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Intraspinal tumors are uncommon. Positive diagnosis is based on medical imaging exams, in particular MRI. Anatomopathological examination allows for definitive diagnosis. Surgery is the treatment of choice for most of them. Prognosis is related to the histological type and patient´s initial clinical condition. We here report the histological profile and progression of intraspinal tumors in our department. We conducted a retrospective study over a period of 10 years. All operated patients with histology-confirmed intraspinal tumor (23 cases) were enrolled. Four unworkable records were excluded. The median time from symptom onset and first consultation was 79 days. Patients presented with spinal cord compression. In 11 cases this was characterized by slow onset. Seven CT scan and 14 MRI were performed, which showed 4 intramedullary tumors, 9 intradural, 1 extradural, and 5 of unknown site. Histological examination showed meningioma in 11 cases, neurinoma in 3 cases. In 7 cases, it confirmed the diagnosis based on Imaging tests (4 CT and 3 MRI). Macroscopically complete resection was performed in 14 cases; it was partial in 5 cases. After a 6-month follow-up period 6 patients had fully recovered, 9 partially. This study highlights diagnosis delays. MRI better defined the lesion, but its histological approach was limited. Meningiomas dominated. Complete resection was most often performed. The postoperative course was uneventful., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Sylvain Denléwendé Zabsonre et al.)

Spinal schwannomas are benign tumors accounting for 30% of all spinal tumors. They originate from the shwann cells of the spinal roots. We report our experience in managing patients with spinal shwannomas, from diagnosis to treatment modalities, in the Department of Neurosurgery at the University Hospital Hassan II in Fez over a period of 13 years. The patients with spinal shwannomas accounted for 19.5% of those with spinal cord compression treated surgically over the same period. The average age of patients was 45 years, with a discreet female predominance. Spinal schwannomas had an insidious onset, then the median of consultation time was 18 months. The main symptoms were spinal and radicular pain. Half of our patients had neurological deficits. Medullary MRI was performed in all of our patients. Spinal schwannomas occurred predominantly in the chest (40%); 62% of shwannomas were intradural lesions, rarely extradural lesions (8%) and mixed lesions(4%). Complete Surgical resection was performed in 96% of cases with osteosynthesis in two cases and arthrodesis in a single case. Histological examination confirmed the diagnosis of benign neurinoma in 23 cases, malignant shwannoma in one case and neurofibroma in one case. Outcome was favorable in the majority of cases, two patients had complications, an infection of the wall and neurological worsening. The interest in the subject of our study is to highlight the features of these lesions and to compare the results of our case series with the data in the literature., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Meryem Himmiche et al.)

Schwannomas are well encapsulated mesenchymal tumors of peripheral nerves, with slow growth. The laryngeal schwanomma is exceptional, we present a case not described in the literature of shwannoma in the pre epiglottic space. A 50-year-old woman, who had a history of foreign body sensation for 4 years ago, progressing to high dysphagia and hoarseness. Direct laryngoscopy in suspension demonstrated a regular submucosal mass in the supraglottic space, reducing pharyngo-laryngeal space. CT and MRI concluded with a benign tumor of the preepiglottic space. External surgical excision was performed and a primary tracheotomy was required. The histological examination with an immunochemical study confirmed a benign schwannoma. There was no complication postoperatively. The outcome was excellent after 2 years of follow-up.

