cell proliferation and survival and highlights salicylates as promising pharmacotherapies against VS.

  1. Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study

    SciTech Connect

    Varughese, Jobin Kotakkathu; Wentzel-Larsen, Tore; Pedersen, Paal-Henning; Mahesparan, Ruby; Lund-Johansen, Morten

    2012-10-01

    Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68) and -13.1 years (95% confidence intervals, -111.0 to -6.94), respectively. Tumor control, defined as a post-GKRS growth rate {<=}0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected by treatment, but quality of life was improved.

  2. The management of incidental findings of reduction mammoplasty specimens.

    PubMed

    Goodwin, Jessica T; Decroff, Chantelle; Dauway, Emilia; Sybenga, Amelia; Mahabir, Raman C

    2013-01-01

    Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors' institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients. PMID:24497763

  3. The management of incidental findings of reduction mammoplasty specimens

    PubMed Central

    Goodwin, Jessica T; DeCroff, Chantelle; Dauway, Emilia; Sybenga, Amelia; Mahabir, Raman C

    2013-01-01

    Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors’ institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients. PMID:24497763

  4. Anxiety perseverance in intergroup interaction: When incidental explanations backfire.

    PubMed

    West, Tessa V; Pearson, Adam R; Stern, Chadly

    2014-11-01

    Intergroup interactions are often anxiety provoking, and this can lead members of both majority and minority groups to avoid contact. Whereas negative consequences of experiencing intergroup anxiety are well documented, the role of perceived anxiety has received substantially less theoretical and empirical attention. We demonstrate in 3 experiments that the perception of anxiety in others can undermine intergroup interactions even when the anxiety can be attributed to a source that is unrelated to the interaction. Participants who learned that a cross-race partner's anxiety could be attributed to an upcoming evaluation (Study 1) or a stimulant (i.e., caffeine, Studies 2 and 3) expressed less interest in continuing an interaction (Studies 1 and 2), showed less self-disclosure (Study 2), and increased physical distance between themselves and their partner (Study 3) than did those given no source information and participants who interacted with a same-race partner. Moreover, compared to control participants, perceivers who were given an incidental explanation for their partner's anxiety perceived outgroup, but not ingroup, partners as more anxious (Studies 1 and 3) and showed heightened accessibility of anxiety words (Study 3), indicating that incidental source information enhanced accessibility of intergroup (but not intragroup) anxiety at early stages of information processing. Theoretical and practical implications for combating paradoxical effects of perceived anxiety in intergroup interactions are considered.

  5. Small Renal Masses: Incidental Diagnosis, Clinical Symptoms, and Prognostic Factors

    PubMed Central

    Sánchez-Martín, F. M.; Millán-Rodríguez, F.; Urdaneta-Pignalosa, G.; Rubio-Briones, J.; Villavicencio-Mavrich, H.

    2008-01-01

    Introduction. The small renal masses (SRMs) have increased over the past two decades due to more liberal use of imaging techniques. SRMs have allowed discussions regarding their prognostic, diagnosis, and therapeutic approach. Materials and methods. Clinical presentation, incidental diagnosis, and prognosis factors of SRMs are discussed in this review. Results. SRMs are defined as lesions less than 4 cm in diameter. SRM could be benign, and most malignant SMRs are low stage and low grade. Clinical symptoms like hematuria are very rare, being diagnosed by chance (incidental) in most cases. Size, stage, and grade are still the most consistent prognosis factors in (RCC). An enhanced contrast SRM that grows during active surveillance is clearly malignant, and its aggressive potential increases in those greater than 3 cm. Clear cell carcinoma is the most frequent cellular type of malign SRM. Conclusions. Only some SRMs are benign. The great majority of malign SRMs have good prognosis (low stage and grade, no metastasis) with open or laparoscopic surgical treatment (nephron sparing techniques). Active surveillance is an accepted attitude in selected cases. PMID:19165347

  6. Incidental Medical Information in Whole-Exome Sequencing

    PubMed Central

    Hadley, Donald W.; Pineda-Alvarez, Daniel E.; Kamat, Aparna; Teer, Jamie K.; Cherukuri, Praveen F.; Hansen, Nancy F.; Cruz, Pedro; Young, Alice C.; Berkman, Benjamin E.; Chandrasekharappa, Settara C.; Mullikin, James C.

