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Hadjigeorgiou GF, Strouthou EM, Koulousakis D, Patsouris V, Neff F, Lumenta CB, Schul DB. Olfactory schwannomas – an enigmatic clinical entity. Br J Neurosurg 2019. [DOI: 10.1080/02688697.2019.1661968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Georgios F. Hadjigeorgiou
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
| | | | - Dimitri Koulousakis
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | | | - Frauke Neff
- Department of Pathology, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | - Christianto B. Lumenta
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
| | - David B. Schul
- Department of Neurosugery, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University Munich, Munich, Germany
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Esquivel-Miranda M, De la O Ríos E, Vargas-Valenciano E, Moreno-Medina E. Schwannoma de base anterior de cráneo. Neurocirugia (Astur) 2017; 28:298-305. [DOI: 10.1016/j.neucir.2017.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
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Bohoun CA, Terakawa Y, Goto T, Tanaka S, Kuwae Y, Ohsawa M, Morisako H, Nakajo K, Sato H, Ohata K, Yokoo H. Schwannoma-like tumor in the anterior cranial fossa immunonegative for Leu7 but immunopositive for Schwann/2E. Neuropathology 2016; 37:265-271. [PMID: 27925298 DOI: 10.1111/neup.12357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Abstract
Schwannoma arising from the olfactory system, often called olfactory groove schwannoma (OGS), is rare, as the olfactory bulb and tract, belonging to the central nervous system, should lack Schwann cells. Another rare entity called olfactory ensheathing cell tumor (OECT) has been reported, which mimics clinical and radiological characteristics of OGS. Here, we report two rare cases of schwannoma-like tumor in the anterior cranial fossa that showed negative staining for Leu7, but positive staining for Schwann/2E, and discuss their origin. Two cases of mass lesions in the anterior cranial fossa in a 26-year-old man and a 24-year-old woman were successfully removed. Morphological examination of these tumors was compatible with a diagnosis of schwannoma. Immunohistochemically, both cases were negative for Leu7, yielding a diagnosis of OECT, but were positive for the schwannoma-specific marker, Schwann/2E. Immunohistochemical staining results in our two cases question the current assumption that OGS and OECT can be distinguished only by Leu7 staining pattern. In conclusion, the origins of OGS and OECT remain to be determined, and further studies in larger numbers of cases are needed to characterize these rare tumors in the anterior cranial fossa.
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Affiliation(s)
- Christian Aïssè Bohoun
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuzo Terakawa
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Neurosurgery, Hokkaido Ohno Memorial Hospital, Sapporo, Japan
| | - Takeo Goto
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Sayaka Tanaka
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuko Kuwae
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiko Ohsawa
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Morisako
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kosuke Nakajo
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Sato
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji Ohata
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
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Manto A, Manzo G, De Gennaro A, Martino V, Buono V, Serino A. An enigmatic clinical entity: A new case of olfactory schwannoma. Neuroradiol J 2016; 29:174-8. [PMID: 26944065 DOI: 10.1177/1971400915595581] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Olfactory schwannomas, also described as subfrontal or olfactory groove schwannomas, are very rare tumors, whose pathogenesis is still largely debated. We report a case of olfactory schwannoma in a 39-year-old woman who presented with anosmia and headache. The clinical examination did not show lesions in the nose-frontal region and there was no history of neurofibromatosis. Head MRI and CT scan revealed a lobulated extra-axial mass localized in the right anterior cranial fossa that elevated the ipsilateral frontal pole. Bilateral frontal craniotomy demonstrated a tumor strictly attached to the right portion of the cribriform plate that surrounded the right olfactory tract, not clearly identifiable. The immunohistochemical analysis suggested the diagnosis of typical schwannoma. The patient was discharged without any neurological deficit and a four-month postoperative MRI scan of the brain showed no residual or recurrent tumor.