Introduction: Neurogenic mediastinal tumors are tumors develop at the expense of peripheral nerve elements of the mediastinum, the sympathetic nervous tissue and paraganglia. The series that we propose has the distinction of a high frequency of malignant forms and a wealth of clinical symptomatology., Methods: This is a retrospective study of 9 patients collected over a period of 6 years. The epidemiological aspect, clinical, radiological, surgical treatment and his results, histological diagnosis and prognosis were reviewed., Results: Five women and 4 men were identified. All patients were symptomatic at diagnosis. Tumor resection was complete in 8 cases. In 3 patients, there was a malignant tumor. Two of them had received chemo-radiotherapy. The others showed good clinical progress with a mean of 35 months., Conclusion: Neurogenic tumors in adults are usually discovered incidentally. When the malignant forms predominate or in the presence of large tumor, the symptoms can be quite marked. In all cases the treatment based on a complete surgical resection remains the only guarantee of a good prognosis., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Schwannomas are a form of rare tumor, arising from neural tissue and representing 2 % of mediastinal tumors. They are usually located in the posterior mediastinum, most often in the paravertebral gutters and typically appended to intercostal nerves., Case Reports: We report two cases of unusual mediastinal schwannomas, appended to the vagus nerve. The schwannoma was located in the subcarinal region in the first case and in the right para-tracheal region in the second case. The lesions were thought to be bronchogenic cysts preoperatively in both cases because of a cystic appearance on preoperative CT scan and endobronchial ultrasonography. A surgical approach was adopted to remove the tumors. Video-assisted thoracoscopy was used in one case and robotic-assisted surgery in the second case, without any complication, allowing for complete resection and to establish a certain pathological diagnosis., Conclusion: Despite this location and cystic presentation being unusual, schwannoma should be considered as a possible cause of cystic lesions in the mediastinum. Minimally invasive surgery allows for complete resection and definitive pathological diagnosis., (Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Schwannoma is usually a benign tumor of nervous origin arising from Schwann sheath cells. It is an extremely rare tumour because of its low incidence and its retrovescical localization. Histological and immunohistochemical examinations confirm the histological type as well as the benign or malignant origin of schwannoma. Because of the risk of recurrence and malignant transformation, excision must be complete. We report the case of a 39 years old patient, hospitalized for chronic pelvic pain accompanied by a sensation of heaviness, lower urinary tract irritation and urinary hesitancy. Diagnostic imaging (ultrasound, CT scan, MRI) of the pelvis showed a left-lateralized retrovescical mass with a thin wall, measuring 68x70x70 mm exerting mass effect on the bladder and the sigmoid. The surgical procedure, a midline laparotomy, allowed the removal of a well encapsulated retrovesical mass. Histological and immunohistochemical examinations concluded to a benign schwannoma. Recidivism and malignant transformation, although rare after surgery, impose postoperative clinical monitoring and annual CT scanning.

Malignant peripheral nerve sheath tumors (MPNST) are rare nervous tumors usually located in the posterior mediastinum in the paravertebral gutters. We report the case of a non-smoking 62-year-old man who was admitted with a 4 months history of cough, hoarseness and shortness of breath. Physical examination noted a superior vena cava syndrome. CT scan of the chest revealed a right anterior and middle mediastinal mass compressing the superior vena cava, the ascending aorta, the right pulmonary artery, invading the superior root of the pulmonary vein and the right auricle. Flexible bronchoscopy showed extrinsic compression of the right main bronchus, the right upper lobe bronchus and intermedius bronchus. The patient underwent surgical biopsy of the mass by mediastinoscopy. Histological examination revealed a malignant peripheral nerve sheath tumor. The patient received a single cycle of chemotherapy (ifosfamid-adriamycin). Clinical course was marked by the fast worsening of the dyspnea and the general state. Patient died three weeks after the cure of the chemotherapy. This case is original by the exceptional clinical presentation of MPSNT with a superior vena cava syndrome and the very rare location of this tumor in the anterior and middle mediastinum., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

We report the case of a 55-year-old woman suffering from a type I neurofibromatosis (also known as Von Recklinghausen neurofibromatosis) who was diagnosed with a high-grade schwannosarcoma of the median nerve, between the upper third and the medium third of the arm, upon contact with the humerus, invading the humeral vessels. The oncologic treatment of this tumour consisted in the amputation of the arm through the surgical neck of the humerus. In order to create a laterothoracic claw, to bring a partial function of the upper limb back, we decided to realize a free fillet forearm flap. This composite flap was composed of the radius and the ulna, all the forearm muscles and the skin of the anterior side of the forearm. A humeroradial plate osteosynthesis was done and the flap was then harvested with the radial pedicle, and anastomosed to the axillar artery. This procedure gave our patient a functional stump, giving back the arm functionality, especially the claw movement., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Introduction: The schwannoma of the glossopharyngeal nerve is a rare etiology among the tumor masses developed in the parapharyngeal space., Case Report: We report the case of a 33 years old woman in whom a large schwannoma of the left glossopharyngeal nerve was discovered incidentally on a brain MRI. Respiratory evolutionary prognosis imposed trans-oral surgical treatment., Discussion: We discuss the diagnostic and therapeutic strategy for the benign tumors of the parapharyngeal space., Conclusion: The schwannoma of the glossopharyngeal nerve is a benign rare lesion. The difficulty lies on the surgical strategy and the choice of the approach. The functional suites are marked by difficulty swallowing and require intensive speech therapy.

