Dumbbell-shaped hypoglossal schwannoma. A case report

Dumbbell-shaped neuromas of the 12th cranial nerve extending intra- and extracranially are extremely rare. The present paper reports on a 32-year-old patient who presented with hypoglossal nerve palsy and a two-year history of headache. MRI showed inhomogeneous contrast agent enhancement in a tumor that was partly cystic, partly solid, in the cerebellopontine cistern. The tumor, with its main lesion mass located in the parapharyngeal space, extended along the canal of the hypoglossal nerve. The tumor was excised by two-stage suboccipital osteoclastic craniotomy and later through a cervical approach. Pathohistology showed a grade I schwannoma and the patient was discharged symptom-free without any further therapy.