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Nascimento LA, Settanni FAP, Filho JFDG, Sanchez IND, Cavalcante BB, Stávale JN. Isolated schwannoma of the olfactory groove: a case report. Int Arch Otorhinolaryngol 2015; 19:93-5. [PMID: 25992159 PMCID: PMC4392511 DOI: 10.1055/s-0033-1353368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 07/01/2013] [Indexed: 11/30/2022] Open
Abstract
Introduction Schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectives The authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Report The patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0 × 4.3 × 3.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions) mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusion Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves.
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Affiliation(s)
- Luiz Augusto Nascimento
- Division of Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo/SP, Brazil
| | - Flávio Aurélio Parente Settanni
- Division of Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo/SP, Brazil
| | | | | | | | - João Noberto Stávale
- Department of Pathology, Universidade Federal de São Paulo, São Paulo/SP, Brazil
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Sunaryo PL, Svider PF, Husain Q, Choudhry OJ, Eloy JA, Liu JK. Schwannomas of the sinonasal tract and anterior skull base: a systematic review of 94 cases. Am J Rhinol Allergy 2015; 28:39-49. [PMID: 24717879 DOI: 10.2500/ajra.2014.28.3978] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Schwannomas of the anterior skull base (ASB) and sinonasal tract are extremely rare. These lesions mimic other pathologies such as olfactory groove meningiomas, hemangiopericytomas, and esthesioneuroblastomas. Because of their low incidence, ASB and sinonasal tract schwannomas have not been well characterized. A systematic review of ASB and sinonasal tract schwannomas was conducted to further elucidate the presentation and surgical management of these lesions. METHODS A MEDLINE/PubMed search was performed, identifying 71 articles representing 94 cases of ASB and sinonasal schwannomas. Each case was analyzed for demographics, clinical presentation, anatomic location, radiographic features, and surgical treatment. RESULTS In 94 patients with ASB and sinonasal schwannomas, 44 (46.8%) were exclusively sinonasal, 30 cases (31.9%) were exclusively intracranial, 12 (12.8%) were primarily intracranial with extension into the paranasal sinuses, and 8 (8.5%) were primarily sinonasal with intracranial extension. Headaches and nasal obstruction were the most common presenting symptoms occurring in 30.9 and 29.8% of cases, respectively. Magnetic resonance imaging typically showed a hyperintense mass on T2-weighted imaging (70%) and hypointense (41%) on T1-weighted imaging. Most patients underwent surgical gross total resection via craniotomy, endoscopic endonasal approach, rhinotomy, or other sinonasal approaches. Recurrence occurred in three cases ranging from 4 months to 13 years. Postoperative complications included cerebral spinal fluid leakage, bacterial meningitis, epidural hematoma, and pneumocranium. CONCLUSION ASB and sinonasal schwannomas are rare lesions and should be considered in the differential diagnosis of ASB masses involving the cribriform plate with sinonasal extension. Gross total resection of these lesions should be considered the goal of operative management.
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Affiliation(s)
- Peter L Sunaryo
- Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Sauvaget F, François P, Ben Ismail M, Thomas C, Velut S. Anterior fossa schwannoma mimicking an olfactory groove meningioma: case report and literature review. Neurochirurgie 2013; 59:75-80. [PMID: 23587626 DOI: 10.1016/j.neuchi.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 12/30/2012] [Accepted: 02/21/2013] [Indexed: 11/19/2022]
Abstract
Intracranial schwannomas not associated with cranial nerves account for less than 1% of surgically treated schwannomas of the central and peripheral nervous system. With only 45 cases reported to date, subfrontal schwannomas are very rare tumors, leaving the issue of their origin controversial. A 66-year-old woman presented with a 1-year history of progressive headaches. Clinical examination revealed hypoesthesia of the nasal tip. CT-scan and MRI studies revealed a large subfrontal tumor thought preoperatively to be a meningioma. Intraoperatively, a large extra-axial tumor arising from the floor of the right frontal fossa was encountered. Histopathology identified the tumor as a schwannoma. This current case gives strong clinical presumption of an origin from the anterior ethmoidal nerve. We reviewed the literature in order to establish the epidemiology of these tumors, from which there appear to be divergent profiles depending on tumor origin and histology. Despite close similarities with olfactory groove meningiomas, patient history and radiological findings provide substantial evidence for differential diagnosis.
