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http://dx.doi.org/10.4172/2324-8785.1000155
Case Report
Journal of
Otology & Rhinology
a SciTechnol journal
Abstract
Vestibular schwannomas are the most commonly occurring
skull base tumors. Increasing availability of magnetic resonance
imaging has allowed early recognition of these tumors and better
characterization of their natural course. Recently, several series
have presented data with regard to the slow growth of these tumors
and challenged the need for tumor resection or radiation in cases
involving small to medium-sized tumors. This is a case report of
spontaneous regression of a medium-sized vestibular schwannoma
occurring after initial slow tumor growth.
Keywords
Skull base tumor; Vestibular schwannoma; Tumor resection; Serial
high-resolution MRI
Introduction
Vestibular schwannoma (VS), also called acoustic neuroma, is a
common benign tumor of the supporting cells of the eighth cranial
nerve axons. VS accounts for as much as 6% of all intracranial tumors,
representing about 13 cases per 1 million people per year [1]. With
the increased use and improved resolution of magnetic resonance
imaging (MRI), smaller and more commonly asymptomatic tumors
are being discovered, and the medical and surgical paradigms for their
management continue to evolve. Treatment options for vestibular
schwannoma include: observation, stereotactic radiosurgery,
stereotactic radiotherapy, and microsurgical resection. Conservative
management with serial imaging has become more common for
small and medium-sized tumors, as data demonstrating the slow
growth and limited morbidity of observing these tumors over
extended periods has become available. The growth rate of vestibular
schwannoma has been studied extensively, and a recent meta-analysis
defined the range of growth as 0.3-4.8mm per year, with a mean of 1-2
mm per year [2].
We present a patient whose vestibular schwannoma exhibited
initial growth before diminishing in size over several years of
observation. Previously published case series estimate from 4% to
13% of vestibular schwannomas may regress spontaneously [3].
Unique to this case is a period of slow or typical growth followed by
dramatic regression in tumor size.
Case Report
A 75-year-old male was initially diagnosed via contrast-enhanced
MRI with a right sided medium-sized vestibular schwannoma as
*Corresponding author: Nicholas Scalzitti, 2338 Jarve Valley, San Antonio,
TX 78251, USA, Tel: 630-308-0359 / 210-916-8040; Fax: 210-916-8366;
Email: nicholas.j.sclazitti.mil@mail.mil
Received: February 03, 2014 Accepted: April 21, 2014 Published: April 30,
2014
All articles published in Journal of Otology & Rhinology are the property of SciTechnol, and is protected by copyright laws.
Copyright 2014, SciTechnol, All Rights Reserved.
Citation: Scalzitti NJ, Pfannenstiel TJ, (2014) Spontaneous Size Regression of a Vestibular Schwannoma. J Otol Rhinol 3:3.
doi:http://dx.doi.org/10.4172/2324-8785.1000155
Our report further supports the continued need for research
into the growth behavior of these tumors, as growth is often the
determining factor in the decision for treatment. Unfortunately,
identifying which tumors will grow continues to be an elusive task.
Conclusion
2006
Largest diameter
(mm)
11.9
(84.4%)
2008
2012
Size by AAO-HNS
guideline (mm)
13.0
(92.9%)
Discussion
Disclaimer
The views expressed herein are those of the authors and do not
reflect the official policy or position of the San Antonio Military
Medical Center, the U.S. Army Medical Department, the U.S.
Army Office of the Surgeon General, the Department of the Army,
Department of Defense or the U.S. Government.
Conflict of Interest
Authors do not have any conflict of interest.
References
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Author Affiliations
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