Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-19T11:26:30.018Z Has data issue: false hasContentIssue false
  • English
  • Français

Cystic vestibular schwannomas: neuroimaging and growth rate

Published online by Cambridge University Press:  29 June 2007

Samih Charabi ,
Margit Mantoni ,
Mirko Tos  and
Jens Thomsen
Samih Charabi*
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Gentofte University Hospital, DK-2900 Hellerup, Denmark.
Margit Mantoni
Affiliation:
Radiology and Ultrasoundt, Gentofte University Hospital, DK-2900 Hellerup, Denmark.
Mirko Tos
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Gentofte University Hospital, DK-2900 Hellerup, Denmark.
Jens Thomsen
Affiliation:
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Gentofte University Hospital, DK-2900 Hellerup, Denmark.
*
Samih Charabi, M.D., Department of ORL, Head and Neck Surgery, Gentofte University Hospital, DK-2900 Hellerup, Denmark.
Get access Rights & Permissions [Opens in a new window]

Abstract

In a series of 571 vestibular schwannomas (VS) operated on in the period 1976–1992, via the translabyrinthine approach, 23 tumours (4 per cent) from 23 patients were radiologically, peroperatively and histologically identified as cystic VS. Neuroimaging examinations (CT and MRI) revealed 15 tumours (2.6 per cent) with extracystic formations and in eight cases (1.4 per cent) intratumoural cysts. In 15 cases (65 per cent), tumours were located extracanalicularly with no involvement of the internal auditory canal (IAC). The extracanalicular tumour extension including the cystic elements ranged between 10 and 60 mm with a mean of 45 mm. In eight cases out of 23 (35 per cent) other diagnostic possibilities such as trigeminal schwannoma, epidermoid cyst and meningioma were proposed at the primary evaluation. Deformation, displacement and/or impression of the fourth ventricle was demonstrated in 17 cases (74 per cent). Three patients (13 per cent) had obstructive hydrocephalus which demanded shunt insertion. Residual tumour was detected in two patients (9 per cent). Growth rate in four cases was more than 10 times higher when compared to the annual growth rate of noncystic VS. The results of this study provide data on cystic VS attenuation demonstrated by CT or MRI which may be valuable in neuroradiological diagnosis of these cystic lesions and emphasizes that the wait-and-see policy should not be applied to the cystic variant of VS.