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Affiliation(s)
- F Sauvaget
- Department of Neurosurgery, François-Rabelais University, 10, boulevard Tonnellé, 37044 Tours, France.
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Figueiredo EG, Soga Y, Amorim RLO, Oliveira AMP, Teixeira MJ. The puzzling olfactory groove schwannoma: a systematic review. Skull Base 2012; 21:31-6. [PMID: 22451797 DOI: 10.1055/s-0030-1262945] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We systematically reviewed the literature concerning the anterior cranial fossa schwannomas to understand their pathogenesis, determine their origin, and standardize the terminology. We performed a MEDLINE, EMBASE, and Science Citation Index Expanded search of the literature; age, gender, clinical presentation, presence or absence of hyposmia, radiological features, and apparent origin were analyzed and tabulated. Cases in a context of neurofibromatosis and nasal schwannomas with intracranial extension were not included. Age varied between 14 and 63 years (mean = 30.9). There were 22 male and 11 female patients. The clinical presentation included seizures (n = 15), headache (n = 16), visual deficits (n = 7), cognitive disturbances (n = 3), and rhinorrhea (n = 1). Hyposmia was present in 14 cases, absent in 13 cases (39.3%), and unreported in five. Homogeneous and heterogeneous contrast enhancement was observed in 14 and 15 cases, respectively. The region of the olfactory groove was the probable site in 96.5%. Olfactory tract could be identified in 39.3%. The most probable origin is the meningeal branches of trigeminal nerve or anterior ethmoidal nerves. Thus, olfactory groove schwannoma would better describe its origin and pathogenesis and should be the term preferentially used to name it.
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Solitary olfactory schwannoma without olfactory dysfunction: a new case report and literature review. Neurol Sci 2011; 33:137-42. [PMID: 21484358 PMCID: PMC3275737 DOI: 10.1007/s10072-011-0573-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 03/26/2011] [Indexed: 02/05/2023]
Abstract
Schwannomas are rare and seldom extend into the anterior cranial fossa. Herein, we report a case of schwannoma arising from the olfactory groove in a 16-year-old girl who presented with generalized seizures without olfactory dysfunction or other neurologic deficits. Computerized tomography (CT) scan showed a large mass with abundant calcification located in the olfactory groove, which was confirmed as a schwannoma by histology and totally resected via basal subfrontal approach. The presentation, imaging findings and histogenesis of the tumor are discussed along with a review of the pertinent literature.
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Darie I, Riffaud L, Saïkali S, Brassier G, Hamlat A. Olfactory ensheathing cell tumour: case report and literature review. J Neurooncol 2010; 100:285-9. [PMID: 20376552 DOI: 10.1007/s11060-010-0162-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 03/15/2010] [Indexed: 11/30/2022]
Abstract
Olfactory ensheathing cell tumour (OECT) and olfactory groove schwannoma (OGS) are among the rarest intracranial tumour types that develop within anterior cranial fossa. These tumours share several similarities, including radiological and histological aspects, and only immunohistochemical staining can differentiate between them. We report a case of OECT occurring in a 28-year-old woman with a history of complex partial seizures, emotional lability and anosmia. Radiological features showed a predominantly left subfrontal extra-axial mass. Total excision of the tumour, connected to the cribriform plate and contiguous to the left olfactory bulb, was performed. Histological examination suggested an atypical schwannoma; however, immunohistochemical staining was strongly positive for S-100 protein but negative for both epithelial membrane antigen (EMA) and CD 57 (Leu-7). The final diagnosis was olfactory ensheathing cell tumour. We describe the third case of OECT and emphasize the important role of immunohistochemical staining in diagnosis: awareness of this entity, and use of immunohistochemistry help to distinguish it from OGS.
