Schwanoma Vestibular de Crescimento Rápido

The natural history of vestibular schwannomas is not yet fully understood. Most of these lesions have a tendency of slow growth, some of them without clinical manifestations during the patient´s life and the tumor may not be discovered until occasional autopsies. Improvements in the knowledge of skull base microsurgery anatomy as well as the development in neurophysiological monitoring skills, such as intraoperative monitoring, reduce the risk of injury to the facial nerve during vestibular schwannomas resection. Due to the feasibility of electroneurography and intraoperative facial monitoring, gross total surgical removal consists in the treatment of choice whenever possible. In selected cases, conservative treatment is still an accepted option , once follow up imaging control can be strictly done. Radiosurgery also represents a validtreatment choice and should be considered in the neurosurgical armamentarium. New studies concerning the development of chemotherapeutic agents (bevacizumab) may also change the overall assesment related to surgical indications. The article reports a middle-aged woman diagnosed with right vestibular intracanalicular schwannoma in 2006 and presenting with a rapid tumor growth pattern seen in follow-up exams five years later. The paper also present a complete literature review about the growth patterns of vestibular schwannoma as well as treatment options and follow-up of the lesion.