    2012-01-01

    Genomic technologies, such as whole-exome sequencing, are a powerful tool in genetic research. Such testing yields a great deal of incidental medical information, or medical information not related to the primary research target. We describe the management of incidental medical information derived from whole-exome sequencing in the research context. We performed whole-exome sequencing on a monozygotic twin pair in which only 1 child was affected with congenital anomalies and applied an institutional review board–approved algorithm to determine what genetic information would be returned. Whole-exome sequencing identified 79 525 genetic variants in the twins. Here, we focus on novel variants. After filtering artifacts and excluding known single nucleotide polymorphisms and variants not predicted to be pathogenic, the twins had 32 novel variants in 32 genes that were felt to be likely to be associated with human disease. Eighteen of these novel variants were associated with recessive disease and 18 were associated with dominantly manifesting conditions (variants in some genes were potentially associated with both recessive and dominant conditions), but only 1 variant ultimately met our institutional review board–approved criteria for return of information to the research participants. PMID:22585771

  7. Word imageability and N400 in an incidental memory paradigm.

    PubMed

    Nittono, Hiroshi; Suehiro, Maki; Hori, Tadao

    2002-06-01

    High imagery words are memorized better than low imagery words. To examine how these words are processed at encoding, event-related potentials (ERPs) were recorded in an incidental memory paradigm. Frequency-matched high and low imagery words (45 words each) were presented in a random order on a computer screen. Twelve university students were asked to rate the imageability of a word's referent on a five-point scale. High imagery words elicited a larger N400 than low imagery words did. The N400 was more left-lateralized for low imagery words than for high imagery words, suggesting that some neural generators (probably in the right hemisphere) were not involved in the processing of low imagery words. Difference waveforms showed that the N400 was followed by a second negativity (N800), which was also larger for high imagery words and had a scalp distribution similar to that of the N400. Subsequent free recall showed a classical imagery effect that high imagery words were recalled better than low imagery words. These results suggest that the superiority of high imagery words over low imagery words in incidental memory results from more extensive activation of a semantic network distributed across the left and right hemispheres, the latter of which probably deals with imagery-related information that is not activated by low imagery words. PMID:12031296

  8. Unexpected but Incidental Positive Outcomes Predict Real-World Gambling.

    PubMed

    Otto, A Ross; Fleming, Stephen M; Glimcher, Paul W

    2016-03-01

    Positive mood can affect a person's tendency to gamble, possibly because positive mood fosters unrealistic optimism. At the same time, unexpected positive outcomes, often called prediction errors, influence mood. However, a linkage between positive prediction errors-the difference between expected and obtained outcomes-and consequent risk taking has yet to be demonstrated. Using a large data set of New York City lottery gambling and a model inspired by computational accounts of reward learning, we found that people gamble more when incidental outcomes in the environment (e.g., local sporting events and sunshine) are better than expected. When local sports teams performed better than expected, or a sunny day followed a streak of cloudy days, residents gambled more. The observed relationship between prediction errors and gambling was ubiquitous across the city's socioeconomically diverse neighborhoods and was specific to sports and weather events occurring locally in New York City. Our results suggest that unexpected but incidental positive outcomes influence risk taking. PMID:26796614

  9. 78 FR 24161 - Takes of Marine Mammals Incidental to Specified Activities; Navy Training Conducted at the Silver...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    .... ACTION: Notice; proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received a complete application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to conducting training exercises at the...

  10. 77 FR 19231 - Takes of Marine Mammals Incidental to Specified Activities; Navy Training Conducted at the Silver...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    .... ACTION: Notice; additional information for the proposed incidental harassment authorization; request for comments. SUMMARY: NMFS has received an application from the U.S. Navy (Navy) for an Incidental Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to conducting training exercises at...

  11. 12 CFR 1501.2 - What activities has the Secretary determined to be financial in nature or incidental to a...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to be financial in nature or incidental to a financial activity? 1501.2 Section 1501.2 Banks and... the Secretary determined to be financial in nature or incidental to a financial activity? (a... following types of activities are financial in nature or incidental to a financial activity when...

  12. 12 CFR 1501.2 - What activities has the Secretary determined to be financial in nature or incidental to a...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... be financial in nature or incidental to a financial activity? 1501.2 Section 1501.2 Banks and Banking... Secretary determined to be financial in nature or incidental to a financial activity? (a) Activities... of activities are financial in nature or incidental to a financial activity when conducted...

  13. 12 CFR 1501.2 - What activities has the Secretary determined to be financial in nature or incidental to a...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... be financial in nature or incidental to a financial activity? 1501.2 Section 1501.2 Banks and Banking... Secretary determined to be financial in nature or incidental to a financial activity? (a) Activities... of activities are financial in nature or incidental to a financial activity when conducted...

  14. 12 CFR 1501.2 - What activities has the Secretary determined to be financial in nature or incidental to a...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... be financial in nature or incidental to a financial activity? 1501.2 Section 1501.2 Banks and Banking... Secretary determined to be financial in nature or incidental to a financial activity? (a) Activities... of activities are financial in nature or incidental to a financial activity when conducted...

  15. 12 CFR 1501.2 - What activities has the Secretary determined to be financial in nature or incidental to a...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... be financial in nature or incidental to a financial activity? 1501.2 Section 1501.2 Banks and Banking... Secretary determined to be financial in nature or incidental to a financial activity? (a) Activities... of activities are financial in nature or incidental to a financial activity when conducted...

