Giant cystic intraventricular schwannoma with chronic haemorrhage in an adolescent: diagnostic pitfalls and targeted literature review.

Authors

Xuchen Dong, Ji Xiong, Lu Liu, Rong Xu, Kai Quan

Published in

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. Volume 42. Issue 1. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

Intraventricular schwannomas are exceptionally rare; fewer than fifty cases have been documented since 1957. We report an adolescent case with massive cystic degeneration and chronic intratumoural haemorrhage, and synthesise the current literature.
Clinical, radiological, operative, and histopathological data for a 16-year-old male were collected prospectively. A targeted literature review (1957-2025) was performed. To ensure diagnostic accuracy, imaging characteristics were analysed exclusively in cases with documented CT or MRI findings.
A 16-year-old male presented with headache and left-arm tremor. CT/MRI demonstrated a 9.2 cm cystic, haemorrhagic mass in the right lateral ventricle. Gross-total resection was achieved; histology confirmed benign schwannoma (Ki-67 5%). A review of 46 cases (mean age 33.4 years; 63% ≤ 40 years; 65% male) revealed 95.7% had benign histology, and 74% of cases underwent gross-total excision, with no recurrence at a mean follow-up of 32 months. Among them, 42 cases had detailed CT/MRI data available; in this subgroup, 17 (40.5%) showed cystic degeneration, and 13 (31.0%) showed haemorrhage.
 Chronic haemorrhage and massive cystic degeneration can obscure the diagnosis of intraventricular schwannoma. Although these features may mimic malignant ventricular neoplasms, identifying specific signs such as haemosiderin deposition may provide critical clues for differential diagnosis. Accurate diagnosis requires clinico-radiological-pathological correlation. Complete microsurgical excision offers an excellent prognosis; however, elevated Ki-67 index warrants vigilant surveillance.

PMID:
42340430
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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