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Related Experiment Videos

Are acoustic neuromas encapsulated tumors?

T C Kuo1, R K Jackler, K Wong

  • 1Department of Otolaryngology, University of California, San Francisco, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|January 7, 1998
PubMed
Summary

Acoustic neuromas are not truly encapsulated, despite common surgical descriptions. Microscopic analysis reveals a very thin connective tissue layer, not a thick capsule, meaning the observed "peel" is surgically created.

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Area of Science:

  • Neurosurgery
  • Pathology
  • Oncology

Background:

  • Acoustic neuromas are widely described as well-encapsulated tumors in medical literature.
  • Surgical dissection often creates a cleavage plane, leaving a tumor surface remnant.
  • The nature of this surface and the encapsulation status require clarification.

Purpose of the Study:

  • To microscopically analyze the surface of acoustic neuromas.
  • To determine if acoustic neuromas are truly encapsulated in the conventional pathological sense.
  • To clarify the nature of the intraoperative
  • capsular
  • remnant.

Main Methods:

  • Microscopic analysis of 10 surgical specimens of acoustic neuroma.

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  • Harvesting wedges from the tumor's free surface in the cerebellopontine angle.
  • Histologic examination of the tumor-surrounding connective tissue.

    • Main Results:

    • Acoustic neuromas possess an extremely thin (3-5 microm) connective tissue layer, less than the diameter of a red blood cell.
    • Neoplastic Schwann cells are compressed at the tumor surface.
    • The thin layer is not macroscopically or microscopically evident as a capsule intraoperatively.

    Conclusions:

    • Acoustic neuromas are nonencapsulated tumors in the conventional pathological definition.
    • The apparent "capsular" remnant observed during surgery is a surgically induced cleavage plane.
    • This finding redefines the understanding of acoustic neuroma surface characteristics.