{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:10:55Z","timestamp":1769731855038,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,8,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The prognosis for cancer patients has been improved because of the development of molecularly targeted drugs. Treatment of intracranial tumors must be personalized while prioritizing the treatment of comorbid cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A 38-year-old man presented with bloody sputum, bilateral multiple nodules, and a mass in the lower lobe of his right lung. Bronchoscopy revealed stage IV lung adenocarcinoma with an epidermal growth factor receptor (\n                      <jats:italic>EGFR<\/jats:italic>\n                      ) mutation. Screening head magnetic resonance imaging revealed a 38-mm-diameter mass in the left petroclival area. Because the patient was neurologically intact, the treatment of lung adenocarcinoma was prioritized, and the third-generation EGFR\n                      <jats:italic>\u2013<\/jats:italic>\n                      tyrosine kinase inhibitor osimertinib was used. Although nodules in the lung began to shrink, the intracranial lesion expanded and caused hydrocephalus, necessitating a ventriculoperitoneal shunt. The tumor also caused diplopia, dysarthria, and gait abnormalities. A left anterior transpetrosal approach was used to remove the tumor derived from the trochlear nerve. The pathological examination revealed schwannoma. Neurological symptoms improved following surgery. Osimertinib was continued during the perioperative period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Osimertinib was effective for lung adenocarcinoma but not for trochlear nerve schwannoma, which required surgical intervention. It is necessary to tailor the treatment of benign brain tumors in patients with concurrent malignant cancers.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24144\">https:\/\/thejns.org\/doi\/10.3171\/CASE24144<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24144","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T02:46:02Z","timestamp":1723430762000},"source":"Crossref","is-referenced-by-count":0,"title":["Trochlear nerve schwannoma with concomitant osimertinib-responsive stage IV lung adenocarcinoma: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Shunya","family":"Kashiwagi","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Tanji","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noritaka","family":"Sano","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Ozasa","sequence":"additional","affiliation":[{"name":"Departments of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Natori","sequence":"additional","affiliation":[{"name":"Departments of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan"},{"name":"Department of Respiratory Medicine, Kishiwada City Hospital, Kishiwada, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhide","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhide","family":"Makino","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuko","family":"Yamamoto Hattori","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukinori","family":"Terada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Mineharu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Arakawa","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Signal Transduct Target Ther","first-page":"201","article-title":"Small molecules in targeted cancer therapy: advances, challenges, and future perspectives","volume":"6","author":"Zhong","year":"2021","unstructured":"Zhong LLi YXiong L, et al. 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Neurosurgery. 2006;58(4):E791."},{"key":"bib19","series-title":"Case Rep Neurol Med","first-page":"672314","article-title":"The middle fossa approach for the removal of a trochlear schwannoma","volume":"2014","author":"Boucher","year":"2014","unstructured":"Boucher ABMichael LMII. The middle fossa approach for the removal of a trochlear schwannoma. Case Rep Neurol Med. 2014;2014:672314."},{"issue":"6","key":"bib20","series-title":"J Neurosurg","first-page":"1747","article-title":"Editorial. Classes of evidence in neurosurgery","volume":"126","author":"Rutka","year":"2017","unstructured":"Rutka JT. Editorial. Classes of evidence in neurosurgery. J Neurosurg. 2017;126(6):1747-1748."},{"issue":"1","key":"bib1","series-title":"Signal Transduct Target Ther","first-page":"201","article-title":"Small molecules in targeted cancer therapy: advances, challenges, and future perspectives","volume":"6","author":"Zhong","year":"2021","unstructured":"Zhong LLi YXiong L, et al. 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Dramatic growth of a vestibular schwannoma after 16 years of postradiosurgery stability in association with exposure to tyrosine kinase inhibitors. Otol Neurotol. 2021;42(10):e1609-e1613."},{"issue":"31","key":"bib8","series-title":"Future Oncol","first-page":"4045","article-title":"Neoadjuvant osimertinib with\/without chemotherapy versus chemotherapy alone for EGFR-mutated resectable non-small-cell lung cancer: NeoADAURA","volume":"17","author":"Tsuboi","year":"2021","unstructured":"Tsuboi MWeder WEscriu C, et al. Neoadjuvant osimertinib with\/without chemotherapy versus chemotherapy alone for EGFR-mutated resectable non-small-cell lung cancer: NeoADAURA. Future Oncol. 2021;17(31):4045-4055."},{"key":"bib9","series-title":"Lung Cancer","first-page":"151","article-title":"Osimertinib as neoadjuvant therapy in patients with EGFR-mutant resectable stage II-IIIB lung adenocarcinoma (Neos): a multicenter, single-arm, open-label phase 2b trial","volume":"178","author":"Lv","year":"2023","unstructured":"Lv CFang WWu N, et al. Osimertinib as neoadjuvant therapy in patients with EGFR-mutant resectable stage II-IIIB lung adenocarcinoma (Neos): a multicenter, single-arm, open-label phase 2b trial. Lung Cancer. 2023;178:151-156."},{"issue":"1","key":"bib10","series-title":"Lancet Oncol","first-page":"29","article-title":"Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial","volume":"14","author":"Bennouna","year":"2013","unstructured":"Bennouna JSastre JArnold D, et al. 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N Engl J Med. 2020;382(20):1894-1905."},{"issue":"3","key":"bib13","series-title":"Neurosurg Rev","first-page":"699","article-title":"Schwannoma of the trochlear nerve\u2014an illustrated case series and a systematic review of management","volume":"41","author":"Torun","year":"2018","unstructured":"Torun NLaviv YJazi KK, et al. Schwannoma of the trochlear nerve\u2014an illustrated case series and a systematic review of management. Neurosurg Rev. 2018;41(3):699-711."},{"key":"bib14","series-title":"World Neurosurg","first-page":"218","article-title":"Trochlear schwannoma arising from transition zone of nerve sheath in the pineal region: case report and review of the literature","volume":"137","author":"Lan","year":"2020","unstructured":"Lan YHLi YCChang CNZhang BLu YJ. Trochlear schwannoma arising from transition zone of nerve sheath in the pineal region: case report and review of the literature. 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