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Affiliation(s)
- Ioana Darie
- Department of Neurosurgery, CHU Pontchaillou, Rennes, France
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Lin SC, Chen MH, Lin CF, Ho DMT. Olfactory ensheathing cell tumor with neurofibroma-like features: a case report and review of the literature. J Neurooncol 2009; 97:117-22. [DOI: 10.1007/s11060-009-9986-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 08/06/2009] [Indexed: 11/29/2022]
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Mirone G, Natale M, Scuotto A, Rotondo M. Solitary olfactory groove schwannoma. J Clin Neurosci 2009; 16:454-6. [DOI: 10.1016/j.jocn.2008.04.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 04/17/2008] [Accepted: 04/18/2008] [Indexed: 11/15/2022]
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Choi YS, Sung KS, Song YJ, Kim HD. Olfactory schwannoma-case report-. J Korean Neurosurg Soc 2009; 45:103-6. [PMID: 19274121 DOI: 10.3340/jkns.2009.45.2.103] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 01/27/2009] [Indexed: 11/27/2022] Open
Abstract
Intracranial schwannomas preferentially arise from the vestibular branch of the eighth nerve, and rarely from the trigeminal nerve, facial nerve, and lower cranial nerves. Anterior cranial fossa schwannomas are extremely uncommon and few details about them have been reported. The patient was a 39-year-old woman whose chief complaints were anosmia and frontal headache for 2 years. The gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) showed an extra-axial mass from ethmoid sinus to right frontal base region near the midline, with solid enhancement in lower portion and multicystic formation in upper portion. The tumor was totally resected via basal subfrontal approach. At operation, the tumor had cystic portion with marginal calcification and the anterior skull base was destructed by the tumor. The olfactory bulb was involved, and the tumor capsule did not contain neoplastic cells. The histopathological diagnosis was schwannoma. We report a rare case of anterior cranial fossa schwannoma with literature review.
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Affiliation(s)
- Yu-Seok Choi
- Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea
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Martínez-Soto L, Alfaro-Baca R, Torrecilla-Sardón M, Fernández-Vallejo B, Ferreira-Muñóz R, De Diego T. Un nuevo caso de “schwannoma del olfatorio”; presentación y revisión de la literatura. Neurocirugia (Astur) 2009. [DOI: 10.1016/s1130-1473(09)70172-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kanaan HA, Gardner PA, Yeaney G, Prevedello DM, Monaco EA, Murdoch G, Pollack IF, Kassam AB. Expanded endoscopic endonasal resection of an olfactory schwannoma. J Neurosurg Pediatr 2008; 2:261-5. [PMID: 18831660 DOI: 10.3171/ped.2008.2.10.261] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Olfactory schwannomas are rare tumors of the anterior skull base that are possibly derived from ectopic Schwann cells, perivascular neural tissue, or sensory nerves of the meninges. The authors report the case of a 14-year-old boy with an olfactory schwannoma that extended inferiorly through the cranial base and superiorly into the frontal lobe. Because of the growth characteristics of the tumor and the significant overlying frontal lobe edema, the lesion was approached via an endonasal endoscopic route, as a strategy to minimize brain retraction. This tumor was characterized radiographically as contrast-enhancing with cystic areas and erosion into bone. The tumor showed immunoreactivity for S100 protein and leukocyte antigen 7 (CD57) but not epithelial membrane antigen, supporting the diagnosis of olfactory schwannoma. A gross-total resection was achieved. This approach represents a novel application of endoscopic endonasal surgery to the pediatric neurosurgical context, as well as a favorable outcome in an extremely unusual tumor type, that should be applicable to other appropriately selected pediatric brain tumors.
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Affiliation(s)
- Hilal A Kanaan
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
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Ahmad FU, Gupta A, Sharma MC, Shukla G, Mehta VS. The enigmatic origin of subfrontal schwannomas: report of a case without hyposmia. Acta Neurochir (Wien) 2006; 148:671-2; discussion 672. [PMID: 16467962 DOI: 10.1007/s00701-005-0720-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Accepted: 11/24/2005] [Indexed: 10/25/2022]
Abstract
Subfrontal schwannomas are rare intracranial tumors. Most of them are associated with hyposmia/anosmia. The source of origin of these tumors is still incompletely understood. We report a 23-year-old male who presented with recurrent focal motor seizures, but had no hyposmia. The tumor was completely removed by a subfrontal approach. Relevant literature has been reviewed.
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Affiliation(s)
- F U Ahmad
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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