  16. Long-Term Follow-up of Acoustic Schwannoma Radiosurgery With Marginal Tumor Doses of 12 to 13 Gy

    SciTech Connect

    Chopra, Rahul; Kondziolka, Douglas; Niranjan, Ajay; Lunsford, L. Dade; Flickinger, John C. . E-mail: flickingerjc@upmc.edu

    2007-07-01

    Purpose: To define long-term tumor control and clinical outcomes of radiosurgery with marginal tumor doses of 12 to 13 Gy for unilateral acoustic schwannoma. Methods and Materials: A total of 216 patients with previously untreated unilateral acoustic schwannoma underwent Gamma Knife radiosurgery between 1992 and 2000 with marginal tumor doses of 12 to 13 Gy (median, 13 Gy). Median follow-up was 5.7 years (maximum, 12 years; 41 patients with >8 years). Treatment volumes were 0.08-37.5 cm{sup 3} (median, 1.3 cm{sup 3}). Results: The 10-year actuarial resection-free control rate was 98.3% {+-} 1.0%. Three patients required tumor resection: 2 for tumor growth and 1 partial resection for an enlarging adjacent subarachnoid cyst. Among 121 hearing patients with >3 years of follow-up, crude hearing preservation rates were 71% for keeping the same Gardner-Robertson hearing level, 74% for serviceable hearing, and 95% for any testable hearing. For 25 of these patients with intracanalicular tumors, the respective rates for preserving the same Gardner-Robertson level, serviceable hearing, and testable hearing were 80%, 88%, and 96%. Ten-year actuarial rates for preserving the same Gardner-Robertson hearing levels, serviceable hearing, any testable hearing, and unchanged facial and trigeminal nerve function were 44.0% {+-} 11.7%, 44.5% {+-} 10.5%, 85.3% {+-} 6.2%, 100%, and 94.9% {+-} 1.8%, respectively. Conclusions: Acoustic schwannoma radiosurgery with 12 to 13 Gy provides high rates of long-term tumor control and cranial nerve preservation after long-term follow-up.

  17. One-Step Posterior and Anterior Combined Approach for L5 Retroperitoneal Schwannoma Eroding a Lumbar Vertebra

    PubMed Central

    Picotti, Veronica; Raco, Antonino

    2016-01-01

    We report the case of a large lumbar schwannoma eroding the vertebra and originating from spinal canal with invasion of the retroperitoneal space. We also review all the cases in literature reporting lumbar schwannomas eroding the vertebral bodies and invading the retroperitoneal space focusing on the surgical strategies to manage them. Spinal CT-scan revealed a 44 mm × 55 mm inhomogeneous soft-tissue mass arising from the right L5-S1 neural foramen and its most anterior portion had a clear colliquative aspect. Magnetic resonance image showed a neoplastic lesion with homogeneous low signal in T1WI, heterogeneous signal in T2WI, and strong enhancement in postgadolinium examination. It developed as well in the retroperitoneal space, posteriorly to the iliac vein, up to the psoas muscle with wide erosion of the omolateral conjugate foramen. We performed a one-step combined approach together with the vascular surgeon because the lesion was too huge to allow a complete resection via a posterior approach and furthermore its tight relationship with the psoas muscle and the iliac vessels in the retroperitoneal space should be more safely managed via a retroperitoneal approach. We strongly suggest a 1-step surgery first approaching the dumbbell and the intraspinal schwannomas posteriorly achieving the decompression of the spinal canal and the cleavage of the tumor cutting the root of origin and the vascular supply and valuating the stability of the spine for potential artrodesis procedure. The patient must be then operated on via a retroperitoneal approach achieving the complete en bloc resection of the tumor. PMID:27766176

  18. Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell Gamma Knife Society 2000 debate.

    PubMed

    Linskey, Mark E

    2013-12-01

    By definition, the term "radiosurgery" refers to the delivery of a therapeutic radiation dose in a single fraction, not simply the use of stereotaxy. Multiple-fraction delivery is better termed "stereotactic radiotherapy." There are compelling radiobiological principles supporting the biological superiority of single-fraction radiation for achieving an optimal therapeutic response for the slowly proliferating, late-responding, tissue of a schwannoma. It is axiomatic that complication avoidance requires precise three-dimensional conformality between treatment and tumor volumes. This degree of conformality can only be achieved through complex multiisocenter planning. Alternative radiosurgery devices are generally limited to delivering one to four isocenters in a single treatment session. Although they can reproduce dose plans similar in conformality to early gamma knife dose plans by using a similar number of isocenters, they cannot reproduce the conformality of modern gamma knife plans based on magnetic resonance image--targeted localization and five to 30 isocenters. A disturbing trend is developing in which institutions without nongamma knife radiosurgery (GKS) centers are championing and/or shifting to hypofractionated stereotactic radiotherapy for vestibular schwannomas. This trend appears to be driven by a desire to reduce complication rates to compete with modern GKS results by using complex multiisocenter planning. Aggressive advertising and marketing from some of these centers even paradoxically suggests biological superiority of hypofractionation approaches over single-dose radiosurgery for vestibular schwannomas. At the same time these centers continue to use the term radiosurgery to describe their hypofractionated radiotherapy approach in an apparent effort to benefit from a GKS "halo effect." It must be reemphasized that as neurosurgeons our primary duty is to achieve permanent tumor control for our patients and not to eliminate complications at the

