Death from a malignant cerebellopontine angle triton tumor despite stereotactic radiosurgery. Case report.
Malignant vestibular nerve tumors are rare: to date, only three cases have been reported in the literature. The authors report a case of an eighth cranial nerve tumor that progressed 5 years after stereotactic radiosurgery. The patient was a 44-year-old man who underwent stereotactic radiosurgery for a 27-mm cerebellopontine angle tumor that was discovered on investigation of tinnitus and hearing loss. He developed facial weakness after 5 years, and repeated imaging revealed tumor enlargement. Despite complete microsurgical excision, the tumor rapidly recurred locally and subsequently disseminated within the neuraxis. The patient died 1 year after tumor progression was detected. Histopathological analysis revealed a malignant spindle cell neoplasm with frequent mitotic figures. The presence of positive rhabdoid elements on immunohistochemical studies confirmed that it was a triton tumor. The authors review the relevant literature concerning the classification and management of malignant vestibular nerve tumors and discuss the implications of tumor progression after stereotactic radiosurgery.
Comey
C H
CH
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
McLaughlin
M R
MR
Jho
H D
HD
Martinez
A J
AJ
Lunsford
L D
LD
D000328:Adult; D002528:Cerebellar Neoplasms / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery*; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000601:surgery; D018450:Disease Progression; D005158:Facial Paralysis / Q000209:etiology; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D008297:Male; D008866:Microsurgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D016634:Radiosurgery; D014012:Tinnitus / Q000209:etiology; D014725:Vestibular Nerve / Q000473:pathology / Q000601:surgery