Abstract：
BACKGROUND: \"Watch, wait, and rescan\" (WWR) has an established place as a successful management option for a significant proportion of vestibular schwannomas (VS) as an alternative to microsurgical removal or stereotactic radiotherapy. VS may grow slowly and continuously, followed by stagnation or even shrinkage. We present two case reports of spontaneous shrinkage of VS along with a review of the literature.
METHODS: A 29-year-old female presented with a progressive history of visual blurring and intermittent diplopia over 2 months. A 29 mm of maximum intracranial diameter (ICD) VS with secondary obstructive hydrocephalus was diagnosed. The patient underwent a ventriculo-peritoneal shunt with resolution of her symptoms and opted for initial WWR management. Interval scanning between 2007 and 2014 showed progressive reduction in the maximum ICD together with reduction in the degree of central tumor enhancement. Maximum ICD at most recent follow up was 22 mm. A 28-year-old female was referred with right sensorineural deafness. A right VS of maximum ICD of 27 mm was diagnosed. Initial WWR management was planned after discussion. Serial imaging showed an initial increase in the size of the tumor followed by progressive reduction in size. The most recent follow up showed a maximum ICD of 20 mm.
CONCLUSIONS: Early WWR management can be associated with spontaneous shrinkage of VS over time. Prospective clinical study of larger numbers of such cases using the UK VS database may help to identify predictive factors for the spontaneous regression of VS.
METHODS: A 29-year-old female presented with a progressive history of visual blurring and intermittent diplopia over 2 months. A 29 mm of maximum intracranial diameter (ICD) VS with secondary obstructive hydrocephalus was diagnosed. The patient underwent a ventriculo-peritoneal shunt with resolution of her symptoms and opted for initial WWR management. Interval scanning between 2007 and 2014 showed progressive reduction in the maximum ICD together with reduction in the degree of central tumor enhancement. Maximum ICD at most recent follow up was 22 mm. A 28-year-old female was referred with right sensorineural deafness. A right VS of maximum ICD of 27 mm was diagnosed. Initial WWR management was planned after discussion. Serial imaging showed an initial increase in the size of the tumor followed by progressive reduction in size. The most recent follow up showed a maximum ICD of 20 mm.
CONCLUSIONS: Early WWR management can be associated with spontaneous shrinkage of VS over time. Prospective clinical study of larger numbers of such cases using the UK VS database may help to identify predictive factors for the spontaneous regression of VS.
摘要：
背景：\"观看，等等,和重新扫描（WWR）已成为相当大比例前庭神经鞘瘤（VS）的成功治疗选择，可替代显微外科手术切除或立体定向放射治疗。VS可以缓慢和连续地增长，其次是停滞甚至萎缩。我们介绍了两例VS自发收缩的病例报告以及文献综述。
方法：一名29岁女性，在2个月内表现出视觉模糊和间歇性复视的进行性病史。诊断出29mm的最大颅内直径（ICD）VS伴有继发性梗阻性脑积水。患者接受了脑室-腹膜分流术，症状得以缓解，并选择了最初的WWR管理。2007年至2014年的间隔扫描显示，最大ICD逐渐减少，中央肿瘤增强程度降低。最近一次随访的最大ICD为22mm。一名28岁的女性因右感音神经性耳聋而被转诊。诊断出最大ICD为27mm的右VS。经过讨论，计划了最初的WWR管理。连续成像显示肿瘤尺寸的初始增加,随后尺寸逐渐减小。最近的随访显示最大ICD为20mm。
结论：早期WWR管理可能与VS随时间的自发收缩有关。使用UKVS数据库对大量此类病例进行前瞻性临床研究可能有助于确定VS自发消退的预测因素。
方法：一名29岁女性，在2个月内表现出视觉模糊和间歇性复视的进行性病史。诊断出29mm的最大颅内直径（ICD）VS伴有继发性梗阻性脑积水。患者接受了脑室-腹膜分流术，症状得以缓解，并选择了最初的WWR管理。2007年至2014年的间隔扫描显示，最大ICD逐渐减少，中央肿瘤增强程度降低。最近一次随访的最大ICD为22mm。一名28岁的女性因右感音神经性耳聋而被转诊。诊断出最大ICD为27mm的右VS。经过讨论，计划了最初的WWR管理。连续成像显示肿瘤尺寸的初始增加,随后尺寸逐渐减小。最近的随访显示最大ICD为20mm。
结论：早期WWR管理可能与VS随时间的自发收缩有关。使用UKVS数据库对大量此类病例进行前瞻性临床研究可能有助于确定VS自发消退的预测因素。
