Sporadic vestibular schwannoma in a pediatric population: a case series.
Acoustic neuroma
Facial nerve
Microsurgery
Stereotactic radiosurgery
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227
Informations de publication
Date de publication:
27 Oct 2023
27 Oct 2023
Historique:
received:
21
06
2023
accepted:
10
10
2023
medline:
27
10
2023
pubmed:
27
10
2023
entrez:
27
10
2023
Statut:
aheadofprint
Résumé
To describe the characteristics, management, and outcomes of pediatric patients with sporadic vestibular schwannoma (sVS). This was a case series at a tertiary care center. Patients were identified through a research repository and chart review. Interventions were microsurgery, stereotactic radiosurgery (SRS), and observation. Outcome measures were tumor control, facial nerve function, and hearing. Eight patients over 2006-2022 fulfilled inclusion criteria (unilateral VS without genetic or clinical evidence of neurofibromatosis type 2 (NF2); age ≤ 21) with a mean age of 17 years (14-20). Average greatest tumor length in the internal auditory canal was 9.7 mm (4.0-16.1). Average greatest tumor dimension (4/8 tumors) in the cerebellopontine angle was 19.1 mm (11.3-26.8). Primary treatment was microsurgery in five (62.5%) patients, observation in two (25%), and SRS in one (12.5%). Four (80%) surgical patients had gross total resections, and one (20%) had regrowth post-near total resection and underwent SRS. One observed patient and the primary SRS patient have remained radiographically stable for 3.5 and 7 years, respectively. The other observed patient required surgery for tumor growth after 12 months of observation. Two surgical patients had poor facial nerve outcomes. All post-procedural patients developed anacusis. Mean follow-up was 3 years (0.5-7). We describe one of the largest reported cohorts of pediatric sVS in the USA. Diligent exclusion of NF2 is critical. Given the high likelihood of eventually requiring intervention and known adverse effects of SRS, microsurgery remains the preferred treatment. However, observation can be considered in select situations.
Identifiants
pubmed: 37889276
doi: 10.1007/s00381-023-06184-9
pii: 10.1007/s00381-023-06184-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Malina GEK, Heiferman DM, Riedy LN et al (2020) Pediatric vestibular schwannomas: case series and a systematic review with meta-analysis. J Neurosurg Pediatr 26(3):302–310. https://doi.org/10.3171/2020.3.PEDS19514
doi: 10.3171/2020.3.PEDS19514
pubmed: 32470932
Huang MJ, Kano H, Mousavi SH et al (2017) Stereotactic radiosurgery for recurrent vestibular schwannoma after previous resection. J Neurosurg 126(5):1506–1513. https://doi.org/10.3171/2016.5.JNS1645
doi: 10.3171/2016.5.JNS1645
pubmed: 27471891
Sass H, Cayé-Thomasen P (2018) Contemporary molecular biology of sporadic vestibular schwannomas: a systematic review and clinical implications. J Int Adv Otol 14(2):322–329. https://doi.org/10.5152/iao.2018.4929
doi: 10.5152/iao.2018.4929
pubmed: 30100540
pmcid: 6354447
Lei Y, Guo P, Li X, Zhang Y, Du T (2019) Identification of differentially expressed miRNAs and mRNAs in vestibular schwannoma by integrated analysis. Biomed Res Int 2019:7267816. https://doi.org/10.1155/2019/7267816
doi: 10.1155/2019/7267816
pubmed: 31309113
pmcid: 6594327
Håvik AL, Bruland O, Myrseth E et al (2018) Genetic landscape of sporadic vestibular schwannoma. J Neurosurg 128(3):911–922. https://doi.org/10.3171/2016.10.JNS161384
