Ganglioneuroma of the Internal Auditory Canal Presenting as a Vestibular Schwannoma

Kimon Bekelis; Duncan A Meiklejohn; Symeon Missios; Brent Harris; James E Saunders; Kadir Erkmen

doi:10.1055/s-0031-1276722

Skull Base Reports, Table of Contents

Skull Base Rep 2011; 1(2): 089-094
DOI: 10.1055/s-0031-1276722

Ganglioneuroma of the Internal Auditory Canal Presenting as a Vestibular Schwannoma

Kimon Bekelis¹ , Duncan A. Meiklejohn² , Symeon Missios¹ , Brent Harris³ , James E. Saunders² , Kadir Erkmen¹

¹Section of Neurosurgery, Dartmouth–Hitchcock Medical Center, Lebanon, New Hampshire
²Section of Ear Nose and Throat Surgery, Dartmouth–Hitchcock Medical Center, Lebanon, New Hampshire
³Section of Pathology, Dartmouth–Hitchcock Medical Center, Lebanon, New Hampshire

Abstract

ABSTRACT

In most series, 90% of cerebellopontine angle tumors are vestibular schwannomas. Meningiomas and epidermoid tumors follow with decreased frequency. Ganglioneuroma is a benign tumor usually found in the retroperitoneum and posterior mediastinum. We report a case of a 21-year-old man with gradual sensorineural hearing loss and a minimally enhancing lesion of the internal auditory canal, which was excised through a middle fossa approach and found histologically to be a ganglioneuroma. Like vestibular schwannomas, these lesions are benign in nature and may be managed in a similar fashion, although the possibility of malignant transformation may support surgical resection over conservative management or radiosurgery. Ganglioneuromas should be considered in patients with atypical radiographic findings for vestibular schwannomas.

KEYWORDS

Ganglioneuroma - vestibular schwannoma - internal auditory canal - cerebellopontine angle

Full Text

References

REFERENCES

1 Geoerger B, Hero B, Harms D, Grebe J, Scheidhauer K, Berthold F. Metabolic activity and clinical features of primary ganglioneuromas. Cancer. 2001; 91 1905-1913
2 Scheithauer B W, Woodruff J M, Erlandson R A. Ganglioneuroma. In: Tumors of the Peripheral Nervous System. Bethesda, MD: Armed Forces Institute of Pathology; 1999: 259
3 Slattery III W H, Brackmann D E, Hitselberger W. Middle fossa approach for hearing preservation with acoustic neuromas. Am J Otol. 1997; 18 596-601
4 Abe T, Asano T, Manabe T, Matsuura H, Furuta T, Taguchi K. Trigeminal ganglioneuroma. Brain Tumor Pathol. 1999; 16 49-53
5 Brouwers F M, Eisenhofer G, Lenders J W, Pacak K. Emergencies caused by pheochromocytoma, neuroblastoma, or ganglioneuroma. Endocrinol Metab Clin North Am. 2006; 35 699-724 viii
6 Estefano J, Algaba J, Gorostiaga F, Urruticoechea A, Hernández J M. Ganglioneuroma of the middle ear. Apropos of a case. An Otorrinolaringol Ibero Am. 1992; 19 5-12
7 Kaufman M R, Rhee J S, Fliegelman L J, Costantino P D. Ganglioneuroma of the parapharyngeal space in a pediatric patient. Otolaryngol Head Neck Surg. 2001; 124 702-704
8 Lonergan G J, Schwab C M, Suarez E S, Carlson C L. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics. 2002; 22 911-934
9 Ozluoglu L N, Yilmaz I, Cagici C A, Bal N, Erdogan B. Ganglioneuroma of the internal auditory canal: a case report. Audiol Neurootol. 2007; 12 160-164
10 Radin R, David C L, Goldfarb H, Francis I R. Adrenal and extra-adrenal retroperitoneal ganglioneuroma: imaging findings in 13 adults. Radiology. 1997; 202 703-707
11 Palmer C A, Townsend J J, Harnsberger H R, Parkin J L, Apfelbaum R I. Cerebellopontine angle glioneuronal hamartoma. Surg Neurol. 1996; 45 467-469
12 Ambros I M, Zellner A, Roald B et al.. Role of ploidy, chromosome 1p, and Schwann cells in the maturation of neuroblastoma. N Engl J Med. 1996; 334 1505-1511
13 Miura K, Mineta H, Yokota N, Tsutsui Y. Olfactory neuroblastoma with epithelial and endocrine differentiation transformed into ganglioneuroma after chemoradiotherapy. Pathol Int. 2001; 51 942-947
14 Ichikawa T, Ohtomo K, Araki T et al.. Ganglioneuroma: computed tomography and magnetic resonance features. Br J Radiol. 1996; 69 114-121
15 Rha S E, Byun J Y, Jung S E, Chun H J, Lee H G, Lee J M. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics. 2003; 23 29-43
16 Califano L, Zupi A, Mangone G M, Long F. Cervical ganglioneuroma: report of a case. Otolaryngol Head Neck Surg. 2001; 124 115-116
17 Leonardis M, Sperb D, Alster C, Campisi C, Herter N T. Ganglioneuroma of the neck, masquerading as a goiter. Eur J Surg Oncol. 2003; 29 929-930
18 Hillman T, Chen D A, Arriaga M A, Quigley M. Facial nerve function and hearing preservation acoustic tumor surgery: does the approach matter?. Otolaryngol Head Neck Surg. 2010; 142 115-119
19 Irving R M, Jackler R K, Pitts L H. Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg. 1998; 88 840-845
20 Stárek I, Mihál V, Novák Z, Pospísilová D, Vomácka J, Vokurka J. Pediatric tumors of the parapharyngeal space. Three case reports and a literature review. Int J Pediatr Otorhinolaryngol. 2004; 68 601-606
21 Carvalho G A, Matthies C, Osorio E, Samii M. Hamartomas of the internal auditory canal: report of two cases. Neurosurgery. 2003; 52 944-948 discussion 948-949
22 Gonul E, Yetiser S, Tasar M, Ongoru O. Glioneural hamartoma of the VIIIth nerve. J Laryngol Otol. 2006; 120 70-73
23 Pucci A, Pucci E, Santini F et al.. A ganglioneuroma with features of a thyroid nodule: intense pain on fine needle biopsy as a diagnostic clue. Thyroid. 2009; 19 201-204

Kadir ErkmenM.D.

Section of Neurosurgery, Dartmouth-Hitchcock Medical Center

One Medical Center Drive, Lebanon, NH 03756

Email: Kadir.Erkmen@hitchcock.org