MyMedR

Fulltext A Rare Case of an Undiagnosed Middle Ear Tumor Due to Late Referral

Ng JJ, Ong HY, Nasseri Z, Azmi MI, Abdullah A

Cureus, 2021 Jan 08;13(1):e12584.

PMID: 33457146 DOI: 10.7759/cureus.12584

Facial nerve tumors constitute about 5% of all facial nerve paralysis. As it is relatively uncommon, it could be misdiagnosed. We encountered an 18-year-old girl who had right facial weakness since the age of four, referred to otorhinolaryngology clinic for further evaluation only when her hearing deteriorated and the facial weakness worsened. Further investigation revealed facial nerve schwannoma. Facial nerve paralysis in the pediatric age group is uncommon and should be examined in detail to rule out other possible etiologies besides Bell's palsy.

Matched MeSH terms: Neurilemmoma

Fulltext A Rare Presentation of Spinal Schwannoma Causing Conus Medullaris Syndrome: A Case Series on Surgical Outcome

Khan ESKBM, Thean CAP, Zakaria ZB, Awang MSB, Karupiah RK, Awang MB

J Orthop Case Rep, 2020;10(2):101-105.

PMID: 32953668 DOI: 10.13107/jocr.2020.v10.i02.1718

Introduction: Spinal schwannoma can occur anywhere along the spinal cord but is predominantly seen in the cervical and thoracic region.It composes mainly of well-differentiated schwann cell and is benign in nature. It is typically seen in the peripheral nerves and is commonly associated with neurofibromatosis. Up to 80% of cases, spinal schwannoma is reported to be intradural in location and 15% of cases have both intradural and extradural components. Spinal schwannoma rarely causes conus medullaris syndrome.

Case Report: In this case series, all three female patients in their 4th and 5th decades of life presented with conus medullaris syndrome. Lower back pain, radiculopathy, lower limb weakness, and urinary incontinence are their main clinical presentation. Magnetic resonance imaging shows a well-defined intradural, extramedullary mass compressing onto the conus medullary region. These patients undergone microscopic assisted excision of the tumor and had remarkably good early outcome despite the advanced presentation of neurological deficit.

Conclusion: Despite the late presentation with significant neurological deficit, surgical excision of spinal schwannomas carries a good prognosis postoperatively due to their benign nature and extramedullary location.

Matched MeSH terms: Neurilemmoma

Fulltext An extensive cervical vagal nerve schwannoma: a case report

Chiun KC, Tang IP, Prepageran N, Jayalakshmi P

Med J Malaysia, 2012 Jun;67(3):342-4.

PMID: 23082434 MyJurnal

Vagal nerve schwannoma is extremely rare. The majority of cases present with a slow growing neck swelling without neurological deficit. Magnetic resonance imaging is the gold standard investigation to establish a pre-operative diagnosis. We report a case of a 32-year-old man with an extensive right vagal nerve schwannoma involving the right jugular foramen and parapharyngeal space. The tumour was resected via a transcervical approach. Complete excision of the tumour is the key to prevent recurrence.

Matched MeSH terms: Neurilemmoma/diagnosis*; Neurilemmoma/surgery

Fulltext Ancient Schwannoma Of The Facial Nerve: An Unusual Histological Variant Of A Rare Disease

Baharudin, A., Din Suhaimi, S., Omar, E.

International Medical Journal Malaysia, 2006;5(2):1-4.

MyJurnal

Schwannomas are benign slow growing lesions arising from the Schwann cells that ensheath the axons of the peripheral, cranial and autonomic nervous systems. Intracranial schwannomas develop from the facial nerve much more rarely than from the vestibular or trigeminal nerves. Ancient schwannoma is an unusual histological variant of this rare disease. A 48 years old man who had recurrent facial nerve paralysis and right external auditory mass is presented in this case report.

Matched MeSH terms: Neurilemmoma

Ancient schwannoma of cervical sympathetic chain masquerading as carotid body tumour

Lim CC, Chong HS, Yong DJ, Foong SK, Prepageran N

Med J Malaysia, 2018 04;73(2):114-115.

PMID: 29703877 MyJurnal

Schwannoma of cervical sympathetic chain is a rare cause of neck swelling. We report a 73- year-old male presented with anterior neck triangle swelling mimicking a carotid body tumour. Surgical excision was done, and the histopathological examination reported as ancient schwannoma. We would like to discuss the important differential diagnoses and highlight the possibility of an ancient schwannoma of cervical sympathetic chain masquerading as carotid body tumour. Also, to emphasise the importance of imaging for pre-operative planning and counselling.

