Ectopic schwannoma of the lateral ventricle: case report and review of the literature
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LETTER TO THE EDITOR
Ectopic schwannoma of the lateral ventricle: case report and review of the literature Xianwang Liu1,2,3 · Juan Deng1,2,3 · Caiqiang Xue1,2,3 · Shenglin Li1,2,3 · Junlin Zhou1,3 Received: 10 June 2020 / Accepted: 10 November 2020 © Belgian Neurological Society 2020
Keywords Lateral ventricle · Brain tumor · Schwannoma · Ectopic · Magnetic resonance imaging
Introduction
Case presentation
Schwannomas, which originate from Schwann cells, are mostly benign entities, accounting for approximately 8% of the tumors of the central nervous system (CNS), with acoustic neuroma (vestibular schwannoma) being the most common. Less than 1% of schwannomas occur in the brain parenchyma or ventricle [1, 2]. The nerve fibers in the CNS are not wrapped in Schwann cells. Consequently, schwannomas that occur in the parenchyma or ventricle of the brain are also known as ectopic schwannomas (ES) [3]. ES of the lateral ventricle are very rare. Since the first report describing ES of the lateral ventricle by David in 1965 [4], there have been only 21 cases reported in the English literature. The ages of the patients in these cases were between 8 and 68 years, with a median age of 21 years. Only one case involved malignant biological behavior in the literature [5], with metastasis to the cerebellar angle and cerebellum occurring seven months after the operation. We report the case of a woman with ES in the right lateral ventricle who experienced dizziness and headache for two years, with exacerbation of the symptoms over one month. The present study aimed to review the relevant literature of all ES of the lateral ventricle, and to summarize and analyze the clinical manifestation, pathological and magnetic resonance imaging (MRI) features, to improve the understanding of ES of the lateral ventricle.
A 51-year-old woman, with no significant medical history, experienced intermittent dizziness and headache during the previous two years, which had worsened in the past month. The patient experienced no significant weight loss or other symptoms of discomfort; furthermore, laboratory tests revealed no obvious abnormalities. Contrast-enhanced MRI revealed that the lesion, measuring approximately 3.5 cm × 4.3 cm × 2.9 cm in size, was located in the right lateral ventricle. The solid components of the tumor exhibited equal signal on T1-weighted imaging (T1WI) and slightly lower signal on T2-weighted imaging (T2WI) (Fig. 1a, b). Cystic components with low signal on T1WI and high signal on T2WI were apparent in the center of this lesion. Diffusion-weighted imaging and apparent diffusion coefficient images demonstrated a slightly higher signal. After contrast-enhanced T1WI, the solid part of the lesion was inhomogeneously enhanced (Fig. 1c, d). The patient then underwent resection of the lesion in the lateral ventricle. During the operation, the tumor, measuring approximately 4.0 cm × 4.0 cm × 3.5 cm in size, was found to be located in the right lateral ventricle and exhibited reddish color, irregular shape, fragile texture, an
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