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Pathology of Vestibular Schwannoma

  Dr Sampurna Roy MD    

Dermatopathology Quiz Case 213 

Diagnosis: Vestibular Schwannoma

 

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Syn: Acoustic neuroma ; Schwannoma of the eighth cranial nerve ; Acoustic Neurilemmoma ; Acoustic Neurofibroma.

Vestibular schwannoma is a benign, usually slow-growing, tumour which is usually unilateral. 8% of lesions are bilateral are associated with neurofibromatosis 2.    

Site: The tumour usually arises from the vestibular division of the eighth cranial nerve (from the Schwann cells) - 10% of intracranial tumours, 90% of tumours at cerebellopontine angle.

In some cases the tumour arises from the cochlear division of the eighth cranial nerve.

Clinical presentation:  Patients complain of hearing loss and tinnitus.

As the tumour grows it can cause dizziness/loss of balance and can interfere with the face sensation nerve (the trigeminal nerve), causing facial numbness.

Vestibular schwannomas can also press on the facial nerve causing facial weakness or paralysis on the side of the tumour.

The tumour may produce serious symptoms and death by damage to the temporal bone and cerebral structures and by causing increased intracranial pressure.

Gross: Smooth round to oval shaped lobulated tumour, with a yellowish cut surface and areas of hemorrhage.

Microscopic features: 

Resemble schwannomas at other locations.

There are interlacing fascicles of cells, Antoni A and Antoni B areas together with Verocay bodies and thickened and hyalinized blood vessels.

Thrombosis and infarction may be prominent and may be associated with degenerative nuclear atypia.

Visit: Schwannoma (Neurilemmoma) and variants of the Soft Tissue                        

 

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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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