Matched MeSH terms: Neurilemmoma

Fulltext Ancient schwannoma of the cervical sympathetic chain : a case report

Athar PP, Norhan NA, Abdul Rahman MS

Malays J Med Sci, 2007 Jan;14(1):75-8.

PMID: 22593658 MyJurnal

Schwannoma of the cervical sympathetic chain is an extremely rare nerve tumour. We report an unusual swelling in a 41-year-old female who presented with an asymptomatic solitary mass in the right parapharyngeal space. Clinical examination and computed tomography showed displaced carotid artery in an antero-medial direction. Surgical excision of the lesion was carried out and histological examination revealed an Ancient Schwannoma.

Matched MeSH terms: Neurilemmoma

Fulltext Ancient schwannoma of the conus medullaris

Saiful Azli MN, Abd Rahman IG, Md Salzihan MS

Med J Malaysia, 2007 Aug;62(3):256-8.

PMID: 18246922 MyJurnal

Cystic spinal or ancient schwannoma is a rare form of intradural tumour especially in the conus medullaris region. Due to its indolent behavior and benign course, the diagnosis of schwannoma is always a challenge and the imaging findings can be misleading. Our patient presented with chronic mild sciatica pain without any other neurological symptom. MRI of the spine showed intradural tumour located at the conus medullaris region with nerves compression and was reported as ependymoma. L3-L5 laminectomy and total excision of tumour was performed without any neurological complication. We concluded that ancient schwannoma of the conus medullaris is a rare benign tumour that can present with minimal non-specific neurological symptom that lead to misdiagnosis. Radical tumour excision is safe with an excellent outcome.

Matched MeSH terms: Neurilemmoma/diagnosis*; Neurilemmoma/pathology; Neurilemmoma/surgery

Fulltext Atypical neurilemmomas of the tongue--report of two cases.

Siar CH, Ng KH, Chia TY, Kulkarni MG

Singapore Med J, 1988 Feb;29(1):83-5.

PMID: 3406779

The aetiology, clinical and histological features of neurilemmomas of the oral and paraoral regions are briefly outlined. Two cases of atypical neurilemmomas of the tongue are described with an intent to document the partial encapsulation and multilobular distribution of the neurogenic tissue noted in these two lesions.

Matched MeSH terms: Neurilemmoma/pathology

Benign orbital apex tumors treated with multisession gamma knife radiosurgery

Goh ASC, Kim YD, Woo KI, Lee JI

Ophthalmology, 2013 Mar;120(3):635-641.

PMID: 23149128 DOI: 10.1016/j.ophtha.2012.08.015

OBJECTIVE: The orbital apex is an important anatomic landmark that hosts numerous critical neurovascular structures. Tumor resection performed at this complex region poses a therapeutic challenge to orbital surgeons and often is associated with significant visual morbidity. This article reports the efficacy and safety of multisession gamma knife radiosurgery (GKRS) in benign, well-circumscribed tumors located at the orbital apex.

DESIGN: Retrospective interventional case series.

PARTICIPANTS: Five patients with visual disturbances resulting from a benign, well-circumscribed orbital apex tumor (3 cases of cavernous hemangioma and 2 cases of schwannoma).

METHODS: Each patient treated with GKRS with a total radiation dose of 20 Gy in 4 sessions (5 Gy in each session with an isodose line of 50%) delivered to the tumor margin.

MAIN OUTCOME MEASURES: Best-corrected visual acuity, visual field changes, orbital imaging, tumor growth control, and side effects of radiation.

RESULTS: All patients demonstrated improvement in visual acuity, pupillary responses, color vision, and visual field. Tumor shrinkage was observed in all patients and remained stable until the last follow-up. No adverse events were noted during or after the radiosurgery. None of the patients experienced any radiation-related ocular morbidity.

CONCLUSIONS: From this experience, multisession GKRS seems to be an effective management strategy to treat solitary, benign, well-circumscribed orbital apex tumors.

Matched MeSH terms: Neurilemmoma/pathology; Neurilemmoma/surgery*

Fulltext Brain and spinal tumour

Goh CH, Lu YY, Lau BL, Oy J, Lee HK, Liew D, et al.

Med J Malaysia, 2014 Dec;69(6):261-7.