Primary tumors of the trachea are very rare. In adults, the majority of them are malignant. Schwannomas are exceedingly rare benign tumors in the tracheobronchial tree. We report a case of a 37-year-old man who was hospitalized for increasing dyspnea. He had been treated for bronchial asthma for the last 4 years with no benefit. The CT scan of the chest and bronchoscopy identified a tracheal mass that was prolapsed in the left stem bronchus. The patient did not remain free of disease after endoscopic laser resection. So, surgical resection was made. The tumor was excised at its base. A segment of the left stem bronchus was removed and primary anastomosis was performed. The histopathologic diagnosis was of a benign schwannoma without malignant elements. There was no recurrence during the follow-up period. This case demonstrates that intratracheal masses should be considered in patients with dyspnea or in patients with asthma refractory to conventional therapy., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Schwannoma is a tumor that develops from nerve sheath. The authors report an original observation of a giant schwannoma developed in the arm depending on the musculocutaneous nerve. The diagnosis was based on MRI appearance. Confirmation of the diagnosis was made by histological examination. Surgical treatment was resection, taking care preserving adjacent nerve fibers. This allowed recovery without any sequela. Recurrence rate and potential for malignant transformation of this type of tumor is low., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Introduction: Malignant schwannoma is a rare peripheral nerve-sheath tumour. It represents 5 to 10% of soft tissue sarcomas according to Grobmyer et al. in 2008 [1]. The cervico-facial localisation is very rare, representing only 1% of mandibular tumours., Observation: We report a case of a 64-year-old male patient who developed a malignant schwannoma at the level of the inferior dental nerve. In spite of the initial complete resection of this lesion, the patient has developed a recurrence with a proximal extension. For this reason, he has been transferred to our centre, where we conducted a wide surgical resection, associated with a homolateral neck dissection and postoperative external radiotherapy. After 1 year of follow-up, we did not observe any recurrence., Discussion: Malignant schwannoma is a rare lesion which develops at the level of the peripheral nervous system sheath. Its cervico-facial localisation is very scarce, and its diagnosis is difficult to establish in spite of a complete radiological examination; definitive diagnosis depends on the histological examination. There is no strict consensus for the management of these lesions, however a wide surgical excision and neck dissection associated with or without postoperative radiotherapy and/or chemotherapy are the gold standard methods of treatment. The prognosis is usually bad due to the high risk of recurrence, sometimes difficult to diagnose., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Background: The accessory nerve schwannoma localized in spinal canal is extremely rare; only nine cases have been reported in the literature until now. We report a new case of schwannoma at the spinal root of accessory nerve., Observation: A young woman aged 30 had a high cervical spinal cord compression with respiratory problems. At admission, magnetic resonance imaging (MRI) showed a tumor compressing the spinal cord at C2 to the foramen magnum. The tumor was removed successfully and its origin from the left accessory nerve was confirmed peroperatively., Conclusion: Although schwannoma of the accessory nerve is exceptional, this entity should be considered as a differential diagnosis with the other tumors of the foramen magnum., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Introduction: Primary malignant schwannomas are rare neoplasms of nerve sheath origin, especially in the location of the head and neck where few cases are described in the literature., Report Case: We report the case of a 65-year-old male diagnosed with malignant schwannoma in the left cheek. The patient underwent surgery with wide local excision, reconstruction were made later by skin graft., Discussion: The treatment of choice is radical excision of the lesion with wide margins. In fact, to reduce local tumor recurrence, the use of adjuvant radiation or chemotherapy is still controversial., (Copyright © 2009 Elsevier Masson SAS. All rights reserved.)

