Solitary neurogenous sarcomas of the head and neck

Chemotherapy of bilateral acoustic neuromas

In patients with bilateral acoustic neuromas, it is not unusual for the tumors to be of unequal size. At the time of the first examination, the smaller tumor may have already destroyed the hearing, while the ear with residual hearing may harbor a large acoustic neuroma. The remaining hearing is then at great risk if surgical removal of the tumor is attempted. Chemotherapy of bilateral acoustic neuromas is here presented as a possible alternative to surgery in those patients whose prognosis for conservation of hearing is poor.

Malignant schwannoma of the cervical vagus nerve in a patient with neurofibromatosis (von Recklinghausen's disease)

A patient with malignant schwannoma arising from the cervical vagus nerve has been described. Treatment consisted of wide en bloc resection of the tumor and adjacent carotid artery. A subclavian-middle cerebral arterial bypass procedure, using a saphenous vein graft, was performed. A course of postoperative radiotherapy was administered. The patient remains without evidence of disease 11 months following therapy.

Nonepithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. XII: Schwann cell tumors (neurilemoma, neurofibroma, malignant schwannoma)

Twelve Schwann cell tumors (two neurilemomas, six neurofibromas, and four malignant schwannomas), arising in the nasal cavity, paranasal sinuses or nasopharynx, are described. Schwann cell neoplasms only rarely develop in this area. Clinically, these tumors lead to nonspecific symptoms including nasal obstruction epistaxis, facial pain and swellling, and proptosis, similar to those produced by other neoplasms that involve this area. On radiologic examination, a mass lesion may be identified. Benign Schwann cell tumors may lead to bone erosion, which thus is not necessarily a sign of malignancy. The correct diagnosis of Schwann cell tumor is usually made only when histologic sections are studied. The histologic differentiation between Schwann cell neoplasms and myxomas, fibroblastic tumors, fibrous histiocytomas and fibro-osseous lesions is discussed. Treatment depends upon the type of tumor. Neurilemomas, which usually are encapsulated neoplasms, can be treated by local excision. Neurofibromas may infiltrate extensively, and thus may require an extensive surgical resection; however, functional and cosmetic considerations should be taken into account because neurofibromas, even if incompletely excised, may recur clinically only after many years. Malignant schwannomas tend to be aggressive neoplasms, but because of the anatomy of the area, radical resections leading to complete removal of the tumor cannot always be carried out.

Malignant schwannoma of the vagus nerve: a case report and review of the literature

A case of neuroectodermal tumor, a malignant schwannoma, of the cervical vagus nerve is presented. It had been previously misdiagnosed and was a recurrence. A review of the literature reveals this to be the sixth such case reported. The difficulties in establishing a diagnosis and the principals of adequate therapy are discussed; these include wide surgical resection and postoperative radiotherapy to the tumor bed. The correct recognition of their malignant potential is essential for long-term disease-free survival.