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Abdennadher M, Hadj Dahmane M, Bouassida I, Zribi H, Zairi S, Sahnoun I, Mlika M, Ouerghi S, Marghli A. [Primary benign schwannoma of the pleura: Report of 2 cases]. Rev Mal Respir 2021; 38:199-203. [PMID: 33541754 DOI: 10.1016/j.rmr.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 11/08/2020] [Indexed: 10/22/2022]
Abstract
The preferred thoracic location of a schwannoma is the posterior mediastinum. A pleural location is very rare. To date there have been fewer than 20 cases in the literature. We report two operated cases of primary benign pleural schwannoma. The first occurred in a 52-year-old woman who presented with right-sided chest pain and chronic cough. The radiological appearance suggested a hydatid cyst of the lower right lobe. The second case concerned a 37-year-old, asymptomatic man with no past history, who presented with a left posterior mediastinal mass, discovered incidentally on imaging. Both patients underwent complete surgical resection via a posterolateral thoracotomy. The final anatomo-pathological investigation revealed two primary benign schwannomas of the pleura.
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Affiliation(s)
- M Abdennadher
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie.
| | - M Hadj Dahmane
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - I Bouassida
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - H Zribi
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - S Zairi
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - I Sahnoun
- Service de pneumologie, pavillon D, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - M Mlika
- Service d'anatomopathologie, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - S Ouerghi
- Service d'anesthésie réanimation, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
| | - A Marghli
- Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmane Mami, faculté de médecine de Tunis, université Tunis El Manar, Ariana, Tunisie
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Raj C, Chantelot C, Saab M. Predictive factors of postoperative deficit and functional outcome after surgery for upper limb schwannomas: Retrospective study of 21 patients. Hand Surg Rehabil 2020; 39:229-34. [PMID: 32061856 DOI: 10.1016/j.hansur.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 01/15/2023]
Abstract
Schwannomas are the most frequent benign tumors of the peripheral nerves. Tumor enucleation is the traditional surgical treatment. The incidence of neurological complications after surgery varies and predictive factors for these complications are not clearly defined. The aim of this study was to find predictive factors of postoperative neurological deficit after surgical treatment of schwannomas of the upper limb. Twenty-four schwannomas removed from 21 patients were analyzed retrospectively. The patients' mean age was 45.4years and the mean follow-up was 64.4months. Clinical parameters studied were age, gender, nature of preoperative symptoms, duration of symptoms, type of surgery performed, tumor location and size, nerve involved, QuickDASH and DN4 scores. Postoperative neurological deficits occurred in 14 patients (67%), with 11 having a sensory deficit and 7 a motor weakness. Eleven did not exist before surgery (6 sensory, 5 motor). In the postoperative deficit subgroup, 6 schwannomas involved the brachial plexus, 4 the ulnar nerve, and 4 the median nerve. All patients who had a fascicular resection because tumor enucleation was not feasible were in the postoperative deficit subgroup. Ten patients had either unchanged or worse QuickDASH and/or DN4 scores after surgery. Surgical treatment of schwannomas can lead to postoperative complications. Although none of our findings were statistically significant, advanced age, large tumor size, more than 16months between the first symptoms and surgery, and brachial plexus location seem to be more frequently observed in those with a postoperative neurological deficit.
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Wang HK, Gong YL, Wang RX, Zheng XT, Huang SY, Zhang DS. A rare occurrence of intramasseteric schwannoma - case report and literature review. ACTA ACUST UNITED AC 2016; 117:170-2. [PMID: 27155941 DOI: 10.1016/j.revsto.2016.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/25/2016] [Indexed: 10/21/2022]
Abstract
A schwannoma is a benign, solitary, well-defined, painless, slowly-enlarging nerve sheath tumor, composed of Schwann cells. Intramasseteric localization is very unusual. We report the case of a 33-year-old male who developed an intramasseteric schwannoma. Tumor could be completely removed under general anesthesia. Histopathological examination made the diagnosis of intramasseteric schwannoma through the presence of Antoni A areas and Verocay bodies. The diagnosis of schwannoma should be taken into consideration in case of parotideomasseteric tumors.
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Affiliation(s)
- H-K Wang
- Weihai Municipal Hospital, Department of Oral and Maxillofacial Surgery, Weihai 264200, China; Shandong Provincial Hospital Affiliated to Shandong University, Department of Oral and Maxillofacial Surgery, Jinan 250021, China.
