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At least 19 recordsLinked to original sources
PubMed2026

Surgical treatment of schwannomas around the tarsal tunnel: a case series of 40 patients and systematic review of the literature.

OBJECTIVE: Schwannomas in the tibial, plantar, or medial calcaneal nerves around the ankle can mimic symptoms of tarsal tunnel syndrome. Outcomes after resection of schwannomas from these nerves have mainly been reported in case reports. The objectives of this study were to investigate the presentation and results for resection of schwannomas around the tarsal tunnel in a large case series and systematically review the currently available literature. METHODS: Data from 40 patients (27 sporadic and 13 schwannomatosis cases) treated at 2 centers were retrospectively analyzed for preoperative type and duration of symptoms, schwannoma size at presentation, and outcome after resection. The following different locations around the ankle were compared: proximal to the tarsal tunnel (PTT), at the tarsal tunnel (ATT), and distal to the tarsal tunnel (DTT). The severity of symptoms was categorized in increasing order for pain only on touch, during load-bearing activities, and symptoms also at rest. Surgical outcome was assessed based on pain relief and occurrence of complications. The systematic literature review was performed using a PubMed and Embase search. RESULTS: All but 1 patient presented with pain, local at the ankle, or neuropathic pain during weight-bearing activities (13/40, 32.5%). More than half of the patients also experienced symptoms at rest (52.5%). In 14 cases, the schwannoma was located PTT, in 17 cases ATT, and in 9 cases DTT in the plantar nerves. There were no significant differences in size and symptom duration at presentation for the different locations. Tumor size did not correlate with symptom severity. Outcomes after resection were excellent, with complete pain relief in all but 1 patient (97.0%). Complications included wound infection (5%) and temporary decreased sensation on the heel (7.5%). A review of 44 previously reported cases also frequently showed complete pain relief after resection. CONCLUSIONS: The results of this study show that schwannomas around the tarsal tunnel often present with severe pain symptoms, even if the lesion is still relatively small. Resection frequently results in excellent pain relief. During surgery, it may not be necessary to open the entire length of the tarsal tunnel, thereby limiting the size of the incision, especially in schwannomas located proximally or distally to the tarsal tunnel.

Humans↗
PubMed1979

Malignant Schwannoma associated with von Recklinghausen's neurofibromatosis.

A series of 46 malignant schwannomas occurring in soft parts of patients having von Recklinghausen's neurofibromatosis was analyzed. The diagnosis of malignant schwannoma was based upon the occurrence of malignant spindled cells closely resembling Schwann cells in the neoplasm and the close association or origin of the malignant schwannoma in a neurofibroma (27 tumors), or a large peripheral nerve (31 tumors). Additional histologic features useful in making the diagnosis of malignant schwannoma included the arrangement of the spindled tumor cells in a whorled pattern about thin-walled, gaping blood vessels, perivascular cellular proliferation and the presence of prominent myxoid stroma containing abundant hyaluronidase-sensitive acid mucopolysaccharides. Nuclear palisading was present in only one case. Eight tumors containing both neoplastic Schwann cells and rhabdomyoblasts and five containing both neoplastic Schwann cells and rhabdomyoblasts (malignant "Triton" tumors) and five containing foci of malignant cartilage cells were included in the series. The neoplasms occurred principally in adults (median age, 34 years) and were most common in the lower extremity (18 cases) and retroperitoneum (11 cases). A mass with or without pain was the most common presenting symptom (28 cases). The median size of excised tumors was 11 cm. The malignant schwannomas were highly malignant neoplasms, causing the death of 39 patients within five years and two patients within 6--10 years after diagnosis. Only four patients were alive and free of tumor 5--15 years after diagnosis.

Adolescent↗
PubMed2026

Deletion of the Salmonella pathogenicity island 2 gene, spiC, in attenuated Salmonella Typhimurium VNP20009 optimizes its potential for bacterial schwannoma therapy.

