Acoustic neurilemmoma

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Abstract
Clinical data in 103 patients with acoustic neurilemmoma were correlated with anatomical findings. The tumors were more common in women. Peak prevalence was in the 5th and 6th decade without difference between the sexes. The neoplasms were divided into 4 sizes: small, medium, large and giant. Small (intracanalicular) tumors occurred more often in men, were of equal frequency in the decades from 20-70 yr, were generally associated with long duration of illness, were highly cellular and had few blood vessels. They differed from extracanalicular neurilemmomas, and are better considered as minimal rather than early tumors. Large and giant lesions occurred more often in women, were more heavily vascularized and collagenized, were more liable to bleed, contained fewer cells and were often associated with symptoms of short duration. The length of illness ranged from 1 mo. with a 6 cm lesion, to 30 yr with a 1 cm mass. Although most tumors enlarge slowly, the rate of growth may vary widely. The unilateral acoustic neurilemmoma that rarely occurs in the 1st 2 decades of life may be a limited form of von Recklinghausen''s disease. Mortality in this series was nil and hence was unrelated to size of tumor as described in earlier reports. Angiomas were found in 24 schwannomas and microscopic calcification in 4. Vascular spaces resembling cysts often were formed by tumor cells. The histological development of acoustic neurilemmoma is hypothetically reconstructed.

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