Unilateral Vestibular schwannoma with Pituitary macroadenoma- Rare concurrent dual intracranial lesion
- Vestibular schwannoma, field cancerization, multiple primary tumours, pituitary adenoma
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The presenting clinic features of the cerebellopontine angle tumours and their management are well known, however there is limited knowledge regarding coexistence of other primary brain tumours which can be incidentally detected. A 70-year-old otherwise normal gentleman was referred from routine hearing screening programme centre with more of right sided hearing loss and occasional right sided tinnitus. Pure tone audiogram revealed an asymmetric high frequency sensorineural hearing loss .Gadolinium contrast enhanced MRI showed a right distal mass filling the entire internal acoustic meatus with an intracanalicular dural extension indenting the middle cerebellar peduncle with no significant enhancement. Additionally, an incidental enhancing asymmetric macroadenoma was detected in the pituitary sella indenting the left cavernous sinus without an extension and displacing the pituitary stalk to the right and displacing the carotids superiorly exerting insignificant pressure on the optic nerves. He had Hyperprolactinemia but normal visual fields. Here we present this rare concurrent presentation of dual intracranial primary tumours which by itself clinically is very uncommon.
- Xenellis JE, Linthicum FH. On the myth of the glial/schwann junction (Obersteiner-Redlich zone): origin of vestibular nerve schwannomas.
- Rosenberg SI. Natural history of acoustic neuromas. The Laryngoscope. 2000 Apr;110(4):497-508.
- Gittleman H, Ostrom QT, Farah PD, Ondracek A, Chen Y, Wolinsky Y, Kruchko C, Singer J, Kshettry VR, Laws ER, Sloan AE. Descriptive epidemiology of pituitary tumors in the United States, 2004–2009. Journal of neurosurgery. 2014 Sep;121(3):527-35.
- Andrioli GC, Zuccarello M, Scanarini M, d’Avella D. Concurrent primary intracranial tumours of different histogenesis. InExperimental and Clinical Neuropathology 1981 (pp. 111-115). Springer, Berlin, Heidelberg.
- Reilly KM. Brain tumor susceptibility: the role of genetic factors and uses of mouse models to unravel risk. Brain pathology. 2009 Jan 1;19(1):121-31.
- Braakhuis BJ, Tabor MP, Kummer JA, Leemans CR, Brakenhoff RH. A genetic explanation of Slaughter’s concept of field cancerization: evidence and clinical implications. Cancer research. 2003 Apr 15;63(8):1727-30.
- Fernández J, Méndez-Sánchez SC, Gonzalez-Correa CA, Miranda DA. Could field cancerization be interpreted as a biochemical anomaly amplification due to transformed cells?. Medical hypotheses. 2016 Dec 1;97:107-11.
- HEROIU AD, DANCIU CE, POPESCU CR. Multiple cancers of the head and neck. Maedica. 2013 Mar;8(1):80.
- Amit A, Achawal S, Dorward N. Pituitary macro adenoma and vestibular schwannoma: a case report of dual intracranial pathologies. British journal of neurosurgery. 2008 Jan 1;22(5):695-6.
- Gorman P, Hewer RL. Stroke due to atrial myxoma in a young woman with co-existing acoustic neuroma and pituitary adenoma. Journal of neurology, neurosurgery, and psychiatry. 1985 Jul;48(7):718.
- Vaamonde PL, Castro CV, Soto AV, Frade CG, Santos SP, Labella TC. Asymptomatic acoustic neurinoma associated with hypophyseal macroadenoma. Acta otorrinolaringologica espanola. 2001;52(8):705-8.
- Niu Y, Ma L, Mao Q, Wu L, Chen J. Pituitary adenoma and vestibular schwannoma: case report and review of the literature. Journal of postgraduate medicine. 2010;56(4):281.
- Carlson ML, Patel NS, Glasgow AE, Habermann EB, Grossardt BR, Link MJ. Vestibular schwannoma and pituitary adenoma in the same patient: coincidence or novel clinical association?. Journal of Neuro-Oncology. 2016;1(128):101-8.