Vagal schwannoma – postoperative radiosurgery for residual tumor

SKULL BASE REGION Jugular foramen
HISTOPATHOLOGY Schwannoma originating from vagus nerve

Case description

The 30-year-old patient was incidentally found to have a large jugular foramen mass consistent with schwannoma on imaging ( Figure 10.51.1 ). Examination revealed normal cranial nerve function. The patient was offered observation, upfront stereotactic radiosurgery (SRS), and subtotal resection with postoperative SRS. He elected the retrosigmoid approach for subtotal resection with preservation of the lower cranial nerves, which confirmed a diagnosis of vagal nerve schwannoma ( Figure 10.51.2 ). This was followed by SRS treatment of the residual tumor at 5 months after surgery ( Figure 10.51.3 ).

Radiosurgery Machine Gamma Knife
Radiosurgery Dose (Gy) 15, at the 50% isodose line
Number of Fractions 1

Figure 10.51.1.

Initial preoperative MRI: A. Axial T1-weighted with gadolinium, brainstem interface. B. Axial T1-weighted with gadolinium, jugular foramen extent.

Figure 10.51.2

Postoperative MRI: Axial T1-weighted with gadolinium, residual tumor within the jugular foramen.

Apr 6, 2024 | Posted by in GENERAL RADIOLOGY | Comments Off on Vagal schwannoma – postoperative radiosurgery for residual tumor

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