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Large Middle Cranial Fossa Schwannoma: A Rare Presentation of Vestibular Schwannoma. Cureus 2022 Dec;14(12):e33186

Date

02/03/2023

Pubmed ID

36726879

Pubmed Central ID

PMC9886273

DOI

10.7759/cureus.33186

Abstract

Schwannomas are benign tumors composed of neoplastic Schwann cells and rarely occur in the central nervous system. Schwannomas account for approximately 8% of intracranial tumors and most commonly originate from cranial nerve VIII at the cerebellopontine angle in the posterior fossa. Herein, we report two cases of vestibular schwannomas extending in the middle fossa. The first case shows a 51-year-old male who presented with a history of mild headaches for one year associated with acute nausea, vomiting, and word-finding difficulties. Imaging revealed a large multicystic contrast-enhancing lesion in the left middle cranial fossa. The middle fossa lesion was resected with pathology indicating a schwannoma. The second case shows a 63-year-old woman who presented with seizures, right-sided hearing loss, and right-sided facial weakness. On MRI, she is found to have a large right middle fossa lesion originating from the right internal auditory canal and consistent with vestibular schwannoma with a 9 mm leftward midline shift. The histopathologic examination of the excised tumor indicated a schwannoma. Schwannomas most commonly occur in the posterior fossa when they present intracranially. However, in rare occurrences, they may present as middle fossa masses with significant intracranial compression.

Author List

Gelsomino M, Eraky AM, Awad A, Farhat Y, Shabani S, Mueller W, Zwagerman NT

Author

Nathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin