Intracranial schwannomas not arising from the facial, trigeminal, or vestibular nerves are extremely rare in non-neurofibromatosis patients 1). Only few well-documented cases of intracerebral schwannomas have been reported in the world literature 2).

Intraparenchymatous schwannomas of the central nervous system are rare. A literature survey revealed reports of 65 such cases 3)).

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 4).

The presence of a cyst together with the tumor appears to be characteristic of such intraparenchymal schwannomas of the brain 5).

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 2×2 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.


1)
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.
2) , 4)
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.
3)
Horn EM, Zabramski JM, Lanzino G, Coons SW. Intracerebral schwannomas: case report and review of the literature. Barrow Quarterly. 2006;22(2
5)
Mardi K, Sharma J. Intracranial cystic (ancient) schwannoma of the temporal lobe: a rare occurrence. The Internet Journal of Pathology. 2007;7(1
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