| | - Y-L Gong
- Weihai Women and Children Hospital, Department of Stomatology, Weihai 264200, China
| | - R-X Wang
- Weihai Municipal Hospital, Department of Oral and Maxillofacial Surgery, Weihai 264200, China
| | - X-T Zheng
- Weihai Municipal Hospital, Department of Oral and Maxillofacial Surgery, Weihai 264200, China
| | - S-Y Huang
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Oral and Maxillofacial Surgery, Jinan 250021, China
| | - D-S Zhang
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Oral and Maxillofacial Surgery, Jinan 250021, China
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Dahdah J, Validire P, Grigoroiu M, Lenoir S, Gossot D, Stern JB. [Cystic mediastinal schwannoma appended to the vagus nerve]. Rev Mal Respir 2015; 33:383-7. [PMID: 26303098 DOI: 10.1016/j.rmr.2015.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/31/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Schwannomas are a form of rare tumor, arising from neural tissue and representing 2 % of mediastinal tumors. They are usually located in the posterior mediastinum, most often in the paravertebral gutters and typically appended to intercostal nerves. CASE REPORTS We report two cases of unusual mediastinal schwannomas, appended to the vagus nerve. The schwannoma was located in the subcarinal region in the first case and in the right para-tracheal region in the second case. The lesions were thought to be bronchogenic cysts preoperatively in both cases because of a cystic appearance on preoperative CT scan and endobronchial ultrasonography. A surgical approach was adopted to remove the tumors. Video-assisted thoracoscopy was used in one case and robotic-assisted surgery in the second case, without any complication, allowing for complete resection and to establish a certain pathological diagnosis. CONCLUSION Despite this location and cystic presentation being unusual, schwannoma should be considered as a possible cause of cystic lesions in the mediastinum. Minimally invasive surgery allows for complete resection and definitive pathological diagnosis.
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Affiliation(s)
- J Dahdah
- Département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - P Validire
- Département d'anatomie pathologique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - M Grigoroiu
- Département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - S Lenoir
- Département d'imagerie médicale, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - D Gossot
- Département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - J-B Stern
- Département thoracique, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
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Jibia A, Chenin L, Lefranc M, Peltier J. [Oculomotor nerve schwannoma in a child: Case report and literature review]. Neurochirurgie 2015; 61:283-6. [PMID: 26071177 DOI: 10.1016/j.neuchi.2015.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/13/2015] [Accepted: 03/29/2015] [Indexed: 11/30/2022]
Abstract
An isolated schwannoma of the oculomotor nerve is rare in children without an associated neurofibromatosis. A 13-year-old girl, with a previous medical history of migraine, was admitted for disabling ophthalmic migraine with oblique diplopia. The clinical examination showed a right incomplete ophthalmoplegia with reduced ipsilateral visual acuity (8/10). There was no particular skin reaction. The MRI revealed a right (isosignal-T1 and isosignal-T2) nodular schwannoma located within the cisternal segment of the oculomotor nerve. The angio-CT performed later confirmed the absence of any vascular malformation. The treatment consisted of analgesics and corticotherapy, with complete regression of symptoms three weeks later and a normal MRI follow-up. Therefore, radiosurgery was not performed.
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Affiliation(s)
- A Jibia
- Service de neurochirurgie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
| | - L Chenin
- Service de neurochirurgie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - M Lefranc
- Service de neurochirurgie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J Peltier
- Service de neurochirurgie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
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Aboukais R, Bonne NX, Baroncini M, Zairi F, Schapira S, Vincent C, Lejeune JP. Management of multiple tumors in neurofibromatosis type 2 patients. Neurochirurgie 2015; 64:364-369. [PMID: 26071178 DOI: 10.1016/j.neuchi.2014.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 10/15/2014] [Accepted: 11/02/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neurofibromatosis type 2 is characterized by the presence of bilateral vestibular schwannomas. However, other nervous system tumors may also occur. Therefore, the management of NF2 patients is complex and requires a multidisciplinary discussion in a specialized center. MATERIALS AND METHODS All recent articles concerning tumors other than vestibular schwannoma in NF2 disease were reviewed, using PubMed databases. RESULTS Intracranial meningiomas occur in 50% of NF2 patients, and are often multiple. Surgery remains the main treatment and should be performed in cases of growing tumors. The role of antiangiogenic therapy is currently under evaluation and the role of radiosurgery still remains to be defined in NF2 disease. Spinal tumors occur in about half of NF2 patients. Surgery should be discussed when radiological tumor progression is demonstrated, even if spinal tumors are asymptomatic, in order to preserve neurological function and good quality of life. As regards lower cranial nerve schwannomas, radiosurgery appears to be a more appropriate treatment for growing tumor with a small volume in order to avoid post-operative complications, especially swallowing disorders. Facial nerve schwannomas may appear, on MRI, like vestibular schwannomas. The diagnosis should be suspected when the facial palsy is an early symptom during cerebello-pontine tumor progression. Trigeminal schwannomas are frequent in NF2 disease and fortunately they are often asymptomatic. Among major neurofibromatosis types, peripheral nerve sheath schwannomas are only present in patients with NF2 disease and schwannomatosis. Surgical resection is required when the cutaneous schwannomas is painful or when tumor progression is observed and causes symptoms. CONCLUSION Tumors other than vestibular schwannoma are also associated with a poor prognosis in NF2 patients. Surgery remains the main treatment in most cases. Each treatment decision in NF2 disease requires a complete evaluation of all cranial and spinal locations of the disease in order to establish surgical priorities and strategies.
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Affiliation(s)
- R Aboukais
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France.
| | - N-X Bonne
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - M Baroncini
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - F Zairi
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - S Schapira
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - C Vincent
- Department of Otology and Neurotology, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
| | - J-P Lejeune
- Department of Neurosurgery, Lille University Hospital, rue E.-Lainé, 59037 Lille cedex, France
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Abstract
Peripheral nerve sheath tumors are common neoplasms in daily practice. Diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer; but on occasion, they are diagnostically challenging (especially with locally aggressive and malignant tumors). This article aims to provide an update of the data (clinical, histological, immunohistochemistry and genomic) of benign, intermediate and malignant peripheral nerve sheath tumors, thanks to the latest WHO "Classification of Tumors of Soft Tissue and Bone", published in 2013, which includes a new chapter on "Nerve Sheath Tumors". Advances in molecular biology have provided new insights into the nature of the various peripheral nerve sheath tumors, and have begun to suggest novel targeted therapeutic approaches.
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Affiliation(s)
- Sophie Le Guellec
- Département de pathologie, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
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Ayadi-Kaddour A, Khadhar A, Mlika M, Ismail O, Braham E, Marghli A, Zidi A, El Mezni F. [Tracheal tumor treated as asthma]. Rev Pneumol Clin 2014; 70:353-356. [PMID: 25131369 DOI: 10.1016/j.pneumo.2014.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/28/2014] [Accepted: 04/03/2014] [Indexed: 06/03/2023]
Abstract
Primary tumors of the trachea are very rare. In adults, the majority of them are malignant. Schwannomas are exceedingly rare benign tumors in the tracheobronchial tree. We report a case of a 37-year-old man who was hospitalized for increasing dyspnea. He had been treated for bronchial asthma for the last 4 years with no benefit. The CT scan of the chest and bronchoscopy identified a tracheal mass that was prolapsed in the left stem bronchus. The patient did not remain free of disease after endoscopic laser resection. So, surgical resection was made. The tumor was excised at its base. A segment of the left stem bronchus was removed and primary anastomosis was performed. The histopathologic diagnosis was of a benign schwannoma without malignant elements. There was no recurrence during the follow-up period. This case demonstrates that intratracheal masses should be considered in patients with dyspnea or in patients with asthma refractory to conventional therapy.
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Affiliation(s)
- A Ayadi-Kaddour
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie.
| | - A Khadhar
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - M Mlika
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - O Ismail
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - E Braham
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
| | - A Marghli
- Service de chirurgie thoracique, hôpital Abderrahmen Mami, Ariana, Tunisie
| | - A Zidi
- Service de radiologie, hôpital Abderrahmen Mami, Ariana, Tunisie
| | - F El Mezni
- Service d'anatomie pathologique, hôpital Abderrahmen Mami de pneumo-phtysiologie, Ariana, Tunisie
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Bresson D, McLaughlin N, Ditzel Filho LFS, Griffiths CF, Carrau RL, Kelly DF, Kassam AB. Endoscopic endonasal approach for the treatment of schwannomas of the pterygopalatine fossa: case report and review of the literature. Neurochirurgie 2014; 60:174-9. [PMID: 24952768 DOI: 10.1016/j.neuchi.2014.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pterygopalatine fossa (PPF) schwannomas are rare lesions most often arising from branches of the trigeminal nerve. Symptomatic lesions have been traditionally treated by conventional external approaches. However, the development of an expanded endonasal approach (EEA) enables skull base surgeons to reach these deeply seated lesions via a different route with its own advantages and drawbacks. METHODS Case report and review of the literature. CASE DESCRIPTION A 41-year-old woman presented with a 6-year history of right facial pain and numbness. Her symptoms had increased progressively over a year, and she recently had developed right-sided otalgia. MRI revealed a right PPF mass, hypointense on T1 and T2 sequences with homogeneous enhancement following the use of gadolinium. A biopsy, attempted at another institution, was considered non-diagnostic. We totally removed the lesion through an endoscopic endonasal transmaxillary approach. Final pathology confirmed the diagnosis of schwannoma. Post-operatively, the patient noted a significant improvement of her facial pain (V2 territory). CONCLUSION The endonasal endoscopic transmaxillary approach provides adequate access to the PPF, thus enabling safe tumor removal with less morbidity than conventional routes.
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Affiliation(s)
- D Bresson
- Department of Neurosurgery, hôpital Lariboisière, Paris, France
| | - N McLaughlin
- John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States
| | - L F S Ditzel Filho
- Department of Neurosurgery, Ohio State University, Columbus, OH, United States
| | - C F Griffiths
- John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States
| | - R L Carrau
- Department of Otolaryngology-Head & Neck Surgery, Ohio State University Medical Center, 456, West 10th Avenue Cramblett-Hall, Suite 4A, 43210-1282 Columbus, OH, United States.
| | - D F Kelly
- John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, United States
| | - A B Kassam
- Department of Neurosurgery, University of Ottawa, Ottawa, ON, Canada
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