Intralabyrinthine schwannoma. A case report
Abstract Introduction and objectives: The intralabyrinthine schwannoma is a rare benign tumor, with extradural slow growth, located primarily in the membranous labyrinth. Through a clinical case, we present the characteristics of its evolution, we try to offer a physio-pathological explanation of symptoms and audio-vestibular findings and finally, we describe the therapeutic options. Description: We present a 59 year old woman, beginning with non-specific symptoms of the left ear and then concerned because of a hearing loss in that ear. To confirm that it is a non-justified unilateral hearing loss , MRI was requested and it shows the presence of a small intravestibular tumor of 2-3 mm which we will review periodically. Discussion: The origin and the prevalence of intralabyrinthine schwannomas are unknown. Even though the clinic is confused with other frequent otological processes, the implementation of MRI would increase the number of diagnosed cases. Depending on the patient, their symptoms, evolution and tumor characteristics, the type of treatment is decided. Conclusion: Intralabyrinthine schwannoma should be part of the differential diagnosis in patients with unilateral audio-vestibular symptoms and request a high resolution MRI to obtain the definitive diagnosis. Presenting an excellent prognosis, the observation is considered the best treatment option.
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http://dx.doi.org/10.1159/000331394
PMid:21968195 PMCid:PMC3221249
Van Abel KM, Carlson ML, Link MJ, Neff BA, Beatty CW, Lohse CM, et al. Primary inner ear schwannomas: a case series and systematic review of the literature. Laryngoscope. 2013;123:1957-66.
http://dx.doi.org/10.1002/lary.23928
PMid:23335152
Doyle KJ, Brackmann DE. Intralabyrinthine schwannomas. Otolaryngol Head Neck Surg. 1994;110:517-23.
PMid:8208566
Gosselin É, Maniakas A, Saliba I. Meta-analysis on the clinical outcomes in patients with intralabyrinthine schwannomas: conservative management vs. microsurgery. Eur Arch Otorhinolaryngol. 2015. Feb 12. [Epub ahead of print].
http://dx.doi.org/10.1007/s00405-015-3548-2
Kennedy RJ, Shelton C, Salzman KL, Davidson HC, Harnsberger HR. Intralabyrinthine schwannomas: diagnosis, management, and a new classification system. Otol Neurotol. 2004;25:160-7.
http://dx.doi.org/10.1097/00129492-200403000-00014
PMid:15021777
Salzman KL, Childs AM, Davidson HC, Kennedy RJ, Shelton C, Harnsberger HR. Intralabyrinthine schwannomas: imaging diagnosis and classification. AJNR Am J Neuroradiol. 2012;33:104-9.
http://dx.doi.org/10.3174/ajnr.A2712
PMid:22158921
Tieleman A, Casselman JW, Somers T, Delanote J, Kuhweide R, Ghekiere J, et al. Imaging of intralabyrinthine schwannomas: a retrospective study of 52 cases with emphasis on lesion growth. AJNR Am J Neuroradiol. 2008;29:898-905.
http://dx.doi.org/10.3174/ajnr.A1026
PMid:18321986
Frisch CD, Eckel LJ, Lane JI, Neff BA. Intralabyrinthine Schwannomas. Otolaryngol Clin North Am. 2015;48:423-41.
http://dx.doi.org/10.1016/j.otc.2015.02.004
PMid:25863567
Lee JJ, Lim HJ, Park HY, Choung YH. Recovery of hearing after surgical removal of intralabyrinthine schwannoma. Laryngoscope. 2015;125:1968-71.
http://dx.doi.org/10.1002/lary.25182
PMid:25640324
Fitzgerald DC, Grundfast KM, Hecht DA, Mark AS. Intralabyrinthine schwannomas. Am J Otol. 1999;20:381-5.
PMid:10337982
Dubrulle F, Kohler R, Vincent C, Puech P, Ernst O. Differential diagnosis and prognosis of T1-weighted post-gadolinium intralabyrinthine hyperintensities. Eur Radiol. 2010;20:2628-36.
http://dx.doi.org/10.1007/s00330-010-1835-2
PMid:20862477
Alemi AS, German MA, Hasso AN, Djalilian HR. Radiology quiz case 3. Intralabyrinthine schwannomas (ILS). Arch Otolaryngol Head Neck Surg. 2011;137:825, 827-8.
http://dx.doi.org/10.1001/archoto.2011.125-a
PMid:21844420
Nishimura T, Hosoi H. Progressive hearing loss in intracochlear schwannoma. Eur Arch Otorhinolaryngol. 2008;265:489-92.
http://dx.doi.org/10.1007/s00405-007-0483-x
PMid:17932683
Sataloff RT, Roberts BR, Feldman M. Intralabyrinthine schwannoma. Am J Otol. 1988;9:323-6.
PMid:3052098
Neff BA, Willcox Jr TO, Sataloff RT. Intralabyrinthine schwannomas. Otol Neurotol. 2003;2:299-307.
http://dx.doi.org/10.1097/00129492-200303000-00028
Maseda E, Ablanedo A, Blanco R, Díaz C, Martín A. Schwannoma intralaberíntico: a propósito de dos casos. Acta Otorrinolaringol Esp. 2007;58:70-2.
http://dx.doi.org/10.1016/S2173-5735(07)70306-X
http://dx.doi.org/10.1016/S0001-6519(07)74883-5
Bouchetemblé P, Heathcote K, Tollard E, Choussy O, Dehesdin D, Marie JP. Intralabyrinthine schwannomas: a case series with discussion of the diagnosis and management. Otol Neurotol. 2013;34:944-51.
http://dx.doi.org/10.1097/MAO.0b013e31828687f2
PMid:23598704
Schutt CA, Kveton JF. Cochlear implantation after resection of an intralabyrinthine schwannoma. Am J Otolaryngol. 2014;35:257-60.
