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Dumbbell-shaped abducens schwannoma: case report
Shunsuke Shibao1, Saeko Hayashi, Kazunari Yoshida
1Department of Neurosurgery, Keio University School of Medicine.
Neurologia Medico-Chirurgica
|November 9, 2013
Summary
This study reports the first case of a dumbbell-shaped abducens schwannoma, a rare tumor affecting the sixth cranial nerve. This novel Type 3 tumor presents unique surgical challenges and clinical features.
Area of Science:
- Neurosurgery
- Neuropathology
- Oncology
Background:
- Schwannomas of the abducens nerve are rare, with existing literature classifying them into Type 1 (cavernous sinus) and Type 2 (prepontine area).
- No dumbbell-shaped variant of abducens schwannoma has been previously documented.
Observation:
- A 36-year-old woman presented with a 4-year history of hearing disturbance, 2-year history of dizziness, and 6-month history of dysphagia.
- Neurological examination revealed left sensorineural hearing impairment, trigeminal nerve hypesthesia (V1, V2), a left curtain sign, and gait disturbance.
- Imaging identified a dumbbell-shaped tumor extending from the cavernous sinus to the right cerebellopontine angle.
Findings:
- The first reported case of a dumbbell-shaped abducens schwannoma, classified as Type 3.
- A two-staged surgical approach was employed: anterior transpetrosal and lateral suboccipital.
- Histological examination confirmed schwannoma; the abducens nerve was sacrificed during the first stage, resulting in complete paresis.
Implications:
- Dumbbell-shaped abducens schwannomas represent a new clinical and surgical entity.
- Preservation of the sixth cranial nerve is challenging in this specific tumor morphology.
- This case highlights the need for tailored surgical strategies for complex cranial nerve tumors.
