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Spontaneous Regression Of A Cystic Hypoglossal Schwannoma Causing Unilateral Tongue Atrophy.

Durnford et al., 2014Brain tumor

Durnford, A. J., Harrisson, S. E., Ditchfield, A., & Shenouda, E. (2014). spontaneous regression of a cystic hypoglossal schwannoma causing unilateral tongue atrophy. British journal of neurosurgery, 28(1), 133–134. https://doi.org/10.3109/02688697.2013.815321

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Abstract

A 60-year-old lady presented with intermittent headaches. Examination revealed striking marked unilateral tongue atrophy. Magnetic resonance imaging (MRI) revealed a cystic lesion in the hypoglossal canal and a provisional diagnosis of cystic hypoglossal schwannoma made. Annual surveillance scans showed stable appearances but surprisingly at 3 years they showed a significant reduction in the size of the lesion. Most patients with hypoglossal schwannomas present with ipsilateral hypoglossal nerve palsy; careful cranial nerve examination is vital in diagnosing such rare lesions. Little is known of their natural history, with most lesions undergoing surgery. This case highlights spontaneous regression following non-operative management.

Case Details

Disease Location

Cystic hypoglossal schwannoma

Personal Characteristics

60-year-old female, history of unilateral headaches.

Clinical Characteristics

A 60-year-old female presented with a history of intermittent headaches. Pe: marked unilateral atrophy of the tongue. MRI revealed a cystic lesion in the hypoglossal canal and a provisional diagnosis of cystic hypoglossal schwannoma was made. Treated conservatively. Subsequent yearly surveillance of MRI scans showed stable appearances of the lesion, but surprisingly imaging at 3 years showed significant reduction in the size of the cystic lesion. During this time, she remained headache-free with no progression of neurological symptoms..

Remission Characteristics

Annual surveillance scans showed stable appearances but surprisingly at 3 years they showed a significant reduction in the size of the lesion

Treatment & Mechanisms