Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report

IntroductionIntracranial schwannomas represent a rare group of intracranial tumors, with purely motor nerve schwannomas being the rarest of them. The anatomical proximity of these tumors to the brainstem may present a radiological challenge in differentiating them from intra–axial brainstem tumors,...

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Main Authors: Miroslav Fimic, Patrick Haas, Jose Antonio Ortiz Rey, Marcos Tatagiba
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1474372/full
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author Miroslav Fimic
Patrick Haas
Jose Antonio Ortiz Rey
Marcos Tatagiba
author_facet Miroslav Fimic
Patrick Haas
Jose Antonio Ortiz Rey
Marcos Tatagiba
author_sort Miroslav Fimic
collection DOAJ
description IntroductionIntracranial schwannomas represent a rare group of intracranial tumors, with purely motor nerve schwannomas being the rarest of them. The anatomical proximity of these tumors to the brainstem may present a radiological challenge in differentiating them from intra–axial brainstem tumors, which can influence further decision–making and treatment options.MethodsWe report on a 47–year–old male patient who was diagnosed with a large cystic intracranial tumor with radiological features suggestive of an intrinsic brainstem glioma.ResultsAfter discussing treatment options and risks based on a presumed radiological diagnosis, microsurgical treatment via lateral–suboccipital craniotomy in semi–sitting position, under continuous intraoperative neuromonitoring was performed. Intraoperative findings proved that the tumor was an extra–axial schwannoma originating from the left trochlear nerve. Gross total removal of the lesion was achieved.ConclusionDue to their rarity, non–specific symptoms and the possibility to mimicking intra–axial brainstem tumors on imaging, these tumors may present a diagnostic challenge and should be taken into account during treatment decision-making.
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spelling doaj-art-e0c935d7f5144260a1570cfc1c5dd8bd2024-11-11T06:10:19ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-11-011410.3389/fonc.2024.14743721474372Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case reportMiroslav Fimic0Patrick Haas1Jose Antonio Ortiz Rey2Marcos Tatagiba3Department of Neurosurgery, Tübingen University Hospital, Tübingen, GermanyDepartment of Neurosurgery, Tübingen University Hospital, Tübingen, GermanyDepartment of Pathology, Hospital Álvaro Cunqueiro, Vigo, SpainDepartment of Neurosurgery, Tübingen University Hospital, Tübingen, GermanyIntroductionIntracranial schwannomas represent a rare group of intracranial tumors, with purely motor nerve schwannomas being the rarest of them. The anatomical proximity of these tumors to the brainstem may present a radiological challenge in differentiating them from intra–axial brainstem tumors, which can influence further decision–making and treatment options.MethodsWe report on a 47–year–old male patient who was diagnosed with a large cystic intracranial tumor with radiological features suggestive of an intrinsic brainstem glioma.ResultsAfter discussing treatment options and risks based on a presumed radiological diagnosis, microsurgical treatment via lateral–suboccipital craniotomy in semi–sitting position, under continuous intraoperative neuromonitoring was performed. Intraoperative findings proved that the tumor was an extra–axial schwannoma originating from the left trochlear nerve. Gross total removal of the lesion was achieved.ConclusionDue to their rarity, non–specific symptoms and the possibility to mimicking intra–axial brainstem tumors on imaging, these tumors may present a diagnostic challenge and should be taken into account during treatment decision-making.https://www.frontiersin.org/articles/10.3389/fonc.2024.1474372/fulltrochlear nerveschwannomaneurinomasurgerycase report
spellingShingle Miroslav Fimic
Patrick Haas
Jose Antonio Ortiz Rey
Marcos Tatagiba
Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
Frontiers in Oncology
trochlear nerve
schwannoma
neurinoma
surgery
case report
title Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
title_full Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
title_fullStr Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
title_full_unstemmed Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
title_short Surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma: a case report
title_sort surgical management of a large cystic trochlear nerve schwannoma mimicking a brainstem glioma a case report
topic trochlear nerve
schwannoma
neurinoma
surgery
case report
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1474372/full
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