Cerebellopontine angle tumor neoplasm of cerebellopontine. The authors discuss the current management for cerebellopontine angle cpa tumors in children. It is important to have knowledge of this pathology and to be able to differentiate it from other commonly occurring cpa tumors, such as vestibular and trigeminal schwannomas. Meningiomas 20 cases and epidermoid tumors 16 cases outnumber the rare tumors. Patients with cerebellopontine angle tumors, including acoustic neuromas, usually have a unilaterally reduced vestibular response on caloric testing on the side of the lesion. Cerebellopontine angle an overview sciencedirect topics. The inclusion of an interactive atlas adds to the importance of the text and complements it, and also obviates the need to reference multiple sources. Pdf cerebellopontine angle cpa tumors are uncommon in children, and the pathological spectrum is different from that of adults. Dec 24, 20 to report our experience with a large series of surgical procedures for removal of cerebellopontine angle cpa tumors using different approaches. Charts were retrospectively examined and patients were divided into two groups. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis.
This was a retrospective analysis of 50 patients mean age, 49 years with cpa tumors predominantly acoustic neuroma who underwent surgical removal. Cerebellopontine angle tumor neoplasm of cerebellopontine angle. Surgical outcomes of cerebellopontine angle tumors in 50 cases. Request pdf on dec 31, 2012, madjid samii and others published tumors of the cerebellopontine angle find, read and cite all the research you need on. Lesions of the cerebellopontine angle cpa are frequent and represent 6%10% of all intracranial tumors, 1, 2. The most common of these other lesions are the meningioma and primary cholesteatoma. Nonacoustic tumors of the cerebellopontine angle springerlink. Tumors of the cerebellopontine angle jama otolaryngology. Superior anatomical view of the left cerebellopontine angle cpa. Cerebellopontine angle cpa masses are relatively common. The cerebellopontine angle syndrome is a distinct neurological syndrome of deficits that can arise due to the closeness of the cerebellopontine angle to specific cranial nerves. Acoustic schwannoma most common mass in the cpa, up to 75% of cases usually arises from the superior vestibular nerve usually a solid spaceoccupying mass with a tail in the internal acoustic meatus canal that uniformally enhances with contrast. This is a prospective study of 30 patients at the neurosurgical department medical city, with mean age of 36 years with cpa tumors predominantly acoustic neuroma that underwent surgical removal using a suboccipital retrosigmoid approach over a 1year.
Most cpa tumors are benign, with over 85% being vestibular schwannomas acoustic neuromas, lipomas, vascular malformations, and hemangiomas. There is a wide variety of conditions that can occur at this level, derived from both the structures forming the cerebellopontine angle, as lesions that grow near it and can secondarily invade. Epidermoid cysts are rare congenital tumors of the central nervous system cns, histologically benign and slow growing lesions. Surgery of the cerebellopontine angle 1st edition pdf. Most tumors in the cerebellopontine angle cistern are vestibular schwannomas 75%, followed by meningiomas 10% and epidermoid tumors 5%. Their frequency among primitive intracranial tumors is about 1% and they account for 40% of all intracranial epidermoid of the cerebellopontine angle cpa. The combined microscopic and endoscopic technique has shown significant advantages in the management of various lesions through different approaches. The results obtained by using the mf approach were superior for intracanalicular tumors p0. The cpa is defined as the angle formed in the horizontal section by the pons and the cerebellum in which the trigeminal v and acousticofacial nerve bundle viii are located. The cerebellopontine angle is the site of the cerebellopontine angle cistern one of the subarachnoid cisterns that contains cerebrospinal fluid, arachnoid tissue, cranial nerves, and associated vessels. Other typical locations are the optic pathway and hypothalamus 3011%9, the brainstem 9% 9, and the spinal cord. Primary cerebellopontine angle cpa pnet is an extremely rare entity. Objectives nonacoustic tumours of the cerebellopontine angle differ from vestibular schwannomas in their prevalence, clinical features, operative management, and surgical outcome.
We report one such rare case presenting the cytological features in material obtained during the resection of the tumor. Cerebellopontine angle tumors are encountered rather more commonly than anticipated by otolaryngologist. Synchronous tumors of the cerebellopontine angle mayo clinic. Endoscopicassisted techniques have frequently been applied to cerebellopontine angle cpa surgery in the context of minimally invasive craniotomies. Pdf nonacoustic tumors of the cerebellopontine angle. Cerebellopontine angle primitive neuroectodermal tumor. The educational objectives for this selfassessment module are for the participant to exercise, selfassess, and improve his or her understanding of the imaging features of cerebellopontine angle. Although a diverse range of pathologies may be seen in this region, the most common by far is a vestibular schwannoma.
