Subha Dhua1
BACKGROUND
In this paper authors present three cases of schwannomas including a case of multiple schwannomas without the features of neurofibromatosis (NF). There was no family history of neurofibromatosis. All the patients underwent surgical excision and improved from the symptomatic lesions. Histopathology confirmed these lesions as schwannomas. The authors recommend surgery for symptomatic lesions. Asymptomatic tumours can be monitored. Regular follow up is essential as they may develop fresh lesions at any time. The relevant literature is discussed.
• Malignant transformation of the schwannomas is rare and has poor prognosis. It should be considered in the differential diagnosis of schwannomas.
• We should distinguish between “ancient schwannoma” and malignant transformation of schwannoma since treatment and prognosis vary.
• Imaging is not entirely reliable in differentiating benign from malignant peripheral nerve tumours.
MATERIALS AND METHODS
All the patients underwent surgical excision and improved from the symptomatic lesions. Histopathology confirmed these lesions as schwannomas. The authors recommend surgery for symptomatic lesions.
RESULTS
The histopathological studies confirmed the lesion as Flexi Schwannoma and surgery was considered to be the best option.
CONCLUSION
Schwannomas and meningiomas are usually benign tumours curable by complete removal. They occur either as single sporadic tumors in otherwise healthy individuals in the fourth to sixth decades of life or as multiple tumours at an early age as part of the autosomal dominant genetic disorder neurofibromatosis 2 (NF2). The hallmark feature of NF2 is bilateral vestibular schwannomas. Multiplicity, a lobular growth pattern, and invasiveness are typical features of NF2 schwannomas. The diagnosis of NF2 is difficult in a group of heterogeneous and poorly defined patients who do not have BVSs but present with other features suggestive of NF2, namely (1) multiple meningiomas or schwannomas and/or (2) meningiomas (s) or schwannomas (s) in their relatives. These cases are uncommon and they present problems for prognosis, therapy, follow-up, and genetic counseling.
