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J Neurol Surg B Skull Base 2012; 73 - A295
DOI: 10.1055/s-0032-1312343

Atypical Schwannoma: A 10-Year Experience

Selena E. Heman-Ackah 1(presenter), Maura K. Cosetti 1, John G. Golfinos 1, John T. Roland 1
  • 1New York, USA

Introduction: Atypical schwannoma represents a distinctive disease process whereby histopathologic analysis reveals findings not entirely typical of benign vestibular schwannomas, suggesting an atypical lesion or low-grade malignancy. An initial review of 14 patients with findings consistent with atypical schwannoma or low-grade malignancy was published by representatives from New York University in 2001. It described the clinical presentation and characteristic findings of patients with this distinct entity.

Objective: The goals of this study were to (1) describe the clinical presentation in association with atypical schwannoma of the cerebellopontine angle, (2) describe characteristic findings on pathology in association with atypical schwannoma, (3) describe the long-term outcome of patients with atypical schwannoma, and (4) propose a potential course for clinical surveillance in these patients.

Study Design: A retrospective chart review was performed.

Setting: The study was conducted in a tertiary referral center.

Patients: Individuals with the histopathologic diagnosis of atypical schwannoma of the cerebellopontine angle were diagnosed at the study institution between January of 2000 and December of 2010.

Main Outcomes Measure: Demographic data were recorded. Clinical presentation, including cranial nerve deficits at the time of presentation, was recorded. Findings on pathology were evaluated. Initial treatment and postoperative course were recorded.

Results: At presentation, a somewhat accelerated course of cranial nerve deficit was noted. In the immediate postoperative period, there were no differences noted in the complication rate. Recurrence rates and long-term follow-up will be presented.

Conclusions: Atypical schwannoma is an intermediate disease process with a slightly accelerated clinical course compared with vestibular schwannoma. Traditional operative approaches may be employed without increased concern for postoperative complications. Annual MRI scans to evaluate for recurrence and clinical evaluation are proposed for long-term follow-up in these patients.