{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:35:12Z","timestamp":1761006912111,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":6742,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1997,12]]},"abstract":"<jats:p>In articles and chapters on the subject of acoustic neuroma, it is almost invariably stated that they are well\u2010encapsulated tumors. During surgical procedures, blunt mechanical dissection defines a natural subsurface cleavage plane that leaves intact a several millimeter thick rind of tumor surface. Occasionally, as a concession to neural integrity, less than complete resection is elected, leaving behind this \u201ccapsular\u201d remnant. To clarify the nature of the surface of acoustic neuromas and to test whether this long held description is indeed correct, a microscopic analysis of 10 surgical specimens was performed. A wedge was harvested from the free surface of the tumor in the mid cerebellopontine angle that included a large, undisturbed section of the tumor surface. Histologic analysis showed that for most of the tumor surface only an extremely thin (3 to 5 \u03bcm) layer of connective tissue envelops the tumor. Neoplastic Schwann cells, which extend essentially to the margin of the tumor, were found to be somewhat flattened and compressed in the vicinity of the surface. Although acoustic neuromas are surrounded by a continuous layer of connective tissue, it is so exceptionally thin (on average less than the diameter of a red blood cell) that its edge cannot be visualized intraoperatively by a surgeon. Because the pathologic definition of a capsule is a thick, enveloping layer of connective tissue that is both micro\u2010 and macroscopically evident, it must be concluded that acoustic neuromas are nonencapsulated, at least in the conventional sense of the term. The surface peel observed intraoperatively is surgically produced during tumor debulking by cleaving of the looser central component from the more compressed portion of neoplastic cells that lies immediately beneath the free margin of the lesion.<\/jats:p>","DOI":"10.1016\/s0194-59989770040-8","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T13:37:57Z","timestamp":1664372277000},"page":"606-609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Are Acoustic Neuromas Encapsulated Tumors?"],"prefix":"10.1002","volume":"117","author":[{"given":"Timothy C.","family":"Kuo","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology, Pathology, and Neurosurgery University of California San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K.","family":"Jackler","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology, Pathology, and Neurosurgery University of California San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kondi","family":"Wong","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology, Pathology, and Neurosurgery University of California San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolas H.","family":"Blevins","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology, Pathology, and Neurosurgery University of California San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence H.","family":"Pitts","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology, Pathology, and Neurosurgery University of California San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"204","volume-title":"Tumors of the nervus acusticus and the syndrome of the cerebellopontine angle","author":"Cushing H.","year":"1917"},{"key":"e_1_2_5_3_1","unstructured":"Armed Forces Institute of PathologyTumors of the peripheral nervous system. 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