doi: 10.3171/2016.10.JNS161384
pubmed: 28409725
Başar İ, Hanalioğlu Ş, Narin F, Bilginer B (2018) Pediatric vestibular schwannomas: evaluation of clinical features, treatment strategies and long-term results of 10 cases. Turkish J Ear Nose Throat 28(3):116–125. https://doi.org/10.5606/tr-ent.2018.57966
doi: 10.5606/tr-ent.2018.57966
Ren Y, Chari DA, Vasilijic S, Welling DB, Stankovic KM (2021) New developments in neurofibromatosis type 2 and vestibular schwannoma. Neuro-Oncology Adv 3(1):1–13. https://doi.org/10.1093/noajnl/vdaa153
doi: 10.1093/noajnl/vdaa153
Wang J, Xu Y, Lei T, Zeng L (2015) Treatment decision-making for sporadic small vestibular schwannoma in a pediatric patient: a case report and literature review. Oncol Lett 9(5):2371–2373. https://doi.org/10.3892/ol.2015.3058
doi: 10.3892/ol.2015.3058
pubmed: 26137073
pmcid: 4467327
Zipfel J, Gorbachuk M, Gugel I, Tatagiba M, Schuhmann MU (2022) Management of sporadic vestibular schwannomas in children—volumetric analysis and clinical outcome assessment. Children 9(490). https://doi.org/10.3390/children9040490
Matsushima K, Kohno M, Ichimasu N, Nakajima N, Yoshino M (2022) Pediatric vestibular schwannoma without evidence of neurofibromatosis: consecutive 18 microsurgical experiences. Child’s Nerv Syst 38(8):1505–1512. https://doi.org/10.1007/s00381-022-05477-9
doi: 10.1007/s00381-022-05477-9
Ansari SF, Terry C, Cohen-Gadol AA (2012) Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus 33(3):1–9. https://doi.org/10.3171/2012.6.FOCUS12163
doi: 10.3171/2012.6.FOCUS12163
Jacob JT, Carlson ML, Driscoll CL, Link MJ (2016) Volumetric analysis of tumor control following subtotal and near-total resection of vestibular schwannoma. Laryngoscope 126(8):1877–1882. https://doi.org/10.1002/lary.25779
doi: 10.1002/lary.25779
pubmed: 27426941
Savardekar AR, Terrell D, Lele SJ et al (2022) Primary treatment of small to medium (< 3 cm) sporadic vestibular schwannomas: a systematic review and meta-analysis on hearing preservation and tumor control rates for microsurgery versus radiosurgery. World Neurosurg 160:102–113. https://doi.org/10.1016/j.wneu.2021.11.083
doi: 10.1016/j.wneu.2021.11.083
pubmed: 34838768
Kemink JL, Langman AW, Niparko JK, Graham MD (1991) Operative management of acoustic neuromas: the priority of neurologic function over complete resection. Otolaryngol Neck Surg 104(1):96–99. https://doi.org/10.1177/019459989110400117
doi: 10.1177/019459989110400117
Schwartz MS, Kari E, Strickland BM et al (2013) Evaluation of the increased use of partial resection of large vestibular schwanommas: facial nerve outcomes and recurrence/regrowth rates. Otol Neurotol 34(8):1456–1464. https://doi.org/10.1097/MAO.0b013e3182976552
doi: 10.1097/MAO.0b013e3182976552
pubmed: 23928516
Kasbekar AV, Adan GH, Beacall A, Youssef AM, Gilkes CE, Lesser TH (2018) Growth patterns of residual tumor in preoperatively growing vestibular schwannomas. J Neurol Surg Part B Skull BasePart B Skull Base 79(4):319–324. https://doi.org/10.1055/s-0037-1607421
doi: 10.1055/s-0037-1607421
Pollock BE (2006) Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience. Neurosurgery 58(2):241–248. https://doi.org/10.1227/01.NEU.0000194833.66593.8B
doi: 10.1227/01.NEU.0000194833.66593.8B
pubmed: 16462477
Conlan O, Kontorinis G (2022) Long-term growth patterns of vestibular schwannomas after stereotactic radiotherapy: delayed re-growth. Eur Arch Oto-Rhino-Laryngology 279(10):4825–4830. https://doi.org/10.1007/s00405-022-07281-2