Keywords

SchwannomavestibularNeuroradiographyGrowth
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 5 , May 1994 , pp. 375 - 379
Copyright
Copyright © JLO (1984) Limited 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bilaniuk, L. T. (1990) Adult infratemporal tumours. Semin-Roentgenology 25:155–173.CrossRefGoogle Scholar
Brahe-Pedersen, C., Jørgensen, B., Halaburt, H. (1992) Acoustic neuroma: Observation before operation in elderly patients? In Acoustic Neuromas. (Tos, M., Thomsen, J., eds.), Kugler Publications, Amsterdam, pp 267–271.Google Scholar
Charabi, S., Klinken, L., Mantoni, M., Tos, M., Thomsen, J. (1993) Histology and neuroimaging in cystic acoustic neuromas. Acta Otolaryngologica (Stockholm) 113: 519–523.CrossRefGoogle ScholarPubMed
Curtin, H. D., Hirsch, W. L. (1992) Imaging of acoustic neuromas. Otolaryngologic Clinics of North America 3: 553–607.CrossRefGoogle Scholar
Daniels, D. L., Milien, S. J., Meyer, G. A., Pojunas, K. W., Kilgore, D. P., Shaffer, K. A., Williams, A. P., Haughton, V. M. (1987) MR detection of tumour in the internal auditory canal. American Journal of Roentgenology 148: 1219–1222.CrossRefGoogle ScholarPubMed
Drapkin, A. J., Rose, W. S. (1989) Multicystic acoustic neuroma. Case report and differential diagnosis. Acta Radiology 30: 7–9.CrossRefGoogle ScholarPubMed
Felix, R., Schorner, W., Lanlado, M., Semmler, W. (1985) Contrast media in magnetic resonance tomography: a review. II Biological basis, research technique and clinical application of gadolinium-DTPA in the diagnosis of intracranial tumours. ROFO CYSTIC VEST1BULAR SCHWANNOMAS 379 Fortschritte aur dem Gebiete der Rontgenstrahlen und der neuen Bildgebenden verfahren (Stuttgart) 143: 9–14.CrossRefGoogle Scholar
Goodman, R. R., Torres, R. A. A., McMurtry, J. G. (1991) Acoustic schwannoma and epidermoid cyst occurring as a single cerebellopontine angle mass. Neurosurgery 28: 433–436.CrossRefGoogle ScholarPubMed
Jackler, R. K., Shapiro, M. S., Dillon, W. P., Pitts, L., Lanser, M. J. (1990) Gadolinium–DTPA enhanced magnetic resonance imaging in acoustic neuroma diagnosis and management. Archives of Otolaryngology, Head and Neck Surgery 102: 670–677.CrossRefGoogle ScholarPubMed
Lanser, M. J., Jackler, K. R., Pitts, H. L. (1992) Intratumoural haemorrhage and cyst expansion as cause of acute neurological deterioration in acoustic neuroma patients. In Acoustic Neuromas. (Tos, M., Thomsen, J., eds.),Kugler Publications, Amsterdam, pp 229–234.Google Scholar
Lo, W. W. M. (1991) Tumours of the temporal bone and the cerebellopontine angle. In Head and Neck Imaging. 2nd Edition. (Som, P. M., Bergeron, R. T., eds.), Mosby Year Book, St Louis, pp 1046–1108.Google Scholar
Lunardi, P., Missori, P., Mastroanrdi, L., Fortuna, A. (1991) Cystic acoustic schwannomas. Acta Neurochirurgica 110: 120–123.CrossRefGoogle ScholarPubMed
Maeda, M., Kawamura, Y., Tamagawa, , Matsuda, T., Itoh, S., Kimura, H., Iwasaki, T., Hayashi, N., Yamamoto, K., Ishii, Y. (1992) Intravoxel incoherent motion (IVIM) MRI in intracranial, extraaxial tumours and cysts. Journal of Computer Assisted Tomography 16(4): 514–518.CrossRefGoogle Scholar
MØller, P., Backlund, E.-O., Myrseth, E., Jensen, Ø., Larsen, J. L., Kråkenes, J., Ganz, J. C. (1992) Acoustic neuroma: treatment of choice or choice of treatment. In Acoustic Neuromas. (Tos, M, Thomsen, J., eds.), Kugler Publications, Amsterdam, pp 273–276.Google Scholar
Nedzelski, J. M, Schessel, D. A., Pfleiderer, A., Kassel, E. E., Rowed, D. W. (1992) Conservative management of acoustic neuromas. Otolaryngologic Clinics of North America 3: 691–705.CrossRefGoogle Scholar
Olivecrona, H. (1967) Acoustic tumours. Journal of Neurosurgery 26: 6–13.CrossRefGoogle Scholar
Prakash, G. S. (1990) Multicystic acoustic neuromas (letter). Acta Radiology 331(1):112.CrossRefGoogle Scholar
Press, G. A., Hesselink, J. R. (1988) MR imaging of cerebellopontine angle and internal auditory canal lesions at 1.5 T. American Journal of Roentgenology 150(6): 1371–1381.CrossRefGoogle ScholarPubMed
Sidman, J. D.Carrasco, V. M, Whaley, R. A., Pilisbury, H. C. III. (1989) Gadolinium: the new gold standard for diagnosing cerebellopontine angle tumours. Archives of Otolaryngology, Head and Neck Surgery 115: 1244–1247.CrossRefGoogle Scholar
Tos, M., Thomsen, J. (1991) Management of acoustic neuromas. A review. Acta Otolaryngologica (Stockholm) 111: 616–632.CrossRefGoogle ScholarPubMed
Tos, M., Thomsen, J., Charabi, S. (1992) Incidence of acoustic neuromas. Ear, Nose and Throat Journal 71: 391–393.CrossRefGoogle ScholarPubMed
Valvassori, G. E. (1988) Diagnosis of retrocochlear and central vestibular disease by magnetic resonance imaging. Annals of Otology, Rhinology and Laryngology 97: 19–22.CrossRefGoogle ScholarPubMed
Yamada, S., Aiba, T. (1989) Cystic acoustic neuromas-report of two cases. Neurologia Medica-chirurgica, Tokyo 29(9):830–833.CrossRefGoogle ScholarPubMed