  19. Cochlear Implantation in Patients with Neurofibromatosis Type 2 and Patients with Vestibular Schwannoma in the Only Hearing Ear

    PubMed Central

    Celis-Aguilar, Erika; Lassaletta, Luis; Gavilán, Javier

    2012-01-01

    Cochlear implants are a new surgical option in the hearing rehabilitation of patients with neurofibromatosis type 2 (NF2) and patients with vestibular schwannoma (VS) in the only hearing ear. Auditory brainstem implant (ABI) has been the standard surgical treatment for these patients. We performed a literature review of patients with NF2 and patients with VS in the only hearing ear. Cochlear implantation (CI) provided some auditory benefit in all patients. Preservation of cochlear nerve integrity is crucial after VS resection. Results ranged from environmental sound awareness to excellent benefit with telephone use. Promontory stimulation is recommended although not crucial. MRI can be performed safely in cochlear implanted patients. PMID:22518152

  20. Cystic retroperitoneal renal hilar ancient schwannoma: Report of a rare case with atypical presentation masquerading as simple cyst.

    PubMed

    Nayyar, Rishi; Khattar, Nikhil; Sood, Rajeev; Bhardwaj, Meenakshi

    2011-07-01

    Schwannoma is a benign soft tissue tumor of neural origin arising from the Schwann cells of the neural sheath. It has rarely been reported in renal or perirenal region. The preoperative diagnosis has mostly been confused with renal cell carcinoma in this location in most previous reports. We report a case that presented with a large "simple cystic" mass at the renal hilum. The preoperative differential diagnosis included hilar renal cortical cyst, renal sinus cyst, ureteropelvic junction obstruction (UPJO), or even a hydatid cyst. The final diagnosis was clinched only on histopathological examination.

  1. Schwannoma extending from the umbilical region to the mid-thigh, compressing the major vessels of the right leg: A case report and review of the literature.

    PubMed

    Yorke, Joseph; Duduyemi, Babatunde M; Yifieyeh, Abiboye C; Fiifi-Yankson, P K S; Appiah, Collins; Afful-Yorke, Dorcas; Adinku, Michael O; Ahulu, D

    2016-07-01

    Schwannomas are benign, usually encapsulated, nerve sheath tumours derived from Schwann cells. They commonly arise from the cranial nerves as acoustic schwannomas and are extremely rare in the pelvis and retroperitoneal area (<0.5% of reported cases) unless they are combined with Von Recklinghausen disease (type 1 neurofibromatosis). We report the case of a 23-year-old woman with a mass extending from the umbilical region in the abdomen to the upper two-thirds of the thigh. As this tumour is so rare, and in order to ensure optimal treatment and survival for our patient, a computed tomography-guided biopsy was performed before en bloc tumour excision. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; the diagnosis was a schwannoma. Abdominal schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumours and may offer the advantage of better visualisation of structures owing to the magnification in laparoscopic view, especially in narrow anatomical spaces. However, in our case laparoscopy was not considered owing to the size and anatomical location of the tumour. PMID:27384363

  2. Long-Term Outcomes of Vestibular Schwannomas Treated With Fractionated Stereotactic Radiotherapy: An Institutional Experience

    SciTech Connect

    Kapoor, Sumit; Batra, Sachin; Carson, Kathryn; Shuck, John; Kharkar, Siddharth; Gandhi, Rahul; Jackson, Juan; Wemmer, Jan; Terezakis, Stephanie; Shokek, Ori; Kleinberg, Lawrence; Rigamonti, Daniele

    2011-11-01

    Purpose: We assessed clinical outcome and long-term tumor control after fractionated stereotactic radiotherapy (FSRT) for unilateral schwannoma. Methods and Materials: Between 1995 and 2007, 496 patients were treated with fractionated stereotactic radiotherapy at Johns Hopkins Hospital (Baltimore, MD); 385 patients had radiologic follow-up that met the inclusion criteria. The primary endpoint was treatment failure. Secondary endpoints were radiologic progression and clinical outcome. Logistic regression analysis assessed the association of age, race, tumor side, sex, and pretreatment symptoms. Results: In 11 patients (3%) treatment failed, and they required salvage (microsurgical) treatment. Radiologic progression was observed in 116 patients (30.0%), including 35 patients (9%) in whom the treatment volume more than doubled during the follow-up period, although none required surgical resection. Tumors with baseline volumes of less than 1 cm{sup 3} were 18.02 times more likely to progress than those with tumor volumes of 1 cm{sup 3} or greater (odds ratio, 18.02; 95% confidence interval, 4.25-76.32). Treatment-induced neurologic morbidity included 8 patients (1.6%) with new facial weakness, 12 patients (2.8%) with new trigeminal paresthesias, 4 patients (0.9%) with hydrocephalus (1 communicating and 3 obstructive), and 2 patients (0.5%) with possibly radiation-induced neoplasia. Conclusions: Although the rate of treatment failure is low (3%), careful follow-up shows that radiologic progression occurs frequently. When reporting outcome, the 'no salvage surgery needed' and 'no additional treatment needed' criteria for treatment success need to be complemented by the radiologic data.

