Multicystic vestibular schwannomas with fluid-fluid levels: A report of three cases

Li,Puxian; Bi,Zhiyong; Hao,Shuyu; Zhang,Junting

doi:10.3892/ol.2015.3211

Multicystic vestibular schwannomas with fluid-fluid levels: A report of three cases

Authors:
- Puxian Li
- Zhiyong Bi
- Shuyu Hao
- Junting Zhang
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Affiliations: Department of Neurosurgery, Laiwu Hospital, Taishan Medical University, Laiwu, Shandong 271100, P.R. China, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
Published online on: May 14, 2015 https://doi.org/10.3892/ol.2015.3211
Pages: 206-210
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study reported three rare cases of multicystic vestibular schwannoma with fluid-fluid levels. These three tumors exhibited apparent fluid‑fluid levels that demonstrated a radiological appearance of two fluid levels in the cystic area. Two cases had an acute history, whereas one case presented with a chronic progression. A suboccipital retrosigmoid approach was used for access to the tumors and gross total resection was achieved in all the cases. During the surgical procedures, unclotted blood was observed, and the tumors were adhered to the facial nerve, other cranial nerves or the brain stem. In each case, the facial nerve function of the patients was impaired following surgery. The present study discussed the possible mechanism of the formation of the fluid-fluid levels, the effect of the fluid-fluid levels and the therapeutic strategy employed.

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1	Arthurs BJ, Lamoreaux WT, Giddings NA, Fairbanks RK, Mackay AR, Demakas JJ, Cooke BS and Lee CM: Gamma Knife radiosurgery for vestibular schwannoma: case report and review of the literature. World J Surg Oncol. 7:1002009. View Article : Google Scholar : PubMed/NCBI
2	Park CK, Kim DC, Park SH, Kim JE, Paek SH, et al: Microhemorrhage, a possible mechanism for cyst formation in vestibular schwannomas. J Neurosurg. 105:576–580. 2006. View Article : Google Scholar : PubMed/NCBI
3	Xia L, Zhang H, Yu C, Zhang M, Ren M, Qu Y, et al: Fluid-fluid level in cystic vestibular schwannoma: A predictor of peritumoral adhesion. J Neurosurg. 120:197–206. 2014. View Article : Google Scholar : PubMed/NCBI
4	Lu ZH and Wu M: Unusual features in an adult pancreatic hemangioma: CT and MRI demonstration. Korean J Radiol. 14:781–785. 2013. View Article : Google Scholar : PubMed/NCBI
5	Sommer WH, Zech CJ, Bamberg F, Auernhammer CJ, Helck A, Paprottka PM, et al: Fluid-fluid level in hepatic metastases: A characteristic sign of metastases of neuroendocrine origin. Eur J Radiol. 81:2127–2132. 2012. View Article : Google Scholar : PubMed/NCBI
6	Fu H, Hao SY, Jia GJ, Zhang JT and Zhang LW: A cystic vestibular schwannoma with a fluid-fluid level. Chin Med J (Engl). 125:39202012.PubMed/NCBI
7	Catalano P, Fang-Hui E and Som PM: Fluid-fluid levels in benign neurogenic tumors. AJNR Am J Neuroradiol. 18:385–387. 1997.PubMed/NCBI
8	Li WC, Hong XY, Wang LP, Ge PF, Fu SL and Luo YN: Large cystic hypoglossal schwannoma with fluid-fluid level: A case report. Skull Base. 20:193–197. 2010. View Article : Google Scholar : PubMed/NCBI
9	Gagliardo C, Martines F, Bencivinni F, La Tona G, Lo Casto A and Midiri M: Intratumoral haemorrhage causing an unusual clinical presentation of a vestibular schwannoma. Neuroradiol J. 26:30–34. 2013. View Article : Google Scholar : PubMed/NCBI
10	Chin KF, Babar J, Tzifa K, Chavda SV and Irving RM: Vestibular schwannomas with fluid-fluid level. J Laryngol Otol. 121:902–906. 2007. View Article : Google Scholar : PubMed/NCBI
11	House JW and Brackmann DE: Facial nerve grading system. Otolaryngol Head Neck Surg. 93:146–147. 1985.PubMed/NCBI
12	Yamakami I, Uchino Y, Kobayashi E, Yamaura A and Oka N: Removal of large acoustic neurinomas (vestibular schwannomas) by the retrosigmoid approach with no mortality and minimal morbidity. J Neurol Neurosurg Psychiatry. 75:453–458. 2004. View Article : Google Scholar : PubMed/NCBI
13	Carhart R and Jerger J: Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Disord. 24:330–345. 1959. View Article : Google Scholar
14	Chang WC, Huang GS, Lee HS, Lee CH and Hsu YC: Fluid-fluid level in peripheral nerve schwannoma: Report of a case with histological correlation. Clin Imaging. 33:248–251. 2009. View Article : Google Scholar : PubMed/NCBI
15	Sinha S and Sharma BS: Cystic acoustic neuromas: Surgical outcome in a series of 58 patients. J Clin Neurosci. 15:511–515. 2008. View Article : Google Scholar : PubMed/NCBI
16	de Ipolyi AR, Yang I, Buckley A, Barbaro NM, Cheung SW and Parsa AT: Fluctuating response of a cystic vestibular schwannoma to radiosurgery: Case report. Neurosurgery. 62:E1164–E1165. 2008. View Article : Google Scholar : PubMed/NCBI
17	Ganslandt O, Fahrig A and Strauss C: Hemorrhage into cystic vestibular schwannoma following stereotactic radiation therapy. Zentralbl Neurochir. 69:204–206. 2008. View Article : Google Scholar : PubMed/NCBI
18	Kameyama S, Tanaka R, Honda Y, Hasegawa A, Yamazaki H and Kawaguchi T: The long-term growth rate of residual acoustic neurinomas. Acta Neurochir (Wien). 129:127–130. 1994. View Article : Google Scholar : PubMed/NCBI