Diagnosis of Peripheral Nerve Sheath Tumors around the Pelvis

Ogose, Akira; Hotta, Tomomitsu; Morita, Tetsuro; Higuchi, Tetsuya; Umezu, Hajime; Imaizumi, Satoshi; Hatano, Hiroshi; Kawashima, Hiroyuki; Gu, Wenguang; Endo, Naoto

doi:10.1093/jjco/hyh072

Cited by 44 publications

(45 citation statements)

References 17 publications

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“…The degenerative changes including hemorrhage, xanthoma cells, cyst formation, vessels with hyalinized walls may be found. The proliferative index Ki-67 is positive in less than 5% of tumour cells [11]. Routinely the schwannomas cells strongly and diffusely express S-100 protein.…”

Section: Discussionmentioning

confidence: 97%

“…Malignant schwannomas act as a high grade sarcomas: give a local recurrence and distant metastasis. Von Recklinghausen's disease has a close association with malignant schwannomas [8,9,11].…”

Section: Discussionmentioning

confidence: 99%

“…It helps in differentiation this type of tumour from the malignant peripheral nerve sheath tumours (MPNSTs). Usually only scattered peripheral nerve sheath tumour cells express S-100 protein and, additionally, it happens in 50%-70% of the malignant peripheral nerve sheath tumours (MPNSTs) [5,11,[15][16][17].…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

et al. 2008

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AbstractA huge schwannoma, located in the retroperitoneal space, is found very rarely. The main purpose of this paper is to present the case of a giant retroperitoneal schwannoma which partly invaded L4 vertebral body. The secondary purpose is to summarize the case-report articles on retroperitoneal schwannomas. A circumscribed heterogenic tumour was revealed on transabdominal sonography. It extended into the right retroperitoneal space. CT and MRI revealed a paravertebral tumour in the size of 11 cm × 9 cm, which is causing a partial lysis of L4 vertebral body (15% of vertebral capacity), expanding intravertebral foramen and filling the right retroperitoneal space. A preoperative core needle biopsy was performed and a benign schwannoma was diagnosed. A complete surgical excision of the tumour was achieved by a two-step operation. During the first step, the neurosurgeons made L4 hemilaminectomy, facetectomy and a transverse process resection by posterior extended approach. The general surgeons excised the residual retroperitoneal part of the tumour by midline transabdominal approach 10 days later. The diagnosis of benign schwannoma was verified histochemically. There were no sign of tumour recurrence or spine destabilization at the six-month follow-up. In conclusion, although majority of giant retroperitoneal schwannomas can be completely removed performing one-step operation, a preoperative consideration about rationality of two-step operation should be mandatory when tumour destructs a part of vertebral body. Our case shows that the combined two stage complete surgical excision of a giant retroperitoneal schwannoma, eroding 15% of L4 vertebra’s osseous capacity, is effective and does not have any negative influence on spinal stability.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

et al. 2008

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“…The mean duration of symptoms has also been found to be significantly shorter in BPNT-STS than in BPNT patients (9.4 and 55.3 months, respectively). Symptom duration for BPNT varies from a few months to decades [7,8], whereas that of STS is shorter [1,4,17]. Therefore, patients with symptoms otherwise suggestive of BPNT but who present with painful lesions or relatively short symptom duration should be carefully assessed.…”

Section: Discussionmentioning

confidence: 99%

Soft tissue sarcoma misdiagnosed as benign peripheral neurogenic tumor

Kang

Yoo

Kim

et al. 2015

Journal of Orthopaedic Science

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“…These tumours may arise spontaneously in adults or may occur with increased frequency in patients with neurofibromatosis type I. MPNSTs have a reputation for rapid metastasis. Radiologically benign schwannomas are usually encapsulated but often appear as an inhomogeneous, hypervascular, bone-destructive mass, making differentiation from malignant schwannoma difficult [5] . Forty to fifty percent of benign periph- eral nerve sheath tumours display a central enhancement pattern in CECT and a 'target sign' in T2-weighted MRI which are rarely observed in MPNST [6] .…”

Section: Discussionmentioning

confidence: 99%

Large Pelvic Masses of Obscure Origin: Urologist’s Perspective

Kumar

Sarkar²,

Prasad³

et al. 2012

Urol Int

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Background: Large pelvic masses pose unique diagnostic and therapeutic challenges due to varied aetiology, paucity of characteristic imaging features, lack of therapeutic algorithms and surgical difficulties in resection inside the narrow confines of the pelvis with close proximity of vital structures. Methods: Records of 22 patients with large pelvic