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[A dura-based intracranial schwannoma in the temporal fossa: a case report]
Hayato Funiu1, Takamasa Kayama, Kaori Sakurada
1Department of Neurosurgery, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
Abstract:
We report a rare case of a dura-based intracranial schwannoma in the temporal fossa. A 77-year-old man admitted to our hospital with a 5 months history of mild recent memory disturbance. Magnetic resonance imaging (MRI) revealed a slight enhanced solid mass with a cystic mass in the right temporal lobe. Preoperative diagnosis was glioma and then total resection was performed by the transsylvian approach. Dense adhesion of the tumor to dura matter of the middle cranial fossa was confirmed during surgery. Microscopic examination of the tumor showed biphasic pattern with cellular Antoni A and hypocellular Antoni B areas. Immunohistochemically, the tumor was positive for S-100, vimentin and Schwann/2E and was negative for GFAP. From these findings, the tumor was diagnosed as a schwannoma arising from the dura matter of the middle fossa. The patient was discharged from our hospital with no neurological deficits. Intracranial schwannomas, which are not associated with cranial nerves, are rare. Our case was classified according to the origin into dura-based intracranial schwannoma. To our knowledge, only 14 cases of dura-based intracranial schwannoma have been reported, mostly in children and young adults. This represents the oldest case in the literature of dura-based intracranial schwannoma.
Insights
This study details a rare dura-based intracranial schwannoma in an elderly patient. The successful surgical removal highlights the possibility of treating these unusual brain tumors.
Area of Science:
- Neurosurgery
- Neuropathology
- Oncology
Background:
- Intracranial schwannomas typically arise from cranial nerves.
- Dura-based intracranial schwannomas, independent of cranial nerves, are exceptionally rare.
Observation:
- A 77-year-old male presented with memory disturbance, revealing a temporal fossa mass via MRI.
- Surgical resection via a transsylvian approach was performed, noting dense dural adhesion.
- Histopathology confirmed a biphasic schwannoma (Antoni A/B), positive for S-100 and vimentin, negative for GFAP.
Findings:
- The diagnosis was a dura-based intracranial schwannoma, an unusual presentation in an elderly individual.
- This case represents the oldest reported patient with a dura-based intracranial schwannoma.
- Only 14 such cases have been previously documented, predominantly in younger populations.
Implications:
- This case expands the known age range for dura-based intracranial schwannomas.
- It underscores the importance of considering rare dural tumors in differential diagnoses.
- Successful surgical outcomes are achievable even in elderly patients with these rare neoplasms.
