Cranial Nerve Neoplasms ; pathology ; Geniculate Ganglion ; pathology ; Humans ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology

Adolescent ; Cranial Nerve Neoplasms ; Facial Nerve ; Humans ; Male ; Neurilemmoma ; Parotid Region ; pathology

Adult ; Cranial Nerve Neoplasms ; diagnosis ; Facial Nerve ; pathology ; Female ; Glomus Jugulare Tumor ; diagnosis ; Humans ; Neurilemmoma ; diagnosis

Adult ; Cranial Nerve Neoplasms ; diagnosis ; Diagnostic Errors ; Facial Nerve ; pathology ; Hemangioma ; diagnosis ; Humans ; Male

Cranial Fossa, Middle ; pathology ; Cranial Nerve Neoplasms ; diagnosis ; pathology ; Facial Nerve Diseases ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; Tomography, X-Ray Computed

OBJECTIVETo determine if pathologic examination can be useful in both diagnosing cervical paraganglioma and deducing its vagal origin.

METHODSFour cases of vagal paraganglioma were studied by light microscopy and immunohistochemistry, with clinical and radiologic (computerized tomography and/or magnetic resonance imaging) correlation.

RESULTSAll patients were females and complained of upper neck mass with symptoms and signs of vagus nerve involvement, such as hoarseness of voice, ipsilateral vocal cord dysfunction and cough induced by drinking or local pressure. Radiological examination showed a tumor mass over the common carotid artery bifurcation, lying between the internal carotid artery and internal jugular vein. On gross inspection, the stump of the resected vagus nerve could be identified, with nerve bundles splaying over the tumor surface. Microscopically, the tumors showed a relatively uniform nesting arrangement (Zellballen pattern) of cells and were associated with rich sinusoidal vessels and fibrous stroma. Multiple myelinated nerve fibers were present in stroma and fibrous capsule of the tumor. Sometimes, invasion of nerve trunk by tumor cells was seen. Immunohistochemically, the tumor cells showed diffuse positivity for chromogranin A, neuron-specific enolase and synaptophysin. There was no expression of cytokeratin. The sustentacular cells and nerve bundles were highlighted by S-100 protein.

CONCLUSIONIn addition to the microscopic accurate diagnosis of paraganglioma, histopathologists can be of help in deducing the vagal origin of this tumor.

Cranial Nerve Neoplasms ; pathology ; Female ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Paraganglioma ; pathology ; Tomography, X-Ray Computed ; Vagus Nerve Diseases ; pathology

Adolescent ; Adult ; Child ; Cranial Fossa, Middle ; pathology ; Cranial Fossa, Posterior ; pathology ; Cranial Nerve Neoplasms ; diagnosis ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; surgery ; Trigeminal Nerve Diseases ; diagnosis ; pathology ; surgery

Cranial Fossa, Posterior ; Cranial Nerve Neoplasms ; diagnosis ; pathology ; Ganglioneuroma ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Skull Base Neoplasms ; diagnosis ; pathology ; Trigeminal Ganglion

OBJECTIVE: To evaluate the injuring and rehabilitation of lower cranial nerve after surgery of jugular foramen tumors. METHOD: The lower cranial nerve functions were analyzed retrospectively in 32 cases with jugular foramen tumors in the past six years, including 12 jugular glomus, 10 schwannomas, three meningiomas, one cholesteatoma, two giant cell tumors, one fibromatosis, one chondromyxosarcoma, one adenoid cystic carcinoma and one embryonal rhabdomyosarcoma. All patients received surgical procedures. Total tumor removal was achieved in 30 cases, subtotal and partial resection were performed on one case respectively. RESULT: One case was died of intracranial bleeding after surgery, the other 31 were followed-up with a period from one to six years. Normal lower nerve functions were observed in five cases and new nerve deficits were observed in eight cases. Eighteen cases with poor nerve functions before surgery experienced additional nerve injuring manifestations. Eight cases received tracheotomy in perisurgical period, in which three were transient and five went home with tubes. Twenty cases were compensated well after a short period, and six cases failed to compensate. With a long-term follow-up for these six patients, three cases had well functional rehabilitation, two were partially compensated, and one was decompensated. CONCLUSION Lower cranial nerve dysfunction was the most common complication after jugular foramen tumor surgery. Preoperative nerve function evaluations, protection of nerve during surgery and early postoperative functional rehabilitation training were the key to better prognosis.
Adolescent ; Adult ; Aged ; Child ; Cranial Nerve Injuries ; etiology ; prevention & control ; Cranial Nerve Neoplasms ; surgery ; Cranial Nerves ; pathology ; Female ; Humans ; Jugular Veins ; pathology ; Male ; Middle Aged ; Neurosurgical Procedures ; adverse effects ; Retrospective Studies ; Young Adult

Cochlear Nerve ; chemistry ; pathology ; Cranial Nerve Neoplasms ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Heart Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Neurilemmoma ; metabolism ; pathology ; S100 Proteins ; metabolism ; Vestibulocochlear Nerve Diseases ; metabolism ; pathology ; Vimentin ; metabolism