doi: 10.1007/s00405-022-07281-2
Dixon PR, Moshtaghi O, Khan U et al (2023) Association between facility surgical volume and excess time in the hospital after surgical resection of vestibular schwannomas. JAMA Otolaryngol - Head Neck Surg 149(4):352–358. https://doi.org/10.1001/jamaoto.2022.5243
doi: 10.1001/jamaoto.2022.5243
pubmed: 36862385
Brandel MG, Plonsker JH, Khan UA et al (2023) Going the distance in acoustic neuroma resection: microsurgical outcomes at high-volume centers of excellence. J Neurooncol 163(1):105–114. https://doi.org/10.1007/s11060-023-04313-7
doi: 10.1007/s11060-023-04313-7
pubmed: 37084124
Bozhkov Y, Shawarba J, Feulner J et al (2022) Prediction of hearing preservation in vestibular schwannoma surgery according to tumor size and anatomic extension. Otolaryngol - Head Neck Surg 166(3):530–536. https://doi.org/10.1177/01945998211012674
doi: 10.1177/01945998211012674
pubmed: 34030502
Oh T, Nagasawa DT, Fong BM et al (2012) Intraoperative neuromonitoring techniques in the surgical management of acoustic neuromas. Neurosurg Focus 33(3):1–10. https://doi.org/10.3171/2012.6.FOCUS12194
doi: 10.3171/2012.6.FOCUS12194
Early S, Rinnooy Kan CE, Eggink M, Frijns JHM, Stankovic KM (2020) Progression of contralateral hearing loss in patients with sporadic vestibular schwannoma. Front Neurol 11(796):1–13. https://doi.org/10.3389/fneur.2020.00796
doi: 10.3389/fneur.2020.00796
Nakatomi H, Jacob JT, Carlson ML et al (2017) Long-term risk of recurrence and regrowth after gross-total and subtotal resection of sporadic vestibular schwannoma. J Neurosurg 133:1052–1058. https://doi.org/10.3171/2016.11.JNS16498.J
doi: 10.3171/2016.11.JNS16498.J
Janz TA, Camilon PR, Cheung AY et al (2019) Characteristics and outcomes of pediatric vestibular schwannomas. Otol Neurotol 40(8):1047–1053. https://doi.org/10.1097/MAO.0000000000002316
Carlson ML, Jacob JT, Pollock BE et al (2013) Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline. J Neurosurg 118(3):579–587. https://doi.org/10.3171/2012.9.JNS12919
doi: 10.3171/2012.9.JNS12919
pubmed: 23101446
Carlson ML, Vivas EX, McCracken DJ et al (2018) Congress of neurological surgeons systematic review and evidence-based guidelines on hearing preservation outcomes in patients with sporadic vestibular schwannomas. Clin Neurosurg 82(2):E35–E39. https://doi.org/10.1093/neuros/nyx511
doi: 10.1093/neuros/nyx511
Boari N, Bailo M, Gagliardi F et al (2014) Gamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients. J Neurosurg (Suppl 2) 121:123–142. https://doi.org/10.3171/2014.8.GKS141506
Wise SC, Carlson ML, Tveiten ØV et al (2016) Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery. Laryngoscope 126(11):2580–2586. https://doi.org/10.1002/lary.25943
doi: 10.1002/lary.25943
pubmed: 27107262
Iwai Y, Ishibashi K, Nakanishi Y, Onishi Y, Nishijima S, Yamanaka K (2016) Functional outcomes of salvage surgery for vestibular schwannomas after failed gamma knife radiosurgery. World Neurosurg 90:385–390. https://doi.org/10.1016/j.wneu.2016.03.014
doi: 10.1016/j.wneu.2016.03.014
pubmed: 26987634
Liu AK, Bagrosky B, Fenton LZ et al (2009) Vascular abnormalities in pediatric craniopharyngioma patients treated with radiation therapy. Pediatr Blood Cancer 52:227–230. https://doi.org/10.1002/pbc
doi: 10.1002/pbc
pubmed: 18937328
Denunzio NJ, Yock TI (2020) Modern radiotherapy for pediatric brain tumors. Cancers (Basel) 12(6):1–16. https://doi.org/10.3390/cancers12061533
