PATH-83. Primary Intracerebral Schwannoma: a Systematic Review of Literature from 2000 to 2025

Schwannoma is the commonest tumor of the eighth cranial nerve. Presence of a schwannoma intracerebrally is an oncologic enigma. The prime aim of the study was to assess the clinicoradiological manifestations, surgical management and post-operative sequelae of primary intracerebral schwannoma (PIS). Methodology A thorough literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines via PubMed. Case reports and case series published between 2000 and 2025 were included using advanced search and Boolean strategy. Total 32 studies, amounting to 34 patients were included in the review according to set criteria and quality assessment in accordance with Johanna Briggs critical appraisal checklist. A mean age of 29.63± 18.23 years with a clear male preponderance, 67.6% (23) was noted at presentation. Headache in 44.1% (15) and facial weakness in 14.7% (5) were the commonest symptoms and signs at presentation respectively. Front lobe was the most frequent site in 41.2% (14) cases. The lesion was hypointense on T1 weighted images in 35.3% (12) cases and hyperintense on T2 weighted images in 29.4% (10) cases. Metastasis in 8.9% (3) was the commonest differential diagnosis. Gross total resection was achieved in 70.6% (24) cases. Spindle cells were encountered on microscopy in 67.6% (23). S100 was the commonest immunohistochemical marker positive in 82.4% (28) cases. Transient dysphagia, cough and dysarthria were the post-operative complications in 2.9% (1) cases each. About 8.9% (3) cases presented with local recurrences. Average follow up duration was 21.72 months. PIS is a rare entity that is no different from classic vestibular schwannoma. The varying clinical manifestations, radiological and surgical characteristics depend on the location of the tumor within the brain parenchyma. On imaging, it mimics common neoplastic lesions, making histopathology a key diagnostic investigation.