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Michael J Link - One of the best experts on this subject based on the ideXlab platform.
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synchronous tumors of the Cerebellopontine Angle
Skull Base Surgery, 2017Co-Authors: Christopher S Graffeo, Colin L W Driscoll, Caterina Giannini, Brian A Neff, Avital Perry, William R Copeland, Michael J LinkAbstract:Background Synchronous tumors of the Cerebellopontine Angle (CPA) are very rare and inconsistently described. We present 2 cases of contiguous vestibular schwannoma (VS) and meningioma and a systematic literature review of all multiple CPA tumors. Methods Retrospective chart review and systematic literature review were performed. Results A 64-year-old woman and a 42-year-old man presented with symptoms referable to the CPA. Magnetic resonance imaging in both patients revealed 2 separate contiguous tumors. Retrosigmoid craniotomy and tumor removal in each case confirmed VS and meningioma. Systematic literature review identified 42 previous English-language publications describing 46 patients with multiple CPA tumors. Based on Frassanito criteria, there were 4 concomitant tumors (8%), 16 contiguous tumors (33%), 3 collision tumors (6%), 13 mixed tumors (27%), and 11 tumor-to-tumor metastases (23%). Extent of resection was gross total in 16 cases and subtotal in 16 cases (50% each). Unfavorable House-Brackmann grade III–VI function was documented in 27% overall and in 33% of patients with VS and meningioma, a marked increase from the observed range in isolated VS. Conclusions Multiple CPA tumors are rare, heterogeneous lesions with a marked predisposition toward poor facial nerve outcomes, potentially attributable to a paracrine mechanism that simultaneously drives multiple tumor growth and increases invasiveness or adhesiveness at the facial nerve–tumor interface. Preceding nomenclature has been confounding and inconsistent; we recommend classifying all multiple CPA tumors as “synchronous tumors,” with “schwannoma with meningothelial hyperplasia” or “tumor-to-tumor metastases” reserved for rare, specific circumstances.
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pediatric Cerebellopontine Angle and internal auditory canal tumors clinical article
Journal of Neurosurgery, 2013Co-Authors: Michelle A Holman, Colin L W Driscoll, William R Schmitt, Matthew L Carlson, Charles W Beatty, Michael J LinkAbstract:Object The aim in this study was to describe the clinical presentation, differential diagnosis, and risk for neurofibromatosis Type 2 (NF2) in pediatric patients presenting with Cerebellopontine Angle (CPA) and internal auditory canal (IAC) tumors. Methods The authors conducted a retrospective study at a tertiary care academic referral center. All patients with an age ≤ 18 years who had presented with an extraaxial CPA or IAC tumor between 1987 and 2012 were included in the study cohort. Data regarding symptoms, diagnosis, tumor characteristics, and NF2 status were collected and analyzed. Results Sixty patients (55% female, 45% male) harboring 87 tumors were identified. The mean age at diagnosis was 12.8 years (median 14.0 years, range 0.9–18.9 years). Schwannomas were the most commonly identified lesions (57 of 87 tumors, including 52 vestibular, 3 facial, and 2 trigeminal schwannomas), followed by meningiomas (5 of 87) and epidermoid cysts (4 of 87). Six malignant tumors were diagnosed, including small-...
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primary melanocytic tumor of the Cerebellopontine Angle mimicking a vestibular schwannoma case report
Neurosurgery, 2006Co-Authors: Mark P Piedra, Bernd W Scheithauer, Colin L W Driscoll, Michael J LinkAbstract:OBJECTIVE: The majority of tumors of the Cerebellopontine Angle (CPA) are benign. We report the case of a primary malignant melanoma of the Cerebellopontine Angle that mimicked vestibular schwannoma (acoustic neuroma). We discuss the differential diagnosis and prognosis of melanotic lesions at this location. CLINICAL PRESENTATION: A 49-year-old man presented with a 7-year history of unilateral deafness and a several month history of imbalance, intractable nausea and vomiting, as well as weight loss. A neurological work-up revealed a large tumor in the left CPA radiographically diagnosed as a vestibular schwannoma. INTERVENTION: A translabyrinthine approach revealed a pigmented, vascular neoplasm encasing vessels and cranial nerves of the left CPA. The tumor was subtotally resected, and a histopathological diagnosis of melanoma was made. The patient had no history of cutaneous melanoma, and no other site of disease was ever discovered. CONCLUSION: This case most likely represents primary melanoma of the central nervous system that mimicked a vestibular schwannoma. The differential diagnosis of melanotic lesions of the CPA is discussed as are the prognostic implications of each diagnosis.
