Intraparenchymal schwannoma [Neurosurgery Wiki]

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=====Intraparenchymal schwannoma=====
[[Intracranial schwannoma]]s not arising from the facial, trigeminal, or vestibular nerves are extremely rare in non-neurofibromatosis patients 
((Du R, Dhoot J, McDermott MW, Gupta N. Cystic schwannoma of the anterior
tentorial hiatus. Case report and review of the literature. Pediatr Neurosurg.
2003 Apr;38(4):167-73. Review. PubMed PMID: 12646734.)).
Only few well-documented cases of intracerebral schwannomas have been reported in the world literature
((Casadei GP, Komori T, Scheithauer BW, Miller GM, Parisi JE, Kelly PJ.
Intracranial parenchymal schwannoma. A clinicopathological and neuroimaging study
of nine cases. J Neurosurg. 1993 Aug;79(2):217-22. PubMed PMID: 8331403.
)). 


Intraparenchymatous schwannomas of the central nervous system are rare. A literature survey revealed reports of 65 such cases 
((Horn EM, Zabramski JM, Lanzino G, Coons SW. Intracerebral schwannomas: case report and review of the literature. Barrow Quarterly. 2006;22(2))).

Intraparenchymal schwannomas are detected either in the first two decades, when they present with an indolent, slow-growing course, or in the elderly, when their symptoms evolve rapidly
((Casadei GP, Komori T, Scheithauer BW, Miller GM, Parisi JE, Kelly PJ.
Intracranial parenchymal schwannoma. A clinicopathological and neuroimaging study
of nine cases. J Neurosurg. 1993 Aug;79(2):217-22. PubMed PMID: 8331403.
)). 


The presence of a cyst together with the tumor appears to be characteristic of such intraparenchymal schwannomas of the brain
((Mardi K, Sharma J. Intracranial cystic (ancient) schwannoma of the temporal lobe: a rare occurrence. The Internet Journal of Pathology. 2007;7(1)).

====Case reports====
A 39-year-old female had been subject to headache, and intermittent seizures for 9 years and decreasing memory for one year, without obvious neurological signs. An MRI revealed a 2x2 cm contrast-enhanced lesion in the frontal lobe, with a cyst and peritumoral edema, which was not attached to the dura or falx. Preoperatively, it was diagnosed as a glioma. Total surgical removal of the lesion led to a favorable result. Post-operative histo-pathological examination showed characteristic Antoni A and B areas consistent with intraparenchymal schwannoma. Intraparenchymal schwannoma is an extremely uncommon lesion, which is seen mostly in young adults and children. The main clinical symptoms include rising-intracranial-pressure-related manifestations and associated seizure disorders. The possible developmental origins, histological, imaging features, and protocols of treatment for this entity are discussed.