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Table 1 Summary of calcified VS cases

From: Calcification of vestibular schwannoma: a case report and literature review

Case Author/year Age/sex Duration of disease Symptoms and signs Radiological findings Surgical findings Postoperative complications
1 [Thomsen/1984] 44/male 2 years Progressive right-sided hearing loss with a unilateral sensorineural hearing impairment CT: a mass with a size of 2 × 3 cm with a conglomerate of dense calcification in the right CPA, moderate enhancement after contrast injection, normal internal auditory canal Approach: translabyrinthine craniotomy twice, subtotal removal of the tumor at the initial operation, and total removal of the tumor after 5 months Dysdiadokinesis
Mild facial palsy
     Examination: spontaneous nystagmus, gait disturbance, and a positive Romberg test   Tumor: whitish, hard, and highly vascularized  
2 [Beskin/1989] 47/male 15 years Progressive left-sided hearing loss with ringing and itching deep in the left canal MRI: Hypointensity on T1WI and hyperintensity on T2WI Approach: left posterior fossa craniotomy, total removal of the tumor after debulking Mild facial palsy
     Examination: no response in vestibular testing in the left labyrinth CT: a 3 cm mass with pronounced calcification in the left CPA, enhancement after administration of contrast medium, enlarged internal auditory canal Tumor: rubbery consistency  
3 [Atlas/1992] 50/male 2 years Progressive right-sided hearing loss with a unilateral sensorineural hearing impairment CT: a small mass in the right enlarged internal auditory canal with a conglomerate of dense calcification Approach: translabyrinthine craniotomy, total removal of the tumor with preservation of the facial nerve Complete palsy
     Examination: not described   Tumor: adhesion to the facial nerve  
4 [Tosaka/2002] 36/male 30 years Progressive left-sided hearing loss MRI: a mass with a size of 3.5 × 3 × 2.5 cm in the CPA, hypointensity on T1WI and hyperintensity on T2WI, heterogeneous enhancement after gadolinium administration Approach: left suboccipital craniotomy, removal of 90% of the tumor Hearing was worse on the left side after surgery than before surgery
     Examination: left hearing loss, left canal paresis CT: significant calcification on the tumor that protruded to the enlarged internal auditory canal Tumor: whitish, elastic, hard, fibrous, and demarcated with a rich blood supply No facial palsy
      DSA: no tumor stain   
5 [Katoh/2007] 59/female 15 years A long history of CPA tumor with no treatment, admitted to the hospital following an epileptic seizure MRI: a mass with a 3 cm diameter in the CPA, heterogeneous intensity on T1WI and T2WI, heterogeneous enhancement after gadolinium administration Approach: left suboccipital craniotomy, subtotal removal of the tumor No facial palsy
     Examination: left deafness, left nystagmus, and left cerebellar ataxia CT: circular calcification in the periphery of the tumor Tumor: yellow-grayish, soft, with rich blood supply and old hematoma inside the tumor  
      DSA: no tumor stain   
6 [Gopalakrishnan/2011] 65/male 3 years Progressive left-sided hearing loss with facial numbness MRI: hypointensity on T1WI, and heterogeneous hyperintensity on T2WI, heterogeneous enhancement after gadolinium administration Approach: left suboccipital craniotomy, total removal of the tumor  
     Examination: left hypoesthesia and facial palsy, and sensorineural hearing loss CT: a mass with a 3 cm diameter in the left CPA with a conglomerate of dense calcification, and enlarged internal auditory canal Tumor: not described Death due to myocardial infarction
7 [Gopalakrishnan/2011] 31/female 6 months Right-sided deafness with facial numbness MRI: hypointensity on T1WI, and heterogeneous hyperintensity on T2WI, homogenous enhancement after gadolinium administration Approach: left suboccipital craniotomy, total removal of the tumor  
     Examination: hypoesthesia on the right side of the face, and right sensorineural hearing loss CT: a mass with a 5 cm diameter in the left CPA with two local deposits of calcification at the periphery of the tumor, and enlarged internal auditory canal Tumor: not described Facial palsy (with unknown severity)
8 Present case 48/male 3 years Progressive left-sided hearing loss MRI: a mass with a size of 5.42 × 4.27 × 5.35 cm in the left CPA, hypointensity on T1WI, hyperintensity on T2WI, and heterogeneous enhancement in the contrast-enhanced MRI Approach: left suboccipital craniotomy, total removal of the tumor with preservation of the facial nerve No improvement in left hearing
     Examination: left hearing loss, left cerebellar ataxia CTA: a high-density patchy calcification on the left CPA, no intracranial artery malformation, and no tumor stain Tumor: yellow-grayish in color, soft and brittle in texture with a rich blood supply, and cysts found in the center of the tumor Mild facial palsy