Calcification of vestibular schwannoma: a case report and literature review
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Calcification of vestibular schwannoma: a case report and literature review Yang Zhang1, Jinlu Yu1, Limei Qu2 and Yunqian Li1*
Abstract 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. Keywords: Vestibular schwannoma, Calcification, Cerebellopontine angle, Surgery
Background Vestibular schwannoma (VS), often called acoustic neuroma, is a common cerebellopontine angle (CPA) tumor. Calcification rarely occurs in vestibular schwannoma, and only seven cases of calcified VS have been reported in the literature [1-6]. Calcification of VS causes difficulties in the differential diagnosis of CPA tumors mainly because calcifications have been found in other CPA tumors, such as meningiomas, cavernous angiomas, gangliogliomas, and solitary fibrous tumors [7-10]. Calcified VS is often misdiagnosed before surgery largely due to insufficient numbers of reported cases and the lack of a comprehensive literature review on this type of tumor. In addition, calcification produces a change in the texture of VS, which can lead to difficulties in surgically removing the tumor [11]. Here, we report a case of calcified VS and summarize a literature review of seven cases of calcified VS. Our aim was to identify the relationship between calcified VS and the texture and blood supply of the tumor in order to guide the surgical treatment of calcified VS.
* Correspondence: [email protected] 1 Department of Neurosurgery, First Hospital of Jilin University, 71 Xinmin Avenue, Changchun 130021, China Full list of author information is available at the end of the article
Case presentation The patient, a 48-year old man, was hospitalized for progressive left-sided hearing loss for 3 years. Upon examination, he had left-sided hearing loss. He also had an abnormal finger-nose pointing test, an abnormal rapid alternating movement, and a heel-knee-shin ataxia on the left side. He did not present with facial palsy and had normal muscle tone in the extremities. Magnetic resonance imaging (MRI) of the brain showed a round mass with a size of 5.42 × 4.27 × 5.35 cm in t
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