  3. Pretreatment Growth Rate Predicts Radiation Response in Vestibular Schwannomas

    SciTech Connect

    Niu, Nina N.; Niemierko, Andrzej; Larvie, Mykol; Curtin, Hugh; Loeffler, Jay S.; McKenna, Michael J.; Shih, Helen A.

    2014-05-01

    Purpose: Vestibular schwannomas (VS) are often followed without initial therapeutic intervention because many tumors do not grow and radiation therapy is associated with potential adverse effects. In an effort to determine whether maximizing initial surveillance predicts for later treatment response, the predictive value of preirradiation growth rate of VS on response to radiation therapy was assessed. Methods and Materials: Sixty-four patients with 65 VS were treated with single-fraction stereotactic radiation surgery or fractionated stereotactic radiation therapy. Pre- and postirradiation linear expansion rates were estimated using volumetric measurements on sequential magnetic resonance images (MRIs). In addition, postirradiation tumor volume change was classified as demonstrating shrinkage (ratio of volume on last follow-up MRI to MRI immediately preceding irradiation <80%), stability (ratio 80%-120%), or expansion (ratio >120%). The median pre- and postirradiation follow-up was 20.0 and 27.5 months, respectively. Seven tumors from neurofibromatosis type 2 (NF2) patients were excluded from statistical analyses. Results: In the 58 non-NF2 patients, there was a trend of correlation between pre- and postirradiation volume change rates (slope on linear regression, 0.29; P=.06). Tumors demonstrating postirradiation expansion had a median preirradiation growth rate of 89%/year, and those without postirradiation expansion had a median preirradiation growth rate of 41%/year (P=.02). As the preirradiation growth rate increased, the probability of postirradiation expansion also increased. Overall, 24.1% of tumors were stable, 53.4% experienced shrinkage, and 22.5% experienced expansion. Predictors of no postirradiation tumor expansion included no prior surgery (P=.01) and slower tumor growth rate (P=.02). The control of tumors in NF2 patients was only 43%. Conclusions: Radiation therapy is an effective treatment for VS, but tumors that grow quickly preirradiation may be

  4. Volume Changes After Stereotactic LINAC Radiotherapy in Vestibular Schwannoma: Control Rate and Growth Patterns

    SciTech Connect

    Langenberg, Rick van de; Dohmen, Amy J.C.; Bondt, Bert J. de; Nelemans, Patty J.; Baumert, Brigitta G.; Stokroos, Robert J.

    2012-10-01

    Purpose: The purpose of this study was to evaluate the control rate of vestibular schwannomas (VS) after treatment with linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) or radiotherapy (SRT) by using a validated volumetric measuring tool. Volume-based studies on prognosis after LINAC-based SRS or SRT for VS are reported scarcely. In addition, growth patterns and risk factors predicting treatment failure were analyzed. Materials and Methods: Retrospectively, 37 VS patients treated with LINAC based SRS or SRT were analyzed. Baseline and follow-up magnetic resonance imaging scans were analyzed with volume measurements on contrast enhanced T1-weighted magnetic resonance imaging. Absence of intervention after radiotherapy was defined as 'no additional intervention group, ' absence of radiological growth was defined as 'radiological control group. ' Significant growth was defined as a volume change of 19.7% or more, as calculated in a previous study. Results: The cumulative 4-year probability of no additional intervention was 96.4% {+-} 0.03; the 4-year radiological control probability was 85.4% {+-} 0.1). The median follow-up was 40 months. Overall, shrinkage was seen in 65%, stable VS in 22%, and growth in 13%. In 54% of all patients, transient swelling was observed. No prognostic factors were found regarding VS growth. Previous treatment and SRS were associated with transient swelling significantly. Conclusions: Good control rates are reported for LINAC based SRS or SRT in VS, in which the lower rate of radiological growth control is attributed to the use of the more sensitive volume measurements. Transient swelling after radiosurgery is a common phenomenon and should not be mistaken for treatment failure. Previous treatment and SRS were significantly associated with transient swelling.

