Accelerated Growth of an Orbital Schwannoma During Pregnancy

Sugo, Nobuo; Yokota, Kyosuke; Nemoto, Minoru; Hatori, Tsutomu; Kano, Toshiyuki; Goto, Syozo; Seiki, Yoshikatsu

doi:10.1097/wno.0b013e3180321426

Cited by 24 publications

(18 citation statements)

References 9 publications

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“…Cystic schwannomas in our patient were highly vascular (Fig. 1d–e) consistent with prior reports in pregnancy-associated orbital schwannoma [1] and that women experience larger, more highly-vascular acoustic schwannoma than men [3]. …”

Section: Discussionsupporting

confidence: 91%

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Sporadic NF2 Mosaic: Multiple spinal schwannomas presenting with severe, intractable pain following pregnancy

Zimering

Choi

Koch

et al. 2017

Interdisciplinary Neurosurgery

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The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus. There were two small punctate lesions in the cauda equina suggestive of myxopapillary ependymoma with ‘drop metastases.’ The patient underwent surgical resection of two cystic compressive conus masses. Her low back pain improved after surgery. The masses were consistent with cystic/cellular schwannomas. An incidental finding was of a small, low-grade spinal ependymoma which lacked the characteristic histologic features of myxopapillary ependymoma. Multiple, large cystic schwannomas are not uncommon in schwannomatosis, however, the co-occurrence of low-grade ependymoma strongly suggests a clinical diagnosis of new, sporadic neurofibromatosis type 2. Although cranial nerve schwannomas (orbital, auditory) have been reported to enlarge during pregnancy, to our knowledge, this is the first report of multiple cystic/cellular schwannomas causing severe pain (due to conus compression) during and immediately after pregnancy.

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Section: Discussionsupporting

confidence: 91%

“…There have been isolated case reports of rapid expansion in orbital schwannoma causing visual disturbance during pregnancy [1]. Dr. Harvey Cushing suggested that pregnancy may accelerate the growth in acoustic neurilemmoma [2].…”

Section: Discussionmentioning

confidence: 99%

Sporadic NF2 Mosaic: Multiple spinal schwannomas presenting with severe, intractable pain following pregnancy

Zimering

Choi

Koch

et al. 2017

Interdisciplinary Neurosurgery

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“…While anecdotal information has suggested tumor growth may be exacerbated by pregnancy, at this time there is insufficient evidence to determine whether pregnancy directly results in increased tumor burden or tumor growth in NF1, NF2, and SWN (Cannon et al., 2018; Dugoff & Sujansky, 1996; Gaughan & Harner, 1993; Lusis et al., 2012; Roth, Petty, & Barald, 2008; Sugo et al., 2007). Furthermore, there is insufficient evidence to suggest that NF2 and SWN are associated with an increased risk for pregnancy complications, birth defects, or contraceptive contraindication.…”

Section: Genetic Counseling Processmentioning

confidence: 99%

Genetic Counseling for Neurofibromatosis 1, Neurofibromatosis 2, and Schwannomatosis—Practice Resource of the National Society of Genetic Counselors

Radtke

Bergner

Goetsch

et al. 2020

Journal of Genetic Counseling

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The goal of this practice resource is to provide genetic counselors and other healthcare professionals with a resource to reference when providing genetic counseling services to individuals and families undergoing evaluation for neurofibromatosis (NF) or who have received a diagnosis of NF, including neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis (SWN). Currently, there is no known standard approach to genetic counseling in NF. This resource may be useful in a number of different healthcare settings. 1.1.1 | Pediatric or adult genetic counseling session (general genetics or specialty clinic) These sessions may occur in conjunction with a diagnosing provider, such as a physician or nurse practitioner. • Diagnostic evaluation based on clinical features and/or family history.

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“…In a systematic review of 1,340 patients with schwannomas within a vestibular location, Youshimoto describes a mean annual growth rate of 1.2 mm/year [7]. It is of interest that pregnancy has been associated as a predisposing factor for the accelerated growth of certain schwannomas, i.e., in the orbital space which is believed to be secondary to haemorrhage within the tumour [8].…”

Section: Discussionmentioning

confidence: 99%