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 »  Abstract
 » Introduction
 » Case Report
 »  References
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Table of Contents    
CASE REPORT
Year : 2014  |  Volume : 62  |  Issue : 4  |  Page : 429-431

Olfactory schwannoma: A report of two cases and literature review


1 Department of Neurosurgery, Beijing Tiantan Hospital, Beijing; Beijing Institute for Brain Disorders Brain Tumor Center, Beijing 100050, China
2 Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University; Beijing Institute for Brain Disorders Brain Tumor Center, Beijing 100050, China

Date of Web Publication19-Sep-2014

Correspondence Address:
Jian Xie
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100 050
China
Jian Xie
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100 050
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.141289

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 » Abstract 

Intracranial schwannoma is a kind of benign intracranial tumors, derived from neuron myelin sheath, growing slowly and curable. Olfactory schwannoma is an exceedingly rare kind of schwannoma, whose origin is still uncovered. Although several theories have been put up for pathogenesis of olfactory schwannoma, till now, none of these hypotheses has been widely accepted and acknowledged officially. Up to date, only 46 cases of olfactory schwannoma were reported across numerous institutes worldwide. Here we gathered two cases from Department of Neurosurgery in Beijing Tiantan Hospital across two years collection.


Keywords: Olfactory schwannoma, olfactory groove meningioma, subfrontal lesion


How to cite this article:
Wang Z, Zhang W, You G, Wang J, Li G, Gao Z, Xie J, Wang Z, Zhang W, You G, Wang J, Li G, Gao Z, Xie J. Olfactory schwannoma: A report of two cases and literature review. Neurol India 2014;62:429-31

How to cite this URL:
Wang Z, Zhang W, You G, Wang J, Li G, Gao Z, Xie J, Wang Z, Zhang W, You G, Wang J, Li G, Gao Z, Xie J. Olfactory schwannoma: A report of two cases and literature review. Neurol India [serial online] 2014 [cited 2019 Aug 17];62:429-31. Available from: http://www.neurologyindia.com/text.asp?2014/62/4/429/141289



 » Introduction Top


Olfactory schwannoma is an exceedingly rare disease, and until date, only 46 cases have been reported worldwide. We present two cases of olfactory schwannoma in whom the preoperative diagnosis was olfactory groove meningioma.


 » Case Report Top


Case 1

A 38-year-old woman presented with a history of intermittent vomiting of one-month duration. Examination revealed no neurological deficits except diminished sense of smell. Cranial magnetic resonance imaging (MRI) revealed a 43 mm × 38 mm solid cystic lesion in left anterior cranial fossa with mixed T1- and T2-weighted signals. The lesion enhanced significantly on contrast administration [Figure 1]a-d. Preoperative diagnosis was left olfactory groove meningioma. Intraoperatively, the lesion was gray-white in color and slightly tough with clear boundaries in the left olfactory groove invading the ethmoidal sinus. The lesion was completely excised [Figure 1]e and f Postoperative period was uneventful with little improvement in sense of smell. Histopathological diagnosis was olfactory schwannoma. Microscopic images showed Antoni A type tumor cells, round or spindle-shaped, and aligned regularly as a fibrous cord or vortex structure (single-headed arrow); and Antoni B type cells were also seen (double-headed arrow) [Figure 1]g.
Figure 1: Preoperative and postoperative magnetic resonance imaging (MRI) and histopathological examination in Case 1
(a) and (b) MRI scan showed a round anterior cranial fossa lesion. Ethmoidal sinus was invaded, and the middle line was pushed to the opposite side. (c) and (d) showed that the lesion was solid cystic and was signifi cantly contrasted after the patient was injected contrast medium. (e) and (f) showed that the lesion was completely removed. (g) showed typical schwannoma pathological characteristics (H and E, ×200)


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In another case, MRI scan showed an ovary lesion in the anterior cranial fossa [Figure 2]a-d. The preoperative impression was olfactory groove meningioma. Postoperatively, MRI scan showed that the tumor was totally removed [Figure 2]e and f. Histological examination confirmed the diagnosis of olfactory groove schwannoma [Figure 2]g.
Figure 2: Preoperative and postoperative magnetic resonance imaging (MRI) and histopathological examination in Case 2
(a) and (b) MRI scan showed an anterior cranial fossa lesion. Ethmoidal sinus was invaded. (c) and (d) showed that the lesion was signifi cantly contrasted after injecting contrast medium. (e) and (f) showed that the lesion was completely removed. (g) showed typical schwannoma pathological characteristics (H and E, ×200)


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The common cranial nerves for schwannomas are eight, facial nerves, and trigeminal. Schwannoma of the olfactory bulb is uncommon as the olfactory nerve is unsheathed by schwann cells. Until date, there have been no convincing theories that are widely accepted to explain the origin of olfactory groove schwannoma. [1],[2],[3],[4] Thus far, only 46 cases of olfactory schwannomas have been reported [5] In most reported cases of olfactory groove schwannoma, the chief complaints were headache, vomiting, seizure, hyposmia, diplopia, or even anosmia. [6],[7],[8] Physical examination often revealed loss or reduced sense of smell, which is often neglected by the patient. Surgery is the preferred treatment for olfactory schwannoma. Cerebrospinal fluid rhinohroea and associated central nervous system infections are the most common complications of the surgery. Often the differential diagnosis is olfactory groove schwannoma and is often the preoperative diagnosis in most of the reported cases. [5],[9] Histological examination confirms the diagnosis.

 
 » References Top

1.Esiri M. Russell and Rubinstein′s pathology of tumors of the nervous system. Sixth edition. J Neurol Neurosurg Psychiatry 2000;68:538D.  Back to cited text no. 1
    
2.Redekop G, Elisevich K, Gilbert J. Fourth ventricular schwannoma. Case report. J Neurosurg 1990;73:777-81.  Back to cited text no. 2
    
3.Huang PP, Zagzag D, Benjamin V. Intracranial schwannoma presenting as a subfrontal tumor: Case report. Neurosurgery 1997;40:194-7.  Back to cited text no. 3
    
4.Figueiredo EG, Soga Y, Amorim RL, Oliveira AM, Teixeira MJ. The puzzling olfactory groove schwannoma: A systematic review. Skull Base 2011;21:31-6.  Back to cited text no. 4
    
5.Sauvaget F, Francois 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.  Back to cited text no. 5
    
6.Adachi K, Yoshida K, Miwa T, Ikeda E, Kawase T. Olfactory schwannoma. Acta Neurochir (Wein) 2007;149:605-10.  Back to cited text no. 6
    
7.Darie I, Riffaud L, Saikali S, Brassier G, Hamlat A. Olfactory ensheathing cell tumour: Case report and literature review. J Neurooncol 2010;100:285-9.  Back to cited text no. 7
    
8.Saberi H, Khashayar P. Olfactory groove schwannoma masquerading as an orbital mass. Neurosciences (Riyadh) 2008;13:73-6.  Back to cited text no. 8
    
9.Tan TC, Ho LC, Chiu HM, Leung SC. Subfrontal schwannoma masquerading as meningioma. Singapore Med J 2001;42:275-7.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2]

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