doi: 10.3390/cancers12061533
Yang T, Rockhill J, Born DE, Sekhar LN (2010) A case of high-grade undifferentiated sarcoma after surgical resection and stereotactic radiosurgery of a vestibular schwannoma. Skull Base 20(3):179–183. https://doi.org/10.1055/s-0029-1242195
doi: 10.1055/s-0029-1242195
pubmed: 21318035
pmcid: 3037102
Demetriades AK, Saunders N, Rose P et al (2010) Malignant transformation of acoustic neuroma/vestibular schwannoma 10 years after gamma knife stereotactic radiosurgery. Skull Base 20(5):381–387. https://doi.org/10.1055/s-0030-1253576
doi: 10.1055/s-0030-1253576
pubmed: 21359005
pmcid: 3023338
Akamatsu Y, Murakami K, Watanabe M, Jokura H, Tominaga T (2010) Malignant peripheral nerve sheath tumor arising from benign vestibular schwannoma treated by gamma knife radiosurgery after two previous surgeries: a case report with surgical and pathological observations. World Neurosurg 73(6):751–754. https://doi.org/10.1016/j.wneu.2010.04.009
doi: 10.1016/j.wneu.2010.04.009
pubmed: 20934169
Shin M, Ueki K, Kurita H, Kirino T (2002) Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. Lancet 360(9329):309–310. https://doi.org/10.1016/S0140-6736(02)09521-1
doi: 10.1016/S0140-6736(02)09521-1
pubmed: 12147377
Yanamadala V, Williamson RW, Fusco DJ, Eschbacher J, Weisskopf P, Porter RW (2013) Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. World Neurosurg 79(3/4):593.e1-593.e8. https://doi.org/10.1016/j.wneu.2012.03.016
doi: 10.1016/j.wneu.2012.03.016
pubmed: 22480982
Peker HO, Gok H, Altay T (2019) Malignant transformation of vestibular schwannoma after stereotactic radiosurgery. World Neurosurg 124:81–83. https://doi.org/10.1016/j.wneu.2018.12.149
doi: 10.1016/j.wneu.2018.12.149
pubmed: 30639496
Kawashima M, Hasegawa H, Shin M, Shinya Y, Katano A, Saito N (2021) Outcomes of stereotactic radiosurgery in young adults with vestibular schwannomas. J Neurooncol 154(1):93–100. https://doi.org/10.1007/s11060-021-03803-w
doi: 10.1007/s11060-021-03803-w
pubmed: 34241770
Evans DG, Halliday D, Obholzer R et al (2023) Radiation treatment of benign tumours in NF2-related-schwannomatosis: a national study of 266 irradiated patients showing a significant increase in malignancy/malignant progression. Neuro-Oncology Adv 5(1):vdad025. https://doi.org/10.1093/noajnl/vdad025
Burns R, Niendorf K, Steinberg K et al (2022) Genetic testing to gain diagnostic clarity in neurofibromatosis type 2 and schwannomatosis. Am J Med Genet Part 188(8):2413–2420. https://doi.org/10.1002/ajmg.a.62845
doi: 10.1002/ajmg.a.62845
Evans DGR, Ramsden RT, Gokhale C, Bowers N, Huson SM, Wallace A (2007) Should NF2 mutation screening be undertaken in patients with an apparently isolated vestibular schwannoma? Clin Genet 71(4):354–358. https://doi.org/10.1111/j.1399-0004.2007.00778.x
doi: 10.1111/j.1399-0004.2007.00778.x
pubmed: 17470137
Buss E, Dillon MT, Rooth MA et al (2018) Effects of cochlear implantation on binaural hearing in adults with unilateral hearing loss. Trends Hear 22:1–15. https://doi.org/10.1177/2331216518771173
doi: 10.1177/2331216518771173
Drusin MA, Lubor B, Losenegger T, Selesnick S (2020) Trends in hearing rehabilitation use among vestibular schwannoma patients. Laryngoscope 130(6):1558–1564. https://doi.org/10.1002/lary.28316
doi: 10.1002/lary.28316
pubmed: 31603544
Wallhagen MI (2010) The stigma of hearing loss. Gerontologist 50(1):66–75. https://doi.org/10.1093/geront/gnp107
doi: 10.1093/geront/gnp107
pubmed: 19592638