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Accessory nerve ancient schwannoma: A case report
Paula Otero-Fernández1, Lourdes Ruiz-Escribano-Menchén2, Violeta Herrera-Montoro3
1Department of Neurosurgery, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Surgical Neurology International
|September 21, 2022
Summary
This case report details an extremely rare ancient schwannoma of the accessory nerve (XI). This finding highlights the potential for misdiagnosis of such rare lower cranial nerve tumors.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Neuropathology
Background:
- Lower cranial nerve schwannomas are rare, with only 63 accessory nerve cases documented.
- Intracranial ancient schwannomas are exceptionally uncommon.
Observation:
- A 61-year-old man presented with neurological deficits including dysmetria and ataxia.
- MRI revealed a giant cystic lesion in the cerebellomedullary cistern, initially suspected to be a meningioma.
- The lesion caused significant brainstem compression and hydrocephalus.
Findings:
- Surgical resection revealed the tumor originated from the accessory nerve (XI).
- Histopathology confirmed the diagnosis of an ancient schwannoma, a rare subtype.
- Near-total resection was achieved despite tumor adhesion to surrounding neural structures.
Implications:
- This is the first reported case of an ancient schwannoma arising from the intracisternal accessory nerve.
- The extreme rarity of this tumor at this location can lead to preoperative misdiagnosis.
- Increased awareness is crucial for accurate diagnosis and management of rare cranial nerve tumors.