UNLABELLED: Recent advances in systems biology and immunotherapy have spurred the investigation of bacteria as therapeutic vehicles for cancer treatment. Currently, Bacillus Calmette-Guérin remains the only FDA-approved bacterial cancer therapy; it is a live attenuated mycobacterium that is indicated for the treatment and prophylaxis of carcinoma in situ of the urinary bladder and for the prophylaxis of primary or recurrent papillary tumors following transurethral resection. Although safety concerns have been raised, attenuated Salmonella Typhimurium strains such as VNP20009 have advanced to clinical trials targeting fast-growing human tumors. Notably, this strain induces robust immunological control of slow-growing tumors such as NF2-related schwannomatosis (NF2-SWN) in preclinical murine models. Here, we genetically characterize VNP20009 with the goal of constructing genetically defined attenuated strains that retain its promising therapeutic features while improving safety. Specifically, we investigated the contribution of the Salmonella pathogenicity island I (SPI-1) and SPI-2 type III secretion systems to antitumor efficacy and biosafety. Mutation of the SPI-1 gene sipB, a key structural component required for SPI-1 type III secretion system function, partially reduced tumor control in NF2-SWN murine schwannoma models, suggesting that bacterial invasion alone does not fully account for antitumor activity. In contrast, deletion of the SPI-2 gene spiC, a key effector required for intracellular survival, preserved robust tumor regression in NF2-SWN murine schwannoma models while improving safety and reducing systemic toxicity. To create a genetically defined and tractable platform, we generated two attenuated strains-AST101 and AST101-ΔspiC-which retain key mutations present in VNP20009 but lack ill-characterized background mutations. In the syngeneic NF2-SWN mouse schwannoma model, both strains significantly suppressed tumor growth compared to PBS. Collectively, these findings support the development of rationally engineered Salmonella Typhimurium strains with enhanced safety and preserved antitumor efficacy. IMPORTANCE: Given long-standing safety concerns surrounding the therapeutic use of live bacteria, we constructed a ΔspiC mutant of VNP20009 and demonstrated that it provides a markedly improved safety profile while retaining antitumor efficacy in NF2-related schwannomatosis mouse schwannoma models. In addition, we created two genetically defined Salmonella Typhimurium strains, AST01 and AST01-ΔspiC, which incorporate the key-targeted mutations found in VNP20009 and VNP20009-ΔspiC, respectively. These engineered strains offer a well-defined genetic background, enabling precise investigation of the bacterial traits responsible for Salmonella Typhimurium-mediated tumor control and thus further improvement of attenuated strains optimized for bacteriotherapy of neoplasms.

Salmonella typhimurium↗
PubMed1977

Facial nerve schwannoma.

The present article gives a brief and complete account of the incidence, pathology, clinical features, diagnosis, management and prognosis of the schwannoma with special reference to facial nerve schwannomas. A case report of a rare schwannoma of the vertical part of the facial nerve found on biopsy of tissue during a postaural modified radical mastoidectomy is included.

Facial Nerve↗
PubMed1979

Malignant neurofibroma with glandular differentiation (glandular schwannoma).

A case of malignant shwannoma is reported with unusual elements in an 89-year-old female. A large mass was located in the subcutaneous tissue of the right lateral chest wall and measured 5 cm in the greatest diameter. Histologically the tumor was composed of neurofibroma and malignant schwannoma with glandular differentiation. Neurofibroma characterized by numerous hyaline neural nodules was located in the peripheral portion of the tumor, whereas malignant schwannoma occupied a large part of the central portion of the tumor. The glandular elements observed in some areas of malignant schwannoma consisted of cuboidal and columnar shaped cells and were arranged in tubular or tubulo-medullary fashion in which rosettes or pseudorosettes were found. Mucicarminophilic material was observed, both in the cytoplasm and in the lumen. Seven reported cases of peripheral nerve tumor with glandular differentiation are reviewed briefly.

Aged↗
PubMedDate not supplied

Malignant schwannoma of the trigeminal nerve.

Malignant schwannomas are rare in the head and neck, even though benign schwannomas of this area are common. A case of a malignant schwannoma of the fifth cranial nerve with symptoms of otalgia and serous otitis media is described. About 20 such cases have been reported in the literature.

Aged↗
PubMed1977

[Intracerebellar schwannoma].