  5. Melanotic schwannoma of the cervical spine progressing with pulmonary metastasis: case report.

    PubMed

    Faria, Mário Henrique Girão; Dória-Netto, Ricardo Henrique; Osugue, Gustavo Jun; Queiroz, Luciano de Souza; Chaddad-Neto, Feres Eduardo

    2013-01-01

    Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm. Only 10% of these tumors will undergo malignant degeneration, with exceedingly rare reported metastasis. We present a 32-year-old woman with a 6-month history of cervical pain and left arm progressive weakness. Neurological examination showed a left upper limb radicular pain, with pyramidal syndrome at C5 level. The magnetic resonance imaging (MRI) study highlighted an intradural extramedullary heterogeneous mass along the spinal cord at the C4-C5 level, slightly hyperintense with T1 and hypointense with T2-weighted sequences, invading the left neural foramen. The patient underwent C3-C5 laminectomy with total resection of a black tumor. In the postoperative period, a patent deficit of shoulder abduction ensued related to the nervous section. Microscopically, compactly fascicles of spindle-shaped cells with pleomorphic and hypercromatic nuclei, dark brown intracellular pigments, as well as some mitotic figures were seen. Immunohistochemical stains for S-100, Human Melanoma Black-45 (HMB-45), and vimentin were positive, with Ki-67 Labelling Index (LI) of 15% compatible with MS. Six months after radiotherapy she presents local recurrence and lung metastatic dissemination of the MS. She underwent left pulmonary segmentectomy, followed by chemotherapy and radiosurgery. The patient developed a febrile neutropenia and worsening of general status, and died after 3 months due to respiratory complications. MS are rare tumors with potential for local recurrence and distal metastasis. Complete surgical resection remains as the treatment of choice, once the uncommon cases with malignant progression shows low response to chemo and radiotherapy. PMID:24077273

  6. Incidental radiographic finding of the concealed art of susuk.

    PubMed

    Devang Divakar, Darshan; Mavinapalla, Seema; Al Kheraif, Abdulaziz Abdullah; Ramakrishnaiah, Ravikumar; Abd Rahim, Muhammad Furqon Bin; Khan, Aftab Ahmed

    2016-07-01

    Susuk, or charm needles, are small, metallic needles inserted under the skin, considered to enhance beauty, health and luck. This hidden secret of inserting susuk is a traditional superstitious ritual, widely practiced among women of Southeast Asia. Here, we present an interesting case of incidental radiographic finding of the concealed art of susuk, which was exposed on a panoramic radiograph taken on a routine basis as a part of diagnostic work up at our centre. An orthopantomogram revealed bilateral metallic foreign bodies in the maxillo-facial region. Anamnestic data affirmed the practice of the body art of susuk. The charm needles were present in the orofacial region without the patient experiencing any pathological signs or symptoms.

  7. Adrenal Pheochromocytoma Incidentally Discovered in a Patient With Parkinsonism

    PubMed Central

    Petramala, Luigi; Concistrè, Antonio; Marinelli, Cristiano; Zinnamosca, Laura; Iannucci, Gino; Lucia, Piernatale; De Vincentis, Giuseppe; Letizia, Claudio

    2015-01-01

    Abstract To evaluate the diagnostic route of pheochromocytoma (PHEO) in a patient under dopaminergic treatment. A 70-year-old man with Parkinsonism and under treatment with levodopa and carbidopa came to our observation for evaluation of arterial hypertension and right adrenal mass discovered incidentally. To evaluate adrenal hormone levels we performed a dexamethasone suppression test, plasma aldosterone levels and 24-hr urinary metanephrine, which revealed elevated levels of catecholamines metabolities. 123-I-metaiodobenzylguanidine SPECT scintiscan revealed raised activity within the right adrenal gland concordant with the mass. The diagnosis of PHEO was posed and an elective laparoscopic adrenalectomy was performed; histopathological examination confirmed the PHEO diagnosis. Recently the coexistence of PHEO and Parkinsonism is a very rare association of diseases, with only 3 cases reported in literature. In this article, another case is reported and diagnostic procedures are discussed. PMID:26496334

  8. Self-corrected elaboration and spacing effects in incidental memory.

    PubMed

    Toyota, Hiroshi

    2006-04-01

    The present study investigated the effect of self-corrected elaboration on incidental memory as a function of types of presentation (massed vs spaced) and sentence frames (image vs nonimage). The subjects were presented a target word and an incongruous sentence frame and asked to correct the target to make a common sentence in the self-corrected elaboration condition, whereas in the experimenter-corrected elaboration condition they were asked to rate the appropriateness of the congruous word presented, followed by free recall test. The superiority of the self-corrected elaboration to the experimenter-corrected elaboration was observed only in some situations of combinations by the types of presentation and sentence frames. These results were discussed in terms of the effectiveness of the self-corrected elaboration. PMID:16826672

  9. Incidental radiographic finding of the concealed art of susuk.

    PubMed

    Devang Divakar, Darshan; Mavinapalla, Seema; Al Kheraif, Abdulaziz Abdullah; Ramakrishnaiah, Ravikumar; Abd Rahim, Muhammad Furqon Bin; Khan, Aftab Ahmed