Introduction: Scwhannomas are uncommon neurogenic tumors of the mediastinum. Most of them are located in the posterior mediastinum usually in the paralateral gutters. We report the case of an uncommon localisation of such a tumour appended to the right vagus nerve in the middle mediastinum., Case Report: The patient was 50 years old and complained of thoracic pain, shortness of breath and dysphagia. CT scanning of thorax and abdomen revealed a heterogeneous mass in the middle mediastinum, which was not visible on plain radiography. Further investigation included transoesophageal ultrasound and PET scan. The diagnosis was confirmed by histopathology after mini video-assisted thoracotomy. The schwannoma was entirely removed without any post-surgical complications., Conclusion: We report a novel case of schwannoma arising from the vagus nerve and review the diagnostic strategies. PET scanning has poor sensitivity and specificity and does not therefore contribute to confirm the diagnosis which depends on exploring the mediastimun surgically., (Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: Parapharyngeal space tumours are rare and mostly benign, and their access is difficult. The aim of the study was to define the optimal treatment of these tumours., Material and Methods: Clinical retrospective study, with histological, treatment, prognosis analysis of the parapharyngeal space tumours occurred between 1994 and 2012 and the surgical approach considerations., Results: 35 patients were included with a male sex ratio predominance (51.43%, p = ns). The mean age of diagnosis was 49 years. The majority of tumours were benign (75.76%, p < 0.001). 54.5% originated from salivary gland with a majority of pleomorphic adenomas (42.42%). The second most frequent aetiology found was schwannoma (21.21%). 2 patients refused the treatment. Accidentally discovered were frequent (28.57%). In the symptomatic forms, dysphagia dominated (25.71%). Oropharyngeal (20%) and/or cervical (17.14%) mass were rare. A CT scan and a MR imaging were performed in 82.86% and 71.43% of the cases. A fine needle aspiration cytology was achieved in 10 cases with a positive predictive value of 60%. The cervical submandibular trans digastric approach was the most accomplished (40%). Other approaches were also used: Trans oral (25.71%), parotidectomy (14.71%), combined trans oral and cervical or parotidectomy (14.71%) and the cervical approached associated to a mandibulotomy (5.71%). A complementary treatment was proposed in 85.7% of the cases of malignant tumours. Post-operative complications were dominated by Horner's syndrome (n = 3), a temporary facial palsy (n = 5), definitive (n = 1), a velar insufficiency (n = 1), persistent pain (n = 6)., Conclusions: The presence of 25% of malignant tumours and 40% of pleomorphic adenomas require removal of parapharyngeal tumours, even if non symptomatic.

Background: Schwannoma is generally a benign tumour developing from Schwann cells., Aim: To study epidemiological, clinical and pathological features of scwannoma., Methods: Retrospective study about 26 cases of cutaneous schwannoma collected in our department over 24 years., Results: Our patients were 12 females and 14 males. Mean age was 30 years. Clinically, schwannoma was a subcutaneous tumour which was painful in 11 cases. Individual tumours were located on the limbs (10 cases), on the head (9 cases) and the trunk (5 cases). Multiple tumours were seen in two patients. Histopathological examination confirmed the diagnosis of schwannoma in all cases. Treatment was complete surgical excision in all cases., Conclusion: Cutaneous location of schwannoma is not rare. Usually, and contrarily to our series, there is no sex predominance. Clinically, schwannoma is located on the limbs and head. The diagnosis is confirmed by histopathological examination. Malignant epitheloid schwannoma diagnosed in one of our patients is a rare tumour. Schwannomas usually grow slowly and are poorly invasive. Malignant degeneration is exceptional. Treatment is complete surgical excision.

