Affiliation:
1. Departments of Neurologic Surgery,
2. Otorhinolaryngology-Head and Neck Surgery, and
3. Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
Abstract
Glioblastoma (GBM) of the internal auditory canal (IAC) is exceedingly rare, with only 3 prior cases reported in the literature. The authors present the fourth case of cerebellopontine angle (CPA) and IAC GBM, and the first in which the lesion mimicked a vestibular schwannoma (VS) early in its natural history. A 55-year-old man presented with tinnitus, hearing loss, and imbalance. MRI identified a left IAC/CPA lesion measuring 8 mm, most consistent with a benign VS. Over the subsequent 4 months he developed facial weakness. The tumor grew remarkably to 24 mm and surgery was recommended; the main preoperative diagnosis was malignant peripheral nerve sheath tumor (MPNST). Resection proceeded via a translabyrinthine approach with resection of cranial nerves VII and VIII, followed by facial-hypoglossal nerve anastomosis. Intraoperative frozen section suggested malignant spindle cell neoplasm, but final histopathological and molecular testing confirmed the lesion to be a GBM. The authors report the first case in which absence of any brainstem interface effectively excluded a primary parenchymal tumor, in particular GBM, from the differential diagnosis. Given the dramatic differences in treatment and prognoses between malignant glioma and MPNST, this case emphasizes the importance of surgical intervention on an aggressively growing lesion, which provides both the best probability of local control and the critical tissue diagnosis.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Subject
Genetics,Animal Science and Zoology
Reference36 articles.
1. Distinct molecular profile of diffuse cerebellar gliomas;Nomura;Acta Neuropathol,2017
2. Exophytic pontine glioblastoma mimicking acoustic neuroma;Swaroop;J Neurosurg Sci,1997
3. The hypoglossal nerve anatomical study of its entire course;IaconettaG;World,2018
4. A cytogenetic study of 53 human gliomas;Jenkins;Cancer Genet Cytogenet,1989
5. Glioblastoma with dural tail;Nagatani;J Neurosurg,2011
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