    2016-07-01

    Susuk, or charm needles, are small, metallic needles inserted under the skin, considered to enhance beauty, health and luck. This hidden secret of inserting susuk is a traditional superstitious ritual, widely practiced among women of Southeast Asia. Here, we present an interesting case of incidental radiographic finding of the concealed art of susuk, which was exposed on a panoramic radiograph taken on a routine basis as a part of diagnostic work up at our centre. An orthopantomogram revealed bilateral metallic foreign bodies in the maxillo-facial region. Anamnestic data affirmed the practice of the body art of susuk. The charm needles were present in the orofacial region without the patient experiencing any pathological signs or symptoms. PMID:26271077

  10. Self-corrected elaboration and spacing effects in incidental memory.

    PubMed

    Toyota, Hiroshi

    2006-04-01

    The present study investigated the effect of self-corrected elaboration on incidental memory as a function of types of presentation (massed vs spaced) and sentence frames (image vs nonimage). The subjects were presented a target word and an incongruous sentence frame and asked to correct the target to make a common sentence in the self-corrected elaboration condition, whereas in the experimenter-corrected elaboration condition they were asked to rate the appropriateness of the congruous word presented, followed by free recall test. The superiority of the self-corrected elaboration to the experimenter-corrected elaboration was observed only in some situations of combinations by the types of presentation and sentence frames. These results were discussed in terms of the effectiveness of the self-corrected elaboration.

  11. Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy

    PubMed Central

    Oruç, Mehmet Tahir; Aslaner, Arif; Çekiç, Sema; Sakar, Alkan; Yardimci, Erdem Can

    2016-01-01

    Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LSG. PMID:27284541

  12. Incidental catch of marine birds in high seas driftnets

    USGS Publications Warehouse

    Gould, P.J.; Johnson, D.H.; Shaffer, T.L.; Wohl, K.

    1992-01-01

    The incidental take of marine birds was estimated for the following North Pacific driftnet fisheries in 1990: Japanese squid, Japanese large-mesh, Korean squid, and Taiwanese squid and large-mesh combined. The take was estimated by assuming that the data represented a random sample from an unstratified population of all driftnet fisheries in the North Pacific. Estimates for 13 species or species groups are presented, along with some discussion of inadequacies of the design. About 416,000 marine birds were estimated to be taken incidentally during the 1990 season; 80 % of these were in the Japanese squid fishery. Sooty Shearwaters, Short-tailed Shearwaters, and Laysan Albatrosses were the most common species in the bycatch. Regression models were also developed to explore the relations between bycatch rate of three groups Black-footed Albatross, Laysan Albatross, and dark shearwaters and various explanatory variables, such as latitude, longitude, month, vessel, sea surface temperature, and net soak time (length of time nets were in the water). This was done for only the Japanese squid fishery, for which the most complete information was available. For modelling purposes, fishing operations for each vessel were grouped into 5-degree blocks of latitude and longitude. Results of model building indicated that vessel had a significant influence on bycatch rates of all three groups. This finding emphasizes the importance of the sample of vessels being representative of the entire fleet. In addition, bycatch rates of all three groups varied spatially and temporally. Bycatch rates for Laysan Albatrosses tended to decline during the fishing season, whereas those for Black-footed Albatrosses and dark shearwaters tended to increase as the season progressed. Bycatch rates were positively related to net soak time for Laysan Albatrosses and dark shearwaters. Bycatch rates of dark shearwaters were lower for higher sea surface temperatures.

  13. Radiological and Clinical Factors Predicting the Facial Nerve Outcome following Retrosigmoid Approach for Large Vestibular Schwannomas (VSs).

    PubMed

    Sharma, Mayur; Sonig, Ashish; Ambekar, Sudheer; Nanda, Anil

    2013-10-01

    Objective The aim of our study was to identify the radiological and clinical factors that predict postoperative facial nerve outcome following retrosigmoid approach for large vestibular schwannomas (VSs). Methods A total of 72 patients with large (≥ 3 cm) vestibular schwannomas was included in this retrospective study. Various parameters evaluated were age, gender, clinical presentation, tumor diameter in three planes, intrameatal extension, and pattern of growth. Results Age of the patient and presenting symptoms such as headache, ataxia, or preoperative facial nerve dysfunction correlated with poorer facial nerve outcome (p < 0.05). Patients with larger tumor volumes and extrameatal growth experienced a worse outcome (p < 0.05). Anterior and caudal extension (p = 0.001) correlated with poorer outcome, as well. Intrameatal extension and bony changes of the internal acoustic meatus did not correlate with the outcome (p > 0.05). Of the various examined factors, preoperative facial nerve function independently predicted postoperative facial nerve outcome. Conclusion Our study suggests that young patients with small tumor volume and normal facial nerve function at presentation are more likely to experience a good postoperative facial nerve outcome. These clinical and radiological parameters can be used to predict facial nerve outcome prior to surgery.

