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Cerebrospinal fluid cytology to aid the diagnosis of cerebellopontine angle tumors.
Otol Neurotol. 2006 Jun; 27(4):553-9.ON

Abstract

OBJECTIVE

To determine if cerebrospinal fluid (CSF) cytology can be useful in the workup of patients with internal auditory canal/cerebellopontine angle (IAC/CPA) tumors and facial paralysis to diagnose metastatic disease before surgical intervention.

STUDY DESIGN

Retrospective case series.

SETTING

Tertiary referral center.

PATIENTS

Patients who presented with or developed facial paralysis and IAC/CPA tumors.

OUTCOME MEASURE

Lumbar puncture and CSF cytological analysis.

RESULTS

Seven patients presented with or developed high-grade facial paralysis (greater than House-Brackmann Grade II). In the first patient, excision of the tumor revealed adenocarcinoma. All subsequent patients were evaluated with CSF cytological analysis. In five of these patients, cytological CSF analysis revealed malignant cells, suggesting a diagnosis of a metastatic lesion rather than acoustic neuroma. Primary neoplasms were identified in all but one of these patients. A sixth patient had metastatic breast cancer, but negative CSF cytology and a stable CPA tumor after radiation treatment. Two patients who were being conservatively followed up for their IAC/CPA tumor developed a nonprogressive but persistent mild Grade II facial weakness and underwent CSF analysis which tested negative. One patient had surgical resection with pathologic findings consistent with a typical acoustic schwannoma, and the other patient has been conservatively followed up without change.

CONCLUSION

Our experience suggests that patients presenting with IAC/CPA tumors and progressive facial paralysis of House-Brackmann Grade III or greater should have a CSF cytological examination before surgical intervention to evaluate for a malignant process.

Authors+Show Affiliations

Department of Otorhinolaryngology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, and Midwest Otologic Group, St. Louis, Missouri, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16791049

Citation

Eisen, Marc D., et al. "Cerebrospinal Fluid Cytology to Aid the Diagnosis of Cerebellopontine Angle Tumors." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 27, no. 4, 2006, pp. 553-9.
Eisen MD, Smith PG, Judy KD, et al. Cerebrospinal fluid cytology to aid the diagnosis of cerebellopontine angle tumors. Otol Neurotol. 2006;27(4):553-9.
Eisen, M. D., Smith, P. G., Judy, K. D., & Bigelow, D. C. (2006). Cerebrospinal fluid cytology to aid the diagnosis of cerebellopontine angle tumors. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 27(4), 553-9.
Eisen MD, et al. Cerebrospinal Fluid Cytology to Aid the Diagnosis of Cerebellopontine Angle Tumors. Otol Neurotol. 2006;27(4):553-9. PubMed PMID: 16791049.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebrospinal fluid cytology to aid the diagnosis of cerebellopontine angle tumors. AU - Eisen,Marc D, AU - Smith,Peter G, AU - Judy,Kevin D, AU - Bigelow,Douglas C, PY - 2006/6/23/pubmed PY - 2008/1/9/medline PY - 2006/6/23/entrez SP - 553 EP - 9 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol Neurotol VL - 27 IS - 4 N2 - OBJECTIVE: To determine if cerebrospinal fluid (CSF) cytology can be useful in the workup of patients with internal auditory canal/cerebellopontine angle (IAC/CPA) tumors and facial paralysis to diagnose metastatic disease before surgical intervention. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Patients who presented with or developed facial paralysis and IAC/CPA tumors. OUTCOME MEASURE: Lumbar puncture and CSF cytological analysis. RESULTS: Seven patients presented with or developed high-grade facial paralysis (greater than House-Brackmann Grade II). In the first patient, excision of the tumor revealed adenocarcinoma. All subsequent patients were evaluated with CSF cytological analysis. In five of these patients, cytological CSF analysis revealed malignant cells, suggesting a diagnosis of a metastatic lesion rather than acoustic neuroma. Primary neoplasms were identified in all but one of these patients. A sixth patient had metastatic breast cancer, but negative CSF cytology and a stable CPA tumor after radiation treatment. Two patients who were being conservatively followed up for their IAC/CPA tumor developed a nonprogressive but persistent mild Grade II facial weakness and underwent CSF analysis which tested negative. One patient had surgical resection with pathologic findings consistent with a typical acoustic schwannoma, and the other patient has been conservatively followed up without change. CONCLUSION: Our experience suggests that patients presenting with IAC/CPA tumors and progressive facial paralysis of House-Brackmann Grade III or greater should have a CSF cytological examination before surgical intervention to evaluate for a malignant process. SN - 1531-7129 UR - https://www.unboundmedicine.com/medline/citation/16791049/Cerebrospinal_fluid_cytology_to_aid_the_diagnosis_of_cerebellopontine_angle_tumors_ L2 - https://doi.org/10.1097/01.mao.0000224093.87258.b4 DB - PRIME DP - Unbound Medicine ER -