Only some rare examples of schwannomas localized in the medullary parenchyma are cited in the literature. The first was described by Kernohan in 1933; 9 cases were rapported in the thirty following years. For Brain a few observations about one case were cited by David (1965), Gibson (1966), New (1972) and Ghatak (1975). The authors relate one case of isolated schwannoma in superior vermis. That was a 15 years old young man who had a low evoluting I.C.P. syndrome. The pre-operating neurological investigation revealed a small cerebellar syndrome. The neuroradiological record allowed to localize an expansive median affection in the posterior fossa on a level with the Sylvius aqueduct. The neurosurgical operation allowed to carry off a tumor from the superior vermis; schwannoma tissue was the conclusion of the histological study. The evolution has been good and no cranial nerves were involved. Different theoris about the localisation of Schwann cells in this region are described.

Adolescent↗
PubMed1979

Reversible compression neuropathy of the eighth cranial nerve from a large jugular foramen schwannoma.

Jugular foramen schwannomas are unusual tumors occasionally resulting in neural hearing losses. Two previously reported cases document preservation of hearing following removal of a jugular foramen schwannoma. I report the third such case, in which there was progressive auditory and vestibular dysfunction seen on serial preoperative auditory tests and recovery of function seen on postoperative auditory and vestibular tests. The presumed pathophysiologic feature sub-serving this observation is compression neuropathy. I discuss experiences with compression neuropathy in animals and man under other circumstances.

Adult↗
PubMed1977

Combination chemotherapy of metastatic malignant schwannoma with vincristine, adriamycin, cyclophosphamide, and imidazole carboxamide: a case report.

This report describes a patient with a 15-year history of schwannoma (peripheral nerve sheath sarcoma) who developed extensive pulmonary metastases associated with hypoxemia. Treatment with chemotherapy consisting of cyclophosphamide, vincristine, Adriamycin, and imidazole carboxamide resulted in a complete remission lasting 17+ months. Malignant schwannoma should probably be regarded as a drug sensitive neoplasm.

Cyclophosphamide↗
PubMed1978

Synchronous malignant glandular schwannomas in congenital neurofibromatosis.

An eight-year-old child with congenital neurofibromatosis developed rapidly growing synchronous malignant schwannomas in the neck and mediastinum. These tumors, displaying a biphasic pattern of spindle cell sarcoma admixed with mucinous epithelium, represent the eighth and ninth known examples of glandular schwannoma. The clinical and pathological features of this case are detailed and the histogenesis of the tumors discussed.

Child↗
PubMed1979

Schwannomas of the parapharyngeal space and jugular foramen.

Schwannomas or neurilemmomas are among the most common neoplasms occupying the parapharyngeal space, yet only 107 cases have been previously reported. Neurilemmomas involving the jugular foramen are extremely rare. Only 55 cases have been reported in the world literature. The neoplasm occurred in the parapharyngeal space in three of our patients and in the jugular foramen in another patient. Of the tumors located in the parapharyngeal space, the nerve of origin in one of them was the glossopharyngeal, which is extremely rare. Adequate exposure for complete excision of parapharyngeal space tumors is best obtained through an external incision and should not be attempted transorally. In the jugular foramen case, the neoplasm arose from the vagus nerve high in the neck and extended intracranially in a "dumbbell" shape into the posterior cranial fossa. Total removal was successfully accomplished in one stage, by using a subtotal temporal bone resection--upper neck--posterior cranial fossa approach. Surgical removal is the treatment of choice. Schwannomas rarely recur following complete excision.

Adult↗
PubMed1977

Ultrastructural localisation of sterols in ethylnitrosourea-induced Schwannomas.

Malignant schwannomas of the trigeminal nerves were induced transplacentally by a single intravenous injection of 30 mg of N-ethyl-N-nitrosourea per kg of body weight into pregnant BD-IX rats on the 15th day of gestation. These neoplasms consisted of a pleomorphic population of Schwann cells and occasional fibroblasts. In order to preserve sterols the tumours were fixed in a digitonin-containing aldehyde solution. The electron microscope investigation of the tissues so treated revealed various structures: lamellar, tubular and complex formations were all observed. In addition, the unit membranes, including those of various cytoplasmic organelles, showed areas of increased contrast. The abundance of these fine structural configurations indicated the high sterol content of ethyl-nitrosourea-induced schwannomas.

