ABSTRACT
Changes of contrast uptake are considered to indicate the efficacy of therapy in irradiated vestibular schwannomas. We present a case of a large vestibular schwannoma with heterogeneous contrast uptake on MRI. Using neuronavigation, histological samples were obtained during surgery from an area with homogeneous contrast uptake and from a central tumor portion without contrast enhancement on MRI. Intraoperative investigation found no evidence of necrotic tumor, and histopathological examination revealed an active tumor in both sections, with no central necrosis. This finding illustrates the surgical experience that " necrotic tumor areas " on MRI may not be consistent with intraoperative findings. Lack of contrast uptake in previously irradiated schwannomas may not be indicative of effective radiotherapy.
Subject(s)
Ear Neoplasms/pathology , Ear Neoplasms/surgery , Magnetic Resonance Imaging/methods , Neuroma, Acoustic/pathology , Neuroma, Acoustic/surgery , Audiometry, Pure-Tone , Contrast Media , Hearing Loss/etiology , Hearing Loss/pathology , Humans , Male , Middle Aged , Postoperative CareABSTRACT
UNLABELLED: Hemangiopericytoma (HPC) is a rare entity that is found in only 1% of vascular tumours. Only 5% of HPC are localized in the nasal cavity or paranasal sinuses. The exact incidence is not stated in the literature. CASE REPORT: A case of a 76-year-old female patient is presented. As she suffered from stroke a cranial CT was performed and the tumour of the paranasal sinuses was diagnosed incidentally. The patient had a history of paranasal sinus surgery under local anaesthesia twenty years ago. The former histological diagnosis was stated as "angiofibroma with signs of proliferation ". The histopathologic diagnosis after endonasal sinus surgery was primarily a neoplasia with spindle-shaped cell formation. Just additional immunocytochemistry revealed the finding of primitive mesenchymal cells. This confirmed the diagnosis of a hemangiopericytoma. The two years follow-up showed no signs and symptoms of recurrent tumour on endoscopic examination and CT scans. CONCLUSION: Hemangiopericytoma is a rare endonasal or sinonasal tumour. Occasionally histological diagnosis is difficult. Its characteristics are marked cellularity, vascularity and a dense net of reticular fibres. The entity shows a considerable tendency to recurrence, malignant transformation and metastasizing. After complete sinonasal surgery a regular short term follow up is advisable.
