Schwann Cells and Peripheral Myelin Within Human Central Nervous Tissues

Feigin, Irwin; Ogata, Jun

doi:10.1097/00005072-197110000-00005

Cited by 145 publications

(57 citation statements)

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“…Schwann cells are not indigenous to the brain parenchyma. It has been proposed that the tumors arise from the differentiation of multipotent mesenchymal elements into Schwann cells, 20,21 conversion of the pial cells to Schwann cells, distorted embryogenesis, 40 displaced neural crest cells, 39 or misplaced myelinated nerve fibers. 13,36,38 Based on the frequent perivascular location of these tumors, an alternative pathogenic hypothesis includes these tumors arising from Schwann cells within the adrenergic nerve fibers of cerebral arterioles and the larger arteries within the subarachnoid space.…”

Section: Discussionmentioning

confidence: 99%

Intracerebral schwannomas: a rare disease with varying natural history

Scott

Koral²,

Margraf

et al. 2013

PED

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Although intracerebral schwannomas are typically regarded as benign intracranial tumors, malignancy and recurrence have been reported among patients harboring such neoplasms. The available literature consists of case reports and small series that present variable characteristics distinguishing these unusual lesions. Little advancement has been made to further the understanding and management of these tumors. The authors present 3 cases from their institution that highlight the difference between typical benign intracerebral schwannomas and histopathological variants that may portend more aggressive behavior. Also provided is a review of the literature in the hope of gaining a better understanding of these rare tumors.

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Section: Discussionmentioning

confidence: 99%

Intracerebral schwannomas: a rare disease with varying natural history

Scott

Koral²,

Margraf

et al. 2013

PED

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“…Similar tiny myelinated nerves may be present in the tela choroidea. 2 Feigin and Ogata 11 have reported the presence of non-neoplastic Schwann cells in brain tissue in multiple sclerosis plaques (peripheral type myelin) or at the edge of old infarcts. These may undergo neoplastic conversion.…”

Section: Discussionmentioning

confidence: 99%

Imaging and Clinical Features of an Intra-Axial Brain Stem Schwannoma

Muzzafar¹,

Ketonen²,

Weinberg³

et al. 2009

AJNR Am J Neuroradiol

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SUMMARY:A 68-year-old man presented with a highly symptomatic brain stem tumor originally thought to be a brain stem glioma. Intraoperative MR imaging guidance was used to resect the tumor, and real-time evoked potentials improved during surgery. Pathology findings unexpectedly indicated that the tumor was an intra-axial brain stem schwannoma, a condition reported, to our knowledge, only 6 times previously in the literature. The patient made an excellent recovery with reversal of his symptoms. We report an unusual case of a highly symptomatic intra-axial schwannoma that was successfully treated surgically. Case ReportA 68-year-old man developed gait imbalance, coughing, and hiccups during a 2-month period. The symptoms progressed, and he developed nausea, vomiting, intermittent diplopia, and weakness in his right arm.Physical examination revealed an alert well-oriented patient, with normally reacting pupils and intact extraocular movements. Positive findings included bilateral nystagmus on lateral gaze, right facial weakness, hoarse voice, and weakness in the right upper and lower extremity (4 of 5 weaknesses on the 5-point strength scale). Swallowing and motor speech assessment showed severe pharyngeal phase dysphagia with noneffective and unsafe swallowing.MR imaging showed a cystic septate lesion involving the midbrain, pons, and medulla (Fig 1). The upper extent was in the left midbrain in the anterior pretectal region. The inferior extent was from the left medulla up to the anterior pyramids. The lesion was hypointense on T1 (not shown), hyperintense on T2 (Fig 2), and had enhancing septa on gadolinium-enhanced images (Fig 1). The cerebellar peduncles and anterior cerebellum on the left were also involved, showing fluid-attenuated inversion recovery signal-intensity abnormality (not shown).The patient underwent a craniotomy with intraoperative MR imaging and sonography, with microscopic dissection guided by motorevoked potentials. The surface of the brain stem where the tumor came to the surface was abnormal, but there was no extension along any cranial nerve. A biopsy showed a pure spindle cell tumor. Pathologic considerations at the time were either meningioma, schwannoma, or tanycytic ependymoma. There were no mitotic figures. Xanthochromic intratumoral cyst fluid was found to be under moderate pressure. The tumor was resected but had to be coagulated medially and inferiorly at the brain stem attachment where dissection was difficult. Multiple septa were fenestrated and resected. Right-sided evoked potentials returned immediately once the cyst was decompressed. A gross total resection was achieved.Pathologic results after the surgery showed a spindle cell neoplasm. Additional special studies were performed on permanent tissue. A positive tumor reactivity was seen in tumor cells with S-100, but they were negative for glial fibrillary acidic protein and epithelial membrane antigen. Studies for MIB-1 showed rare labeled tumor nuclei. A diagnosis of schwannoma was made. The patient's neurologic status improv...

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“…They occur more frequently in the anterior cranial fossa, mainly in the midline. The different terminologies associated with their rarity and enigmatic origin further complicates their study [1][2][3][6][7][8] . Schwannomas mainly arise from nerve sheaths of peripheral and cranial nerves (exception for first and second cranial nerves).…”

Section: Discussionmentioning

confidence: 99%

“…Schwannomas mainly arise from nerve sheaths of peripheral and cranial nerves (exception for first and second cranial nerves). However, the pathogenesis of intracranial schwannomas not directed associated with cranial nerves has been puzzling [1][2][3][4][5][6][7][8] . Additionally, considerable debate exists whether they are primarily intra or extra-axial lesion 1,2 .…”

Section: Discussionmentioning

confidence: 99%

“…They account for about 8% of all intracranial tumors and can arise from any nerve containing Schwann cells [1][2][3][4][5] . The most common location is the vestibular portion of the VIII th cranial nerve and, less commonly, the V th , IX th , X th , and VII th cranial nerves 1,2,4,[7][8][9][10] . The occurrence of a schwannoma not related to cranial nerves is exceedingly rare, the most common location being the anterior cranial fossa.…”

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