Animals↗
PubMed1979

Neurofibroma and schwannoma of the oral cavity. A clinical and ultrastructural study.

The clinical parameters of fifty-five cases accessioned as neurofibroma and schwannoma of the oral cavity were reviewed. An electron microscope study was performed on several cases. The component cells of neurofibroma were spindle shaped, with bundles of collagen fibrils between cells. Junctional complexes were observed between adjacent cells. Component cells of the schwannoma showed numerous convoluted cytoplasmic processes. Reduplication of basal lamina was frequently observed and formed the material in the hyalinized area of Verocay bodies.

Adolescent↗
PubMedDate not supplied

Intralabyrinthine schwannoma.

Two cases of unsuspected intralabyrinthine schwannoma are reported and the literature is reviewed. The mean age of the patients was 56 years, with the most common symptoms being hearing loss, dizziness, and tinnitus. All patients demonstrated a profound sensorineural hearing loss with low discrimination scores, and recruitment was elicited in two patients. A radiographic evaluation was negative in all but one case. Five of the six patients had a preoperative diagnosis of Ménière's disease. Transcanal labyrinthectomy was employed to remove tumor in all patients. This review suggests that a patient, presenting with symptoms of atypical Ménière's disease and negative radiographic evaluation, should alert the surgeon to the possibility of an intralabyrinthine schwannoma.

Adult↗
PubMedDate not supplied

Malignant parapharyngeal schwannoma (neurilemmoma).

A malignant parapharyngeal neurilemmoma developed in a 45-year-old woman who had had a benign solitary neurilemmoma removed from the same area nine years previously. Incomplete excision was achieved through a mandibulotomy approach. Malignant schwannoma usually is associated with neurofibromatosis and has a poor prognosis, spreading along the nerve of origin or by blood stream. Small localized tumors should be treated aggressively by surgery. The possibility that a previously benign schwannoma underwent malignant transformation must be considered.

Adult↗
PubMed1975

[Schwannoma in otorhinolaryngology].

In this study 4 cases of Schwannoma are reported. The primary localisation of the tumor in the first case was thought to be near the foreamen lacerum with large areas of bone destruction in the base of the skull. Moreover the internal carotid artery was trophic and thinwalled. In the second patient the onset of the disease must have taken place in childhood as a chronic otitis media. Also in this case the tumor was not diagnosed until it reached a considerable size. The primary localisation was the nervus petrosus superficialis major. In the third patient the neurinoma was located in the facial nerve between the two lobes of the parotid gland. In the fourth case a pedunculated neurinoma of the epipharynx was found. Symptomatology, treatment and differential diagnosis of the Schwannoma are discussed.

Adult↗
PubMed1977

[Schwannoma of the trachea: discussion of a case and review of the literature].

The authors report the case of a 71 years old woman admitted for severe asthmatic condition of recent origin. The chest X ray showed the opaque image of a tumour against the clearness of the trachea. Its benignity was confirmed by endoscopy. A complete surgical exerese is impossible because of the friable nature of the tumour but was attempted to relieve a worsening respiratory distress. A new intervention was necessary because of a mediastinitis; the patient died of renal insufficiency. Only one observation of schwannoma and 3 cases of tracheo-bronchial schwannoma were found in the literature. The nosological place of these tumours was debated particularly in their relation with Recklinghausen disease. Diagnosis was usually done only a few years after an endoscopic exploration. Some symptoms could nevertheless make up a "tracheal syndrome". Endoscopic exeresis of the tumour successfully tried on some cases should be attempted on a first step.

Adult↗
PubMed1978

Glossopharyngeal schwannomas.

Glossopharyngeal schwannomas are rare entities. Our recent experience with three such cases treated successfully, suggests that recognitton of this tumor as a discrete entity is both desirable and feasible. Although this tumor shares with the far more common acoustic schwannoma the presenting symptom of hearing loss, it may be distinguished by an elicitable history of hoarseness, demonstration of abnormal palatal function and absence of expected findings upons standard radiographic examination of the petrous bones and internal auditory canal. We have found that identification of this tumor may be accomplished with currently available diagnostic technics, including computerized tomography. The authors review the literature and report their experiences regarding preoperative assessment, operative technic and the postoperative course.

Adult↗