Case Report
Volume: 6 | Issue: 1 | Published: Jan 30, 2022 | Pages: 5 - 10 | DOI: 10.24911/ejmcr/173-1621184951
Spontaneous malignant transformation of vestibular schwannoma: a case report and review of the literature
Authors: Girish Kulkarni , Asad Abbas
Article Info
Authors
Girish Kulkarni
Department of Neurosurgery, Nottingham University, Hospital, Queens Medical Center, Nottingham, UK
Asad Abbas
Department of Neurosurgery, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
Publication History
Received: May 16, 2021
Revised: June 25, 2021
Accepted: June 25, 2021
Published: January 30, 2022
Abstract
Background: The malignant transformation of vestibular schwannoma (VS) is a rare identity. We present a case of spontaneous transformation of VS and a short literature review. Case Presentation: A 41-year-old female had presented to us with vertigo, tinnitus, and hearing loss. She was diagnosed with left VS and underwent surgical resection. The initial histology was reported as benign grade 1 schwannoma. She subsequently presented to the hospital with hematoma in the tumor cavity after 4 and 5 months, respectively. Her repeat magnetic resonance imaging (MRI) showed growth of the residual tumor. She underwent a second translabyrinthine excision of the tumor. The histology from the second operation showed components of malignant transformation. One month postoperatively she suffered an acute decline in her conscious level. Repeat MRI demonstrated rapid regrowth of the tumor with further hemorrhage. In view of her rapid decline and perceived futility of further intervention and respecting her premorbid wishes, further escalation of therapy was deemed inappropriate. Conclusion: VS can transform into a malignant tumor even in the absence of radiation therapy. This may be considered in case of rapid regrowth of the tumor.
Keywords: Case report, vestibular schwannoma, malignant transformation, cerebellopontine angle tumor, green
