Acoustic neuroma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Acoustic neuroma may be classified into three subtypes based MRI, and into four subtypes based on microscopic histopathology.

Classification

Based on the MRI scan, acoustic neuromas can be classified into three subtypes:

• Entirely intracanalicular: The entire tumor is completely within the bony canal.
• Intracranial extension without brain stem distortion.
• Intracranial extension with brain stem distortion.

Based on microscopic histopathology, acoustic neuroma can be classified into four subtypes:

• Conventional schwannoma.
• Cellular schwannoma.
• Plexiform schwannoma.
• Melanotic schwannoma.
  • Conventional schwannoma: It is the most common.
  • Cellular schwannoma: It may mimic malignant peripheral nerve sheath tumor.
  • Plexiform schwannoma: It may mimic malignant peripheral nerve sheath tumor if cellular- especially in childhood.

    

    Plexiform schwannoma with high magnifaction.jpg

  • Melanotic schwannoma: It may be confused with melanoma.

    

    Psammomatous melanotic schwannoma.jpg

It is associated with psammomatous form (psammomatous melanotic schwannoma) and with a heritable disorder (Carney complex). The Carney complex, also known as Carney syndrome, NAME syndrome and LAMB syndrome, is a bunch of things that occur together due to some genetic problem. It consists of:

• Cutaneous lentigines
• Myxomas (skin (subcutaneous), subcutanous, heart).
• Endocrine neoplasms