In addition to the acoustic tumor, the cerebellopontine angle is the site of many other diverse tumors whose histologic features depend upon their cell of origin. Pdf tumors in the cerebellopontine angle in children. The presented case of an extensive lipoma of the cerebellopontine angle cpa represents 0. Other tumors of the cpa include meningioma 3%, primary cholesteatoma, and facial nerve schwannoma. Jul 11, 2018 cerebellopontine angle cpa tumors are the most common neoplasms in the posterior fossa, accounting for 510% of intracranial tumors. Masses in this region are readily identified on crosssectional im. Thus there may occur cysts, gliomas, ependymomas, aneurysms, osteomas, meningiomas, and cholesteatomas. Cerebellopontine angle tumor definition of cerebellopontine. Methods a retrospective analysis of clinical notes identified 42 patients with nonacoustic tumours of the cerebellopontine. Pathology cerebellopontine angle masses can be divided into four g.
Cerebellopontine angle tumor symptoms, causes, diagnosis, and treatment information for cerebellopontine angle tumor acoustic neuroma with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and prognosis. Tumors of the cerebellopontine angle request pdf researchgate. Pediatric cerebellopontine angle and internal auditory canal tumors. Conventional approach to the cpa is through the retrosigmoid approach with optical aid by the microscope ojemann, 2000. Tumors of the cerebellopontine angle cpa constitute about 610% of all intracranial tumor, it is a disease common in adults and rarely in children. We investigate the diagnosis, management, and prognosis of this disease. Cerebellopontine angle cpa tumors are masses located in the region between the cerebellum and pons. Cerebellopontine angle syndrome is usually due to an acoustic schwannoma arising from the vestibular nerve. The cerebellopontine angle cistern is a cerebrospinal fluidfilled space bound by the pons, cerebellum, and petrous temporal bone. They constitute the most frequently diagnosed tumors of the posterior fossa and account for up to 10% of all intracranial neoplasms. Rare tumors of the cerebellopontine angle derald e. Symptomatic lesion require marsupilization of cyst rather than excision or shunting. Pilocytic astrocytomas of the cerebellopontine angle pa.
Cpa tumors accounted for 1% to 3% of intracranial tumors in children. The combined microscopicendoscopic technique for radical. Cerebellopontine angle is a common site for multiple pathologies, and cpa tumors are among the most common intracranial tumor accounting for 5 to 10% vilela, 2005. These features were studied in patients presenting to the regional neurootological unit. Cerebellopontine angle masses can be divided into four groups, based on imaging characteristics.
Surgical management of primary and secondary pilocytic. Clinical features and outcomes in patients with nonacoustic. Computer tomography in the diagnosis of cerebellopontine. The characteristic morphological features of these depend on the tissue from which the tumors arise. This group of tumors account for nearly 10% of all intracranial tumors. Tumors of the cp angle account for 5% to 10% of all intracranial neoplasms. In a series of 1,354 cerebellopontine angle tumors treated at the otologic medical croup, approximately 10% were lesions other than acoustic neurinomas. Although a diverse range of pathologies may be seen in this region, the most common by far is an acoustic schwannoma. Background synchronous tumors of the cerebellopontine angle cpa are very rare and inconsistently described.
Over 40% 9 of pa are localized in the cerebellum, followed by supratentorial locations 35% 9. Cerebellopontine angle cpa and cerebellomedullary fissure cmf tumors are rare in children and information is scarce in the literature. Cerebellopontine angle arachnoid cysts arachnoid cysts are intraarachnoid masses of uncertain origin filled with csf often present with headache and ataxia. Background meningiomas follow schwannomas as the second most common cerebellopontine angle cpa tumors. Schwannomas affect mainly head and neck peripheral nerves, are benign tumors and derive from schwann cells. Studies reveal that acoustic neuromas vestibular schwannomas constitute nearly 80% of all cerebellopontine angle tumors. Cerebellopontine angle cpa tumors are the most common neoplasms in the posterior. Cerebellopontine angle mass radiology reference article.
Cerebellopontine angle tumors otolaryngologists perspective. Acoustic neuromas, which are also called vestibular schwannomas, 3, and meningiomas are the two most frequent lesions and account for approximately 85%90% of all cpa tumors, 1. Cureus surgical management and outcome experience of 53. The cpa syndrome is the constellation and progression of symptoms as a cpa tumor grows larger. This distinction is essential because of the difference in the overall treatment plan and prognosis. Schwannoma of right cerebellopontine angle is extremely rare to diagnose by cytology. Posterior fossa and cerebellopontine angle cistern. The angle is bordered laterally and anteriorly by the posterior face of the petrous temporal bone. Of the nonacoustic tumors, the majority were meningiomas, primary cholesteatomas, and neurinomas of other cranial nerves in the posterior fossa. Uncommon neoplasms that may involve the cerebellopontine angle include metastatic disease, facial nerve schwannoma, exophytic brainstem glioma, and hemangioma. Surgery of the cerebellopontine angle is a single volume text which meshes the information available in surgical atlases with clinical disease entities. Many different types of tumor may arise in the cerebellopontine angle. Acoustic neuromas are the most common tumors of the cerebellopontine angle cpa, accounting for more than 90% of all such tumors. Intracranial lipomas in an infratentorial and extraaxial location are extremely rare.
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