title: Rare synchronous association of vestibular schwannoma and indolent insular oligodendroglioma in a patient without neurofibromatosis: controversial issue of timing for surgical treatment of asymptomatic low-grade gliomas.
abstract: The co-occurrence of a vestibular schwannoma and a low-grade glioma is rare, and even rarer is the association with an oligodendroglioma. Although various authors have addressed the problem of treating patients with incidentally discovered indolent low-grade gliomas, an established protocol does not exist to date. The common approach is to reserve surgery until there is radiological evidence of tumor growth or high-grade transformation. However, because incidental low-grade glioma may represent the first stage of unavoidable pathological progression towards high-grade glioma, early and radical surgical resection should be advocated in order to increase the chance of a "cure" and prolonged survival. This case report supports this view, and suggests reflection on a possible change from a conservative philosophy to preventative surgical treatment.
authors.affiliation: Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iacoangeli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Rienzo
authors.forename: Roberto
authors.initials: R
authors.lastname: Colasanti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Alvaro
authors.forename: Niccolò
authors.initials: N
authors.lastname: Nocchi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Polonara
authors.forename: Lucia Giovanna Maria
authors.initials: LG
authors.lastname: Di Somma
authors.forename: Antonio
authors.initials: A
authors.lastname: Zizzi
authors.forename: Marina
authors.initials: M
authors.lastname: Scarpelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Scerrati