PMID: 25934956 MyJurnal

This study reviewed the epidemiology of brain and spinal tumours in Sarawak from January 2009 till December 2012. The crude incidence of brain tumour in Sarawak was 4.6 per 100,000 population/year with cumulative rate 0.5%. Meningioma was the most common brain tumour (32.3%) and followed by astrocytoma (19.4%). Only brain metastases showed a rising trend and cases were doubled in 4 years. This accounted for 15.4% and lung carcinoma was the commonest primary. Others tumour load were consistent. Primitive neuroectodermal tumour (PNET) and astrocytoma were common in paediatrics (60%). We encountered more primary spinal tumour rather than spinal metastases. Intradural schwannoma was the commonest and frequently located at thoracic level. The current healthcare system in Sarawak enables a more consolidate data collection to reflect accurate brain tumours incidence. This advantage allows subsequent future survival outcome research and benchmarking for healthcare resource planning.

Matched MeSH terms: Neurilemmoma

Fulltext Cervical schwannoma: report of four cases

Rohaizam J, Tang IP, Jong DE, Tan TY, Narihan MZ

Med J Malaysia, 2012 Jun;67(3):345-8.

PMID: 23082435 MyJurnal

Extracranial schwannomas in the head and neck region are rare neoplasms. The tumours often present as asymptomatic, slowly enlarging lateral neck masses and determination of the nerve origin is not often made until the time of surgery. Preoperative diagnosis maybe aided by imaging studies such as magnetic resonance imaging or computed tomography, while open biopsy is no longer recommended. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We report four cases of cervical schwannomas that we encountered at our center during four years of period. The clinical features, diagnosis and origin, management and pathological findings of these benign tumors are discussed.

Matched MeSH terms: Neurilemmoma/diagnosis*; Neurilemmoma/surgery

Fulltext Coughing on palpation: A rare complication of vagal schwannoma

Samarakkody ZM, Sayuti KA, Mat Zin AA, Wan Abdul Wahab W, Mohamad I

Malays Fam Physician, 2018;13(3):40-43.

PMID: 30800234

Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia, dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused any surgical intervention, conservative management was used.

Matched MeSH terms: Neurilemmoma

Fulltext Coughing on palpation: a rare complication of vagal schwannoma

Samarakkody, Z.M., Sayuti, K.A., Mat Zin, A.A., Wan Abdul Wahab, W.N.N., Mohamad, I.

Malaysian Family Physician, 2018;13(3):40-43.

MyJurnal

Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and
presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia,
dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication
of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused
any surgical intervention, conservative management was used.

Matched MeSH terms: Neurilemmoma

Diagnostic conundrum of a perineal tumour: a rectal gastrointestinal stromal tumour mimic

Shi R, Chew MH, Leow WQ

Malays J Pathol, 2017 Dec;39(3):293-296.

PMID: 29279593

Gastrointestinal stromal tumour (GIST) is a common mesenchymal tumour arising in the gastrointestinal tract, but not frequently encountered in the rectum. Herein, we describe a case of a rectal GIST which mimicked histomorphological features of a schwannoma; thus, making intraoperative frozen section evaluation challenging. Although subsequent immunohistochemistry and molecular findings readily confirmed the diagnosis of a GIST, we wish to draw attention to three clues that will help the pathologist steer clear of this potential diagnostic pitfall. One, GISTs are relatively more common than schwannomas in the rectum. Two, schwannomas usually have very little mitoses. Three, rectal GISTs commonly exhibit nuclear palisades. We also discuss the diagnostic, prognostic and therapeutic functions of immunohistochemical and molecular investigations. As the surgical intent for rectal GISTs is for en-bloc excision with wide margins, we surmise that the intraoperative consult should include GIST as a possible differential diagnosis for rectal mesenchymal tumours. In view of the potential for neoadjuvant treatment with imatinib before surgical excision to preserve sphincter function, a multidisciplinary approach is recommended for establishing most effective treatment strategy in these rare complex cases.

Matched MeSH terms: Neurilemmoma/diagnosis*; Neurilemmoma/pathology

Fulltext Does lightning strike twice?

Qi Qi C, Ajit Singh V

BMJ Case Rep, 2012;2012.

PMID: 22892228 DOI: 10.1136/bcr.01.2012.5518

The authors present an interesting case under our follow-up who has had five different forms of tumours with different pathologies throughout his lifetime. He started off with hepatoma, followed by pleomorphic sarcoma of the thigh, adenocarcinoma of the prostate, meningioma and finally schwanoma. He is still alive to this date.

Matched MeSH terms: Neurilemmoma/diagnosis; Neurilemmoma/pathology*; Neurilemmoma/therapy

Gastric Schwannoma in an elderly man: A case report

Mohamad MA, Jarmin R, Md Pauzi SH

Malays J Pathol, 2020 Dec;42(3):455-459.

