Association of cavernous malformation within vestibular schwannoma: Immunohistochemical analysis of matrix metalloproteinase-2 and -9 - Case report

Hiroyuki Sakata, Miki Fujimura, Mika Watanabe, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

A 65-year-old man presented with a rare case of cavernous malformation with hemorrhage located within vestibular schwannoma. He had suffered hearing impairment for 20 years, and was admitted to our hospital with vertigo and ataxic gait. Neurological examination revealed hearing loss, facial nerve paresis, and left cerebellar ataxia. Magnetic resonance imaging demonstrated a left vestibular schwannoma 35 mm in diameter, as well as a heterogeneous area associated with hypointense rim within the tumor, indicating intratumoral hemorrhage. Subtotal removal of the tumor together with the fibrously encapsulated hematoma was performed through a left retrosigmoid craniotomy. Histological examination of the surgical specimen revealed cavernous malformation within vestibular schwannoma. Immunohistochemistry for matrix metalloproteinase (MMP)-2 and -9, and tissue inhibitors of metalloproteinase-2 showed strong expression in the endothelial cells of the cavernous malformation, but not in the interstitial structures. His symptoms significantly improved after surgery and he underwent gamma-knife therapy for the residual tumor. Cavernous malformations may show dynamic characteristics such as repeated hemorrhage and de novo formation. MMP-2 and -9, which are implicated in angiogenesis and hemorrhage, may be upregulated in such tumors.

Original languageEnglish
Pages (from-to)509-512
Number of pages4
JournalNeurologia medico-chirurgica
Volume47
Issue number11
DOIs
Publication statusPublished - 2007

Keywords

  • Cavernous malformation
  • Hemorrhage
  • Matrix metalloproteinase
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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