How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?

<h4>Background</h4>The natural history of sporadic vestibular schwannoma is unpredictable, with tumors growing, non-growing and even showing spontaneous regression in some rare cases.<h4>Objective</h4>This retrospective study aims to describe the radiologic signs characterizi...

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Main Authors: Ghizlene Lahlou, Mathieu Rodallec, Yann Nguyen, Olivier Sterkers, Michel Kalamarides
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0217752
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author Ghizlene Lahlou
Mathieu Rodallec
Yann Nguyen
Olivier Sterkers
Michel Kalamarides
author_facet Ghizlene Lahlou
Mathieu Rodallec
Yann Nguyen
Olivier Sterkers
Michel Kalamarides
author_sort Ghizlene Lahlou
collection DOAJ
description <h4>Background</h4>The natural history of sporadic vestibular schwannoma is unpredictable, with tumors growing, non-growing and even showing spontaneous regression in some rare cases.<h4>Objective</h4>This retrospective study aims to describe the radiologic signs characterizing and identifying the shrinking vestibular schwannoma.<h4>Methods</h4>Involution was considered to have occurred if tumor size had decreased by 2 mm or more on its largest diameter. All magnetic resonance imaging scans were reviewed for tumor size, internal auditory meatus size, and tumor characteristics. Volumetric measurements were performed on the first and last scan. Audiometric data were collected at the first and last visit.<h4>Results</h4>Fourteen patients with a confirmed spontaneous regression were included, with a mean follow-up of 5 ± 2.6 years. The mean shrinkage rate was 0.9 ± 0.59 mm/year on 2D measurements, and 0.2 ± 0.17 cm3/year on volumetric measurements, with a relative shrinkage of 40 ± 16.9%. Two remarkable radiologic features were observed: First, a festooned aspect, defined by multiple curves in the tumor outline, noticed in 12 cases (86%); second, the appearance of cerebrospinal fluid filling the internal auditory meatus, associated with an enlargement of the internal auditory meatus compared to the contralateral side, and observed in 10 out of 13 cases with internal auditory meatus invasion (77%). Those two aspects were associated in 64% of cases.<h4>Conclusion</h4>These two newly reported radiologic features could help neurosurgeons, oto-neurosurgeons and neuroradiologists to identify a spontaneous vestibular schwannoma involution at first visit. This could allow any treatment to be postponed, monitoring to be more widely spaced, and patients to be reassured.
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spelling doaj.art-5d9b07b332134b159696ec6add3fb75d2022-12-21T18:25:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01146e021775210.1371/journal.pone.0217752How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?Ghizlene LahlouMathieu RodallecYann NguyenOlivier SterkersMichel Kalamarides<h4>Background</h4>The natural history of sporadic vestibular schwannoma is unpredictable, with tumors growing, non-growing and even showing spontaneous regression in some rare cases.<h4>Objective</h4>This retrospective study aims to describe the radiologic signs characterizing and identifying the shrinking vestibular schwannoma.<h4>Methods</h4>Involution was considered to have occurred if tumor size had decreased by 2 mm or more on its largest diameter. All magnetic resonance imaging scans were reviewed for tumor size, internal auditory meatus size, and tumor characteristics. Volumetric measurements were performed on the first and last scan. Audiometric data were collected at the first and last visit.<h4>Results</h4>Fourteen patients with a confirmed spontaneous regression were included, with a mean follow-up of 5 ± 2.6 years. The mean shrinkage rate was 0.9 ± 0.59 mm/year on 2D measurements, and 0.2 ± 0.17 cm3/year on volumetric measurements, with a relative shrinkage of 40 ± 16.9%. Two remarkable radiologic features were observed: First, a festooned aspect, defined by multiple curves in the tumor outline, noticed in 12 cases (86%); second, the appearance of cerebrospinal fluid filling the internal auditory meatus, associated with an enlargement of the internal auditory meatus compared to the contralateral side, and observed in 10 out of 13 cases with internal auditory meatus invasion (77%). Those two aspects were associated in 64% of cases.<h4>Conclusion</h4>These two newly reported radiologic features could help neurosurgeons, oto-neurosurgeons and neuroradiologists to identify a spontaneous vestibular schwannoma involution at first visit. This could allow any treatment to be postponed, monitoring to be more widely spaced, and patients to be reassured.https://doi.org/10.1371/journal.pone.0217752
spellingShingle Ghizlene Lahlou
Mathieu Rodallec
Yann Nguyen
Olivier Sterkers
Michel Kalamarides
How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
PLoS ONE
title How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
title_full How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
title_fullStr How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
title_full_unstemmed How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
title_short How to radiologically identify a spontaneous regression of sporadic vestibular schwannoma?
title_sort how to radiologically identify a spontaneous regression of sporadic vestibular schwannoma
url https://doi.org/10.1371/journal.pone.0217752
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