PMID: 33361729

Schwannomas are mesenchymal tumors that are characteristically benign and slow growing, which originate from any nerve with Schwann cell sheath. Gastrointestinal schwannomas are rare with distinct morphologic features as compared to schwannomas of soft tissue or central nervous system. A 77-year-old male patient was diagnosed with gastrointestinal stromal tumor based on radiological findings and clinical impression when he presented with worsening abdominal discomfort and pain. He underwent distal gastrectomy however histopathological examination of the tumour revealed schwannoma. This case report presents a rare case of a symptomatic gastric schwannoma, whose definitive diagnosis was established by histopathological and immunohistochemical findings postoperatively.

Matched MeSH terms: Neurilemmoma/diagnosis; Neurilemmoma/pathology*

Giant nerve sheath tumour: report of six cases

Ghani AR, Ariff AR, Romzi AR, Sayuthi S, Hasnan J, Kaur G, et al.

Clin Neurol Neurosurg, 2005 Jun;107(4):318-24.

PMID: 15885392

Giant nerve sheath tumour is a rare tumour originating from the nerve sheath. It differs from the conventional nerve sheath tumour only by the size these tumours can reach. There are two main type of tumours that occur in the nerve sheath which include neurofibroma and schwannoma. The current views are that schwannomas arise from the progenitor of the schwann cell. Whereas the neurofibroma series probably arise from a mesenchymal origin closer to a fibroblast. We report on six cases of nerve sheath tumour that occur in the spinal and paraspinal region that presented to us over a 5 year period.

Matched MeSH terms: Neurilemmoma/pathology*; Neurilemmoma/surgery

Fulltext Huge brachial plexus schwannoma, masking as a cystic neck mass

Kho JPY, Prepageran N

AME Case Rep, 2018;2:41.

PMID: 30363802 DOI: 10.21037/acr.2018.08.01

Schwannomas are solitary, benign tumors arising from the nerve sheaths. They are frequently reported in the thorax predominantly in the posterior mediastinum, but are rarely seen to arise from the brachial plexus. Schwannomas are well demarcated lesions with a slow insidious growth. Presented is a case of a large brachial plexus schwannoma, masking as a cystic lesion in the lateral neck. The patient presented with concerns of a cystic mass progressively increasing in size over a period of four years, initially symptomless, but later caused numbness and tingling sensation over his right forearm, tip of right thumb and index finger. Following histological confirmation via fine needle aspiration and magnetic resonance imaging, the patient underwent surgical excision where by the tumor was dissected from its attachment to the nerve sheath. The patient recovered well, and by the third day post operatively, his neurological symptoms resolved completely. Upon follow up in clinic 1-week post-surgery, the scar had healed well, and his numbness or tingling sensation remained in abeyance. This case illustrates that a schwannoma may present insidiously as a cystic lesion and its possible origin may arise from the brachial plexus.

Matched MeSH terms: Neurilemmoma

Fulltext Huge solitary rectal schwannoma mimicking malignant polyp with a successful transanal excision

Sanjeev Sandrasecra, Sindhu Karpayah, Muhammad Ash-Shafhawi Adznan, Firdaus Hayati, Nornazirah Azizan, Rohamini Sibin

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):62-62.

MyJurnal

Introduction: Rectal schwannoma is a rare gastrointestinal mesenchymal tumour with only a few numbers of cases has been reported. It is predominant in the stomach and small bowel, but uncommon in the colon and rectum. Case description: A 74-year-old man presented with features masquerading as low rectal malignancy with a malignant looking pedunculated polyp measuring 10 x 8 cm on colonoscopy. Punch biopsy revealed a diagnosis of benign tumour of schwannoma. After failure of multiple attempts of endoscopic resection, a decision of transanal excision was made. The histopathological assessment was consistent with the preoperative diagnosis and supported by immu-nohistochemistry of S-100 protein. His postoperative recovery was uneventful as he was discharged on the following day. There is no evidence of tumour recurrence on follow up. Conclusion: A huge tumour of the rectum is not always malignant. However, patient with features of low rectal tumour warrants an immediate referral to the surgical team as this non-communicable disease is a public health concern. Preoperative diagnosis is paramount for a necessary surgical intervention.

Matched MeSH terms: Neurilemmoma

Intracranial neoplasms in Malaysia

Selby R, Pereira N

Int Surg, 1973 Aug;58(8):536-41.

PMID: 4738062

Matched MeSH terms: Neurilemmoma/epidemiology

Displaying publications 1 - 20 of 36 in total