Cerebellopontine Angle Schwannoma and Meningioma in Contiguity: Surgical Implications in Neurofibromatosis

J Neurol Surg A Cent Eur Neurosurg. 2018 Mar;79(2):177-180. doi: 10.1055/s-0037-1608873. Epub 2017 Dec 14.

Abstract

Concurrent occurrence of brain tumors in the same location is very unusual and has been noted in patients with neurofibromatosis. Two lesions, occurring in close contact but of different histology, are called contiguous tumors. Schwannoma and meningioma are the two common histologies reported to present as contiguous tumor. We present two patients with contiguous tumors in the cerebellopontine angle. The magnetic resonance imaging characteristics in both cases demonstrate important findings that should be identified to raise the possibility of contiguous tumors. We discuss the surgical implications in identifying the facial nerve in this complex tumor morphology and steps we took to preserve function. Variable displacement of the facial nerve in the presence of multiple tumors needs to be kept in mind during surgical management and can be significantly aided by intraoperative monitoring.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebellar Neoplasms / complications
  • Cerebellar Neoplasms / surgery*
  • Cerebellopontine Angle*
  • Facial Nerve
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / complications
  • Meningeal Neoplasms / surgery*
  • Meningioma / complications
  • Meningioma / surgery*
  • Middle Aged
  • Monitoring, Intraoperative
  • Neurilemmoma / complications
  • Neurilemmoma / surgery*
  • Neurofibromatoses / complications*