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- Title
Intracranial cellular schwannomas: a clinicopathological study of 20 cases.
- Authors
D'Almeida Costa, Felipe; Dias, Tiago M; Lombardo, Kara A; Raghunathan, Aditya; Giannini, Caterina; Kenyon, Lawrence; Saad, Ali G; Gokden, Murat; Burger, Peter C; Montgomery, Elizabeth A; Rodriguez, Fausto J
- Abstract
Aims: Cellular schwannoma is a specific subtype of schwannoma, prone to misinterpretation as a malignant neoplasm. Involvement of the intracranial compartment by these tumours is extremely rare. We aim to characterise this clinicopathological subgroup. Methods and results: We identified a total of 20 cellular schwannomas with predominant intracranial involvement. The mean age of the patients at the time of surgery was 37 years (range = 16–81), with a slight female predominance (1.5:1 ratio). The most common sites were the eighth (n = 8) and fifth (n = 6) cranial nerves. Three tumours involved the anterior cranial fossa/olfactory groove, and a single case involved the glossopharyngeal nerve. All tumours met established criteria for cellular schwannoma, and were composed of interlacing fascicles of spindle cells lacking Verocay bodies with minimal Antoni B pattern and variable chronic inflammation and foamy histiocytes. Rare findings included haemosiderin deposition (n = 6), necrosis (n = 4), brisk mitotic activity (>10 mitoses per 10 high‐power fields) (n = 2), focal epithelioid morphology (n = 2), myxoid areas (n = 2), neuroblastoma‐like pattern (n = 1) and granular cells (n = 1). Immunohistochemical stains demonstrated expression of Schwann cell markers (S100 protein, SOX10, collagen IV) and preserved H3 K27 trimethylation in all cases tested. Fourteen patients had postoperative follow‐up, ranging from 2 months to 21 years (mean = 66 months). In patients with follow‐up, local recurrence/persistence developed in six cases; five tumours were initially incompletely resected. No metastatic disease or deaths were reported. Conclusions: Intracranial cellular schwannomas share morphological and immunophenotypical features with cellular schwannomas at others sites may demonstrate locally aggressive growth but appear to lack metastatic potential.
- Subjects
SCHWANNOMAS; HISTOCHEMISTRY; CRANIAL nerves; MITOSIS; SCHWANN cells; IMMUNOSTAINING; TUMORS; MACROPHAGES
- Publication
Histopathology, 2020, Vol 76, Issue 1, p275
- ISSN
0309-0167
- Publication type
Article
- DOI
10.1111/his.13967