Introduction: Tracheobronchial schwannoma is a rare benign airway tumour. There is no evidence to guide treatment for this condition., Case Report: A 76-year-old woman with a history of ischemic cardiomyopathy was hospitalized for dyspnoea with bronchial symptoms. Incidentally, the CT scan of the chest identified a tracheal mass. The bronchoscopy revealed a multilobar and regular whitish tumour with moderate vascularisation that was not causing obstruction. The patient was treated by complete resection with a rigid bronchoscope followed by cryotherapy. The histopathologic diagnosis was of a benign schwannoma without malignant elements. There was no recurrence during the follow-up period., Conclusions: There is no consensus as to the optimal management of tracheal schwannoma because of the rarity of this tumour. Our observation supports the use of endoscopic resection with the additional of local cryotherapy which may reduce the risk of recurrence., (Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Background: The salivary gland tumors are rare (less than 3% of all tumors) and poorly known. In fact, they are numerous and histologically difficult to diagnose., Aim: This work aims to point at the different histological types of salivary gland tumors, to draw out the principal epidemiological, clinical, radiological and histological characteristics, and to compare our cases to those of the literature., Methods: Accordingly, we performed a descriptive type study about 180 cases of salivary gland tumors from the departments of pathology and oto-rhino-laryngology of Habib Thameur hospital during 25 years, extending from April 1979 to December 2004., Results: Benign tumors were predominant (88%), while malignant ones represented 12% of our cases dominated by carcinomas. The sex-ratio was 0.96. Parotid gland location was the most frequent one, and pleomorphic adenoma was the most frequent tumor (62%)., Conclusion: Histological diversity of salivary tumors results in difficulties for differential diagnosis. These problems can be solved by a precise diagnostic approach and sometimes by an immunohistochemistry study.

Intraorbital schwannomas and solitary neurofibromas account for 2 to 5% of all operated intraorbital tumors. Without any known neurofibromatosis, their diagnosis is only suggested with the MRI data, which displays a heterogeneous signal that may mimic a cavernous angioma. Their treatment is solely surgical., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Benign tumors of the peripheral nerves come from ectodermic tissues. This chapter describes the most common forms: the schwannomas and the neurofibromas. Schwannomas have two possible patterns of cells: Antoni A and B types. Neurofibromas are most often associated with neurofibromatosis NF1 and may be localized, diffuse, or plexiform. The benign tumor structures account for the fact that they can be removed with or without preserving the concerned nerve. Malignant tumors (malignant peripheral sheath tumors) come from degeneration of neurofibromas in two out of three cases and have a poor prognosis.

Plexiform schwannoma is an exceptional schwannoma subtype. It's a benign nerve sheath tumor. Mainly, it's solitary, asymptomatic and slowly growing nodule that occurs in the subcutis or dermis. Histology gives the diagnosis. The authors report a case of solitary superficial plexiform schwannoma of the right forearm of a patient aged 22. A review of literature is done.

Introduction: In patients with a previous history of malignancy, the occurrence of a mediastinal mass with significant uptake of 18 Fluorodeoxyglucose on a PET-scan may lead to biopsy or resection., Case Report: We report the case of a posterior mediastinal mass, with significant uptake of 18 Fluorodeoxyglucose on PET- scan, in a patient with a previous history of testicular seminoma. The lesion was actually a benign schwannoma., Conclusions: In the case of a mediastinal mass with conventional imaging being in favour of a neurogenic tumour a PET scan cannot confirm benignity or malignancy.

The schwannoma is a benign tumour that can be eradicated; it usually occurs in the peripheral nerves of the upper limb. We report an exceptional localization in the axillary nerve. The diagnosis is based on the typical MRI appearance: in addition, confirmation of the diagnosis has to be made by histological examination. The surgical treatment by resection, taking care to preserve adjacent nerve fibres. This allows recovery without any after-effects since the recurrence rate as well as the potential for malignant transformation of this type of tumour is low.