  14. Incidental experiences of regulatory fit and the processing of persuasive appeals.

    PubMed

    Koenig, Anne M; Cesario, Joseph; Molden, Daniel C; Kosloff, Spee; Higgins, E Tory

    2009-10-01

    This article examines how the subjective experiences of "feeling right" from regulatory fit and of "feeling wrong" from regulatory non-fit influence the way people process persuasive messages. Across three studies, incidental experiences of regulatory fit increased reliance on source expertise and decreased resistance to counterpersuasion, whereas incidental experiences of regulatory non-fit increased reliance on argument strength and increased resistance to counterpersuasion. These results suggest that incidental fit and non-fit experiences can produce, respectively, more superficial or more thorough processing of persuasive messages. The mechanisms underlying these effects, and the conditions under which they should and should not be expected, are discussed.

  15. WAIS-III Digit Symbol-Incidental Learning base rates: findings for college student and patient samples.

    PubMed

    Schnakenberg-Ott, Summer; Ryan, Joseph J; Tree, Heather A

    2004-12-01

    Frequencies for Pairing and Free Recall of the WAIS-III Digit Symbol-Incidental Learning procedure were determined separately for 104 college students and 73 patients with substance abuse disorders. Means for age and education were 22.2 yr. (SD=5.1) and 14.7 yr. (SD=1.0) and 46.0 yr. and 12.2 yr. (SD=9.4), respectively. Base rate tables indicated that for Pairing, 93% of students and 89% of patients paired the number 1 with the appropriate symbol. Conversely, only 43% of students correctly paired the number 3 with its associated symbol, while 30% of patients paired the number 4 with its appropriate symbol. When Free Recall was assessed, 98% of students remembered the first symbol, but only 61% recalled the third. The most frequently recalled symbol by patients was the ninth (97%) and the most infrequently recalled symbol was the fourth (50%). The present base rate tables may be helpful for detecting unusual recall frequencies on the Incidental Learning procedures.

  16. Do researchers have an obligation to actively look for genetic incidental findings?

    PubMed

    Gliwa, Catherine; Berkman, Benjamin E

    2013-01-01

    The rapid growth of next-generation genetic sequencing has prompted debate about the responsibilities of researchers toward genetic incidental findings. Assuming there is a duty to disclose significant incidental findings, might there be an obligation for researchers to actively look for these findings? We present an ethical framework for analyzing whether there is a positive duty to look for genetic incidental findings. Using the ancillary care framework as a guide, we identify three main criteria that must be present to give rise to an obligation to look: high benefit to participants, lack of alternative access for participants, and reasonable burden on researchers. Our analysis indicates that there is no obligation to look for incidental findings today, but during the ongoing translation of genomic analysis from research to clinical care, this obligation may arise.

  17. 78 FR 61379 - Proposed Information Collection; Incidental Take of Marine Mammals During Specified Oil and Gas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... their incidental taking of polar bears and Pacific walruses in the Beaufort and Chukchi Seas. The Marine... and Pacific walruses and the availability of those marine mammals for subsistence purposes of...

  18. 50 CFR 216.161 - Specified activity and incidental take levels by species.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... GOVERNING THE TAKING AND IMPORTING OF MARINE MAMMALS Taking of Marine Mammals Incidental to Shock Testing... one full ship-shock trial (FSST) of the USS MESA VERDE (LPD 19) during the time period between July...

  19. Do Researchers Have an Obligation to Actively Look for Genetic Incidental Findings?

    PubMed Central

    Gliwa, Catherine; Berkman, Benjamin E.

    2014-01-01

    The rapid growth of next-generation genetic sequencing has prompted debate about the responsibilities of researchers toward genetic incidental findings. Assuming there is a duty to disclose significant incidental findings, might there be an obligation for researchers to actively look for these findings? We present an ethical framework for analyzing whether there is a positive duty to look for genetic incidental findings. Using the ancillary care framework as a guide, we identify three main criteria that must be present to give rise to an obligation to look: high benefit to participants, lack of alternative access for participants, and reasonable burden on researchers. Our analysis indicates that there is no obligation to look for incidental findings today, but during the ongoing translation of genomic analysis from research to clinical care, this obligation may arise. PMID:23391059

  20. Incidental acquisition of foreign language vocabulary through brief multi-modal exposure.

    PubMed

    Bisson, Marie-Josée; van Heuven, Walter J B; Conklin, Kathy; Tunney, Richard J

    2013-01-01

    First language acquisition requires relatively little effort compared to foreign language acquisition and happens more naturally through informal learning. Informal exposure can also benefit foreign language learning, although evidence for this has been limited to speech perception and production. An important question is whether informal exposure to spoken foreign language also leads to vocabulary learning through the creation of form-meaning links. Here we tested the impact of exposure to foreign language words presented with pictures in an incidental learning phase on subsequent explicit foreign language learning. In the explicit learning phase, we asked adults to learn translation equivalents of foreign language words, some of which had appeared in the incidental learning phase. Results revealed rapid learning of the foreign language words in the incidental learning phase showing that informal exposure to multi-modal foreign language leads to foreign language vocabulary acquisition. The creation of form-meaning links during the incidental learning phase is discussed.