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Review
. 2022 Feb;45(1):915-922.
doi: 10.1007/s10143-021-01620-3. Epub 2021 Aug 15.

Transition of a vestibular schwannoma to a malignant peripheral nerve sheath tumor with loss of H3K27 trimethylation after radiosurgery-a case report and review of the literature

Felix Behling  1   2 , Imane Bersali  3 , Antonio Santacroce  4 , Johann Hempel  5   6 , Kosmas Kandilaris  5   7 , Jens Schittenhelm  5   7 , Marcos Tatagiba  3   5
Affiliations
Review

Transition of a vestibular schwannoma to a malignant peripheral nerve sheath tumor with loss of H3K27 trimethylation after radiosurgery-a case report and review of the literature

Felix Behling et al. Neurosurg Rev. 2022 Feb.
No abstract available

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
MR-images throughout the disease course showing the extent of the tumor prior to the first treatment with gamma knife (A and B) and further tumor growth 2 years later (C and D). Subsequently, the tumor was partially resected and after further growth a second round of gamma knife was applied. Afterwards, the tumor showed further progression (E and F) and gross total resection was done (G and H). Two years later, another tumor recurrence occurred (I and J) prompting another gross total resection now revealing the histology of a MPNST (K and L). Besides all efforts, the tumor showed a massive progression (M) and the patient deceased shortly afterwards
Fig. 2
Fig. 2
The histopathological images show the recurrent schwannoma after the gross total resection in our center as a moderately cellular spindle cell tumor without signs of atypia (A) and retained nuclear expression of H3K27me3 (B) (magnification 100 × . A biopsy of the next recurrence 2 years later revealed again a schwannoma. A spindle cell tumor of moderate cellularity consisting of plump neoplastic cells again with retained nuclear expression of H3K27me3 was seen (C and D) (magnification 100 ×). After the second gross total resection, we observed a highly cellular tumor of moderately atypical cells with signs of intraluminal vascular herniation (E, magnification 200 ×) and several mitotic figures (F, magnification 400 ×). Now, loss of nuclear expression of H3K27me3 in the tumor cells was detected, with positive endothelial cells, which served as an internal control (G, magnification 400 ×)
Fig. 3
Fig. 3
Timeline summarizing the course of disease and treatment
See this image and copyright information in PMC

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