Schwannomas are common ubiquitous benign tumours of the nervous sheaths. Among the various histopathological types, the pigmented schwannoma has to be distinguished from melanoma. We report a case of melanotic schwannoma of the cerebellopontine angle in a 52-year-old man with a slowly progressive cerebellar syndrome since 1978, who presented with a posterior cerebral fossa bleeding. Melanotic schwannoma is a rare form of schwannoma. The diagnosis remains difficult and melanotic schwannoma has been described as a part of the Carney complex. Distinguishing melanotic schwannoma from malignant melanoma is of paramount importance in planning the management, but these two tumours are probably sharing the same origin. It must be distinguished from classic schwannoma because its behaviour is unpredictable, requiring long-term follow-up.

Intrathoracic neurogenic tumors are rare and interest primarily the mediastinum. Their endobronchial localization is exceptional, a fortiori in the child. The authors report a case of endobronchial benign schwannoma in a 11 year-old-child treated by pneumonectomy.

Laryngeal schwannoma is a rare benign tumour of the larynx. Schwannomas derive from the Schwann cells. The majority occurs in supraglottic area and may arise at any age. Magnetic resonance imaging (MRI) is the best imaging tool for suggesting the diagnosis in the appropriate clinical context. Conservative surgery is the treatment of choice. These tumors have to be distinguished from neurofibromas. We report 2 cases of laryngeal schwannoma. The first one concerned an 8-month-old baby with a laryngeal stridor history which seemed to be related to laryngomalacia. The second case was a 22-year-old man with a 5-year history of dysphonia. On nasofibroscopic examination, a sub mucosal mass enlarged the posterior part of the right false vocal cord in both cases. Both CT scan and MRI sequences showed a well margined lesion in the same place. Histological biopsies identified a schwannoma. External surgeries were subsequently and successfully performed. Diagnosis (imaging), specific treatment (endoscopic or external surgery), and possible association of laryngeal schwannomas are discussed.

Introduction: Schwannoma is a rare peripheral nerve tumor of the orbit, the diagnosis of which can only be made with certainty by histopathological examination. We report our experience on the clinical, imaging, and surgical aspects of orbital schwannomas based on our series of six patients., Patients and Methods: We retrospectively reviewed the records of six patients managed at our institution for orbital schwannoma. The age, sex, presenting clinical signs and symptoms, pre- and postoperative visual acuities, magnetic resonance imaging (MRI) features, the surgical techniques employed, and the pitfalls encountered were recorded., Results: There were three female and three male patients. The mean age at diagnosis was 39.5 years. Decreased visual acuity and proptosis were the most common presenting signs. MRI studies showed that schwannoma was hypointense on T1- and slightly hyperintense on T2-weighted images. With the exception of degenerated or myxoid parts of the tumor, there was variable enhancement following gadolinium injection. The tumor was totally removed via the transconjunctival approach in five patients and through a subbrow cutaneous incision in one patient. There was no recurrence during a mean follow-up of 2.2 years., Conclusion: Most orbital schwannomas, whether intraconal or extraconal, can be safely excised through the transconjunctival approach. Meticulous dissection is mandatory to separate the tumor from its surroundings. Cryoextraction may not be advisable because of the risk of fragmentation of the tumor due to its weak pseudoencapsulation.

Introduction: In daily practice, the otorhinolaryngologist may face cases of facial tumors of sinonasal origin. Their diagnosis remains difficult based on clinical findings alone. Therefore, imaging techniques can guide the surgeon toward the correct diagnosis., Methods: A 14-year-old male presented with a history of headaches and nasal obstruction. Physical examination revealed a mass in the right nasal fossa., Results: A computed tomography scan showed an isodense lesion in the posterior half of the right nasal fossa, extending into the maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. Magnetic resonance imaging showed great enhancement upon gadolinium administration. The diagnosis of schwannoma was suggested after angiography was performed. The tumor was then resected via a transfacial approach with maxillozygomatic osteotomy. Pathologic examination confirmed the diagnosis of schwannoma., Conclusion: The definite diagnosis of a sinonasal tumor can be confirmed only histologically. However, preoperative radiological data can direct the surgeon toward the correct diagnosis and above all the most appropriate surgical approach.

Ventricular schwannomas are very uncommon. We report such a tumor in the right lateral ventricle of a 16-year-old young man. The various etiopathogenic hypotheses are discussed.