http://dx.doi.org/10.1016/j.amjoto.2013.11.002
PMid:24321750
Jia H, Marzin A, Dubreuil C, Tringali S. Intralabyrinthine schwannomas: symptoms and managements. Auris Nasus Larynx. 2008;35:131-6.
http://dx.doi.org/10.1016/j.anl.2007.07.010
PMid:17869041
http://dx.doi.org/10.1159/000331394
PMid:21968195 PMCid:PMC3221249
Van Abel KM, Carlson ML, Link MJ, Neff BA, Beatty CW, Lohse CM, et al. Primary inner ear schwannomas: a case series and systematic review of the literature. Laryngoscope. 2013;123:1957-66.
http://dx.doi.org/10.1002/lary.23928
PMid:23335152
Doyle KJ, Brackmann DE. Intralabyrinthine schwannomas. Otolaryngol Head Neck Surg. 1994;110:517-23.
PMid:8208566
Gosselin É, Maniakas A, Saliba I. Meta-analysis on the clinical outcomes in patients with intralabyrinthine schwannomas: conservative management vs. microsurgery. Eur Arch Otorhinolaryngol. 2015. Feb 12. [Epub ahead of print].
http://dx.doi.org/10.1007/s00405-015-3548-2
Kennedy RJ, Shelton C, Salzman KL, Davidson HC, Harnsberger HR. Intralabyrinthine schwannomas: diagnosis, management, and a new classification system. Otol Neurotol. 2004;25:160-7.
http://dx.doi.org/10.1097/00129492-200403000-00014
PMid:15021777
Salzman KL, Childs AM, Davidson HC, Kennedy RJ, Shelton C, Harnsberger HR. Intralabyrinthine schwannomas: imaging diagnosis and classification. AJNR Am J Neuroradiol. 2012;33:104-9.
http://dx.doi.org/10.3174/ajnr.A2712
PMid:22158921
Tieleman A, Casselman JW, Somers T, Delanote J, Kuhweide R, Ghekiere J, et al. Imaging of intralabyrinthine schwannomas: a retrospective study of 52 cases with emphasis on lesion growth. AJNR Am J Neuroradiol. 2008;29:898-905.
http://dx.doi.org/10.3174/ajnr.A1026
PMid:18321986
Frisch CD, Eckel LJ, Lane JI, Neff BA. Intralabyrinthine Schwannomas. Otolaryngol Clin North Am. 2015;48:423-41.
http://dx.doi.org/10.1016/j.otc.2015.02.004
PMid:25863567
Lee JJ, Lim HJ, Park HY, Choung YH. Recovery of hearing after surgical removal of intralabyrinthine schwannoma. Laryngoscope. 2015;125:1968-71.
http://dx.doi.org/10.1002/lary.25182
PMid:25640324
Fitzgerald DC, Grundfast KM, Hecht DA, Mark AS. Intralabyrinthine schwannomas. Am J Otol. 1999;20:381-5.
PMid:10337982
Dubrulle F, Kohler R, Vincent C, Puech P, Ernst O. Differential diagnosis and prognosis of T1-weighted post-gadolinium intralabyrinthine hyperintensities. Eur Radiol. 2010;20:2628-36.
http://dx.doi.org/10.1007/s00330-010-1835-2
PMid:20862477
Alemi AS, German MA, Hasso AN, Djalilian HR. Radiology quiz case 3. Intralabyrinthine schwannomas (ILS). Arch Otolaryngol Head Neck Surg. 2011;137:825, 827-8.
http://dx.doi.org/10.1001/archoto.2011.125-a
PMid:21844420
Nishimura T, Hosoi H. Progressive hearing loss in intracochlear schwannoma. Eur Arch Otorhinolaryngol. 2008;265:489-92.
http://dx.doi.org/10.1007/s00405-007-0483-x
PMid:17932683
Sataloff RT, Roberts BR, Feldman M. Intralabyrinthine schwannoma. Am J Otol. 1988;9:323-6.
PMid:3052098
Neff BA, Willcox Jr TO, Sataloff RT. Intralabyrinthine schwannomas. Otol Neurotol. 2003;2:299-307.
http://dx.doi.org/10.1097/00129492-200303000-00028
Maseda E, Ablanedo A, Blanco R, Díaz C, Martín A. Schwannoma intralaberíntico: a propósito de dos casos. Acta Otorrinolaringol Esp. 2007;58:70-2.
http://dx.doi.org/10.1016/S2173-5735(07)70306-X
http://dx.doi.org/10.1016/S0001-6519(07)74883-5
Bouchetemblé P, Heathcote K, Tollard E, Choussy O, Dehesdin D, Marie JP. Intralabyrinthine schwannomas: a case series with discussion of the diagnosis and management. Otol Neurotol. 2013;34:944-51.
http://dx.doi.org/10.1097/MAO.0b013e31828687f2
PMid:23598704
Schutt CA, Kveton JF. Cochlear implantation after resection of an intralabyrinthine schwannoma. Am J Otolaryngol. 2014;35:257-60.
http://dx.doi.org/10.1016/j.amjoto.2013.11.002
PMid:24321750
Jia H, Marzin A, Dubreuil C, Tringali S. Intralabyrinthine schwannomas: symptoms and managements. Auris Nasus Larynx. 2008;35:131-6.
http://dx.doi.org/10.1016/j.anl.2007.07.010
PMid:17869041
Cámara-Arnaz, J. A., Benito-Orejas, J. I., Rodríguez-Velasco, M., & Morais-Pérez, D. (2016). Intralabyrinthine schwannoma. A case report. Revista ORL, 7(1), 57–62. https://doi.org/10.14201/orl.13550
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