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malignant squamous degeneration of a Cerebellopontine Angle epidermoid tumor case report
Journal of Neurosurgery, 2002Co-Authors: Michael J Link, Paul L Cohen, John C BrenemanAbstract:✓ The authors present the case of a woman with a Cerebellopontine Angle (CPA) epidermoid cyst that degenerated into a squamous cell carcinoma. Malignant degeneration of an epidermoid cyst is an extremely rare occurrence. Malignant transformation must be considered in the differential diagnosis when new contrast enhancement on imaging studies and progressive neurological deficit are seen in a patient harboring an epidermoid cyst. The patient initially presented with a 10-year history of left trigeminal neuralgia, subacute left-sided hearing loss, and with facial weakness of 3 weeks' duration. Initial magnetic resonance (MR) imaging revealed a left CPA mass, consistent with an epidermoid. There was faint contrast enhancement where the tumor was in contact with the lateral brainstem. A subtotal resection was performed. Histopathological findings were consistent with an epidermoid tumor. One year after initial presentation, the patient's neurological deficit had increased, and follow-up MR imaging demonstrate...
Caterina Giannini - One of the best experts on this subject based on the ideXlab platform.
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glioneuronal heterotopia presenting as Cerebellopontine Angle tumor of cranial nerve viii
World Neurosurgery, 2018Co-Authors: Maria Periscelda, Caterina Giannini, Felix E Diehn, Laurence J Eckel, Brian A Neff, Jamie J Van GompelAbstract:Background Vestibular schwannomas and meningiomas account for the great majority of lesions arising in the Cerebellopontine Angle. In this report, we present a case of glioneuronal heterotopia, also known as glioneuronal hamartoma, arising from cranial nerve VIII, which is an extremely uncommon lesion. Important radiologic and surgical aspects are reviewed, which may help in early recognition and intraoperative decision making when these lesions are encountered. Case Description A healthy 29-year-old female presented with intermittent right facial numbness. Magnetic resonance imaging showed an incidental, minimally enhancing Cerebellopontine Angle lesion on the right cranial nerve VII–VIII complex. The patient declined serial observation and opted for operative intervention for resection. Intraoperatively, the lesion resembled neural tissue and was continuous with the VIII cranial nerve. Pathologic analysis demonstrated mature glioneuronal tissue consistent with hamartomatous brain tissue. The patient maintained normal hearing and facial nerve function after surgery. Radiologic, surgical, and pathologic characteristics are described. Conclusions Ectopic glioneuronal tissue of cranial nerve VIII is a rare non-neoplastic lesion and should be considered in the differential diagnosis of unusual-appearing intracanalicular and Cerebellopontine Angle lesions. The congenital and benign nature of this entity makes observation a valid option for these cases, although they are so infrequent that they are often presumptively managed as vestibular schwannomas. Attempts to radically resect these lesions may result in higher rates of hearing loss or facial palsy due to their continuity with cranial nerves.
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synchronous tumors of the Cerebellopontine Angle
Skull Base Surgery, 2017Co-Authors: Christopher S Graffeo, Colin L W Driscoll, Caterina Giannini, Brian A Neff, Avital Perry, William R Copeland, Michael J LinkAbstract:Background Synchronous tumors of the Cerebellopontine Angle (CPA) are very rare and inconsistently described. We present 2 cases of contiguous vestibular schwannoma (VS) and meningioma and a systematic literature review of all multiple CPA tumors. Methods Retrospective chart review and systematic literature review were performed. Results A 64-year-old woman and a 42-year-old man presented with symptoms referable to the CPA. Magnetic resonance imaging in both patients revealed 2 separate contiguous tumors. Retrosigmoid craniotomy and tumor removal in each case confirmed VS and meningioma. Systematic literature review identified 42 previous English-language publications describing 46 patients with multiple CPA tumors. Based on Frassanito criteria, there were 4 concomitant tumors (8%), 16 contiguous tumors (33%), 3 collision tumors (6%), 13 mixed tumors (27%), and 11 tumor-to-tumor metastases (23%). Extent of resection was gross total in 16 cases and subtotal in 16 cases (50% each). Unfavorable House-Brackmann grade III–VI function was documented in 27% overall and in 33% of patients with VS and meningioma, a marked increase from the observed range in isolated VS. Conclusions Multiple CPA tumors are rare, heterogeneous lesions with a marked predisposition toward poor facial nerve outcomes, potentially attributable to a paracrine mechanism that simultaneously drives multiple tumor growth and increases invasiveness or adhesiveness at the facial nerve–tumor interface. Preceding nomenclature has been confounding and inconsistent; we recommend classifying all multiple CPA tumors as “synchronous tumors,” with “schwannoma with meningothelial hyperplasia” or “tumor-to-tumor metastases” reserved for rare, specific circumstances.
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solitary fibrous tumor of the Cerebellopontine Angle with salivary gland heterotopia a unique presentation
The American Journal of Surgical Pathology, 2004Co-Authors: Fausto J Rodriguez, Bernd W Scheithauer, Daniel M Ockner, Caterina GianniniAbstract:We report the unique association of a solitary fibrous tumor of the Cerebellopontine Angle with ectopic salivary gland tissue in a 53-year-old woman. The patient, diagnosed 21 years earlier with a right Cerebellopontine Angle fibrous meningioma, presented with a recurrent mass, which, upon surgical removal, showed features of a solitary fibrous tumor. Strong and diffuse immunoreactivity to CD34 and BCL-2 and a negative epithelial membrane antigen immunostain confirmed the diagnosis. Admixed with the spindle cell neoplasm, a bland glandular element composed of small glands and variably dilated tubules was noted. The vague tubuloacinar arrangement of the glands and the presence of acinar cells with a granular, periodic acid-Schiff-positive, basophilic cytoplasm, resembling serous type acini, were features of benign, although ectopic, salivary gland tissue. The presence of a myoepithelial cell layer, surrounding some of the acini and highlighted by the smooth muscle actin immunostain, strengthened this interpretation.
Bernd W Scheithauer - One of the best experts on this subject based on the ideXlab platform.
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primary melanocytic tumor of the Cerebellopontine Angle mimicking a vestibular schwannoma case report
Neurosurgery, 2006Co-Authors: Mark P Piedra, Bernd W Scheithauer, Colin L W Driscoll, Michael J LinkAbstract:OBJECTIVE: The majority of tumors of the Cerebellopontine Angle (CPA) are benign. We report the case of a primary malignant melanoma of the Cerebellopontine Angle that mimicked vestibular schwannoma (acoustic neuroma). We discuss the differential diagnosis and prognosis of melanotic lesions at this location. CLINICAL PRESENTATION: A 49-year-old man presented with a 7-year history of unilateral deafness and a several month history of imbalance, intractable nausea and vomiting, as well as weight loss. A neurological work-up revealed a large tumor in the left CPA radiographically diagnosed as a vestibular schwannoma. INTERVENTION: A translabyrinthine approach revealed a pigmented, vascular neoplasm encasing vessels and cranial nerves of the left CPA. The tumor was subtotally resected, and a histopathological diagnosis of melanoma was made. The patient had no history of cutaneous melanoma, and no other site of disease was ever discovered. CONCLUSION: This case most likely represents primary melanoma of the central nervous system that mimicked a vestibular schwannoma. The differential diagnosis of melanotic lesions of the CPA is discussed as are the prognostic implications of each diagnosis.
