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Case Reports
. 2016 May 19:7:59.
doi: 10.4103/2152-7806.182740. eCollection 2016.

Spontaneous shrinkage of vestibular schwannoma

Rossana Romani  1 , Jonathan Pollock  1
Affiliations
Case Reports

Spontaneous shrinkage of vestibular schwannoma

Rossana Romani et al. Surg Neurol Int. .

Abstract

Background: "Watch, wait, and rescan" (WWR) has an established place as a successful management option for a significant proportion of vestibular schwannomas (VS) as an alternative to microsurgical removal or stereotactic radiotherapy. VS may grow slowly and continuously, followed by stagnation or even shrinkage. We present two case reports of spontaneous shrinkage of VS along with a review of the literature.

Case description: A 29-year-old female presented with a progressive history of visual blurring and intermittent diplopia over 2 months. A 29 mm of maximum intracranial diameter (ICD) VS with secondary obstructive hydrocephalus was diagnosed. The patient underwent a ventriculo-peritoneal shunt with resolution of her symptoms and opted for initial WWR management. Interval scanning between 2007 and 2014 showed progressive reduction in the maximum ICD together with reduction in the degree of central tumor enhancement. Maximum ICD at most recent follow up was 22 mm. A 28-year-old female was referred with right sensorineural deafness. A right VS of maximum ICD of 27 mm was diagnosed. Initial WWR management was planned after discussion. Serial imaging showed an initial increase in the size of the tumor followed by progressive reduction in size. The most recent follow up showed a maximum ICD of 20 mm.

Conclusion: Early WWR management can be associated with spontaneous shrinkage of VS over time. Prospective clinical study of larger numbers of such cases using the UK VS database may help to identify predictive factors for the spontaneous regression of VS.

Keywords: Conservative treatment; neurinoma; rescan; spontaneous shrinkage; vestibular schwannoma; wait; watch.

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Figures

Figure 1
Figure 1
Right medium-sized (29 mm) vestibular schwannoma in 2007 (a) remaining stable in size in 2009 (b) and then showing a progressive reduction in the maximum intracranial diameter with conspicuous reduction in the degree of central tumor enhancement (c and d). Maximum intracranial diameter of 22 mm at most recent follow-up (e)
Figure 2
Figure 2
Right medium-sized (25 mm) vestibular schwannoma in 2009 (a) remaining stable in size in 2012 (b) and then showing a progressive reduction in size in 2013 (c) to a maximum intracranial diameter of 20 mm (d) at recent follow-up
See this image and copyright information in PMC

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References

    1. Al Sanosi A, Fagan PA, Biggs ND. Conservative management of acoustic neuroma. Skull Base. 2006;16:95–100. - PMC - PubMed
    1. Battaglia A, Mastrodimos B, Cueva R. Comparison of growth patterns of acoustic neuromas with and without radiosurgery. Otol Neurotol. 2006;27:705–12. - PubMed
    1. Bederson JB, von Ammon K, Wichmann WW, Yasargil MG. Conservative treatment of patients with acoustic tumors. Neurosurgery. 1991;28:646–50. - PubMed
    1. Bozorg Grayeli A, Kalamarides M, Ferrary E, Bouccara D, El Gharem H, Rey A, et al. Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol. 2005;125:1063–8. - PubMed
    1. Caye-Thomasen P, Dethloff T, Hansen S, Stangerup SE, Thomsen J. Hearing in patients with intracanalicular vestibular schwannomas. Audiol Neurootol. 2007;12:1–12. - PubMed

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