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solitary fibrous tumor of the Cerebellopontine Angle with salivary gland heterotopia a unique presentation
The American Journal of Surgical Pathology, 2004Co-Authors: Fausto J Rodriguez, Bernd W Scheithauer, Daniel M Ockner, Caterina GianniniAbstract:We report the unique association of a solitary fibrous tumor of the Cerebellopontine Angle with ectopic salivary gland tissue in a 53-year-old woman. The patient, diagnosed 21 years earlier with a right Cerebellopontine Angle fibrous meningioma, presented with a recurrent mass, which, upon surgical removal, showed features of a solitary fibrous tumor. Strong and diffuse immunoreactivity to CD34 and BCL-2 and a negative epithelial membrane antigen immunostain confirmed the diagnosis. Admixed with the spindle cell neoplasm, a bland glandular element composed of small glands and variably dilated tubules was noted. The vague tubuloacinar arrangement of the glands and the presence of acinar cells with a granular, periodic acid-Schiff-positive, basophilic cytoplasm, resembling serous type acini, were features of benign, although ectopic, salivary gland tissue. The presence of a myoepithelial cell layer, surrounding some of the acini and highlighted by the smooth muscle actin immunostain, strengthened this interpretation.
Anthony D Nicastri - One of the best experts on this subject based on the ideXlab platform.
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cellular solitary fibrous tumor hemangiopericytoma with anaplasia at Cerebellopontine Angle a case report
Pathology Research and Practice, 2012Co-Authors: Jianying Zeng, Patricia Ogera, Ethan A Benardete, Anthony D NicastriAbstract:Abstract Cellular solitary fibrous tumor is currently considered a synonym for hemangiopericytoma, as it became increasingly clear that the morphological and immunohistochemical features that separate these two entities have become tenuous, and evidence for a unifying concept has emerged. Furthermore, as no evidence of pericytic differentiation is given in most cases of hemangiopericytoma, this diagnostic term is waning in popularity. We present here a case of cellular solitary fibrous tumor in a 22-year-old man. Neuroimaging revealed a right Cerebellopontine Angle tumor. Most of the tumor was cellular although some less cellular areas were seen. Sinusoidally dilated large vessels, including staghorn type, were seen. Nuclear pleomorphism and increased mitotic activity (5 mitosis/10 high power field) were regarded as evidence of anaplasia. Diffuse CD34 immunoreactivity and focal positivity for Factor XIIIa were seen in the tumor, which was negative for EMA and S100. The tumor also displayed rich reticulin network. Solitary fibrous tumor at Cerebellopontine Angle is rare, and 20 such cases (five reported as hemangiopericytoma) have been reported in the English literature.
Stefano Licci - One of the best experts on this subject based on the ideXlab platform.
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Primary myxopapillary ependymoma of the Cerebellopontine Angle: report of a case
Neurosurgical Review, 2008Co-Authors: Marco Sparaco, Irene Piscioli, Salvatore Donato, Alessia Catalucci, Luca Morelli, Stefano LicciAbstract:Myxopapillary ependymoma is a rare variant of ependymoma, almost exclusively occurring in the region of the cauda equina and filum terminale. We describe a myxopapillary ependymoma located in the left Cerebellopontine Angle of a young man suffering from peripheral vertigo and left sensorineural hearing loss for years. The patient underwent surgical removal of the tumour. Microscopic examination showed histological and immunohistochemical features consistent with a diagnosis of myxopapillary ependymoma. Imaging studies of the spine yielded normal findings, confirming the lesion’s primary nature. To the best of our knowledge, this is the first case of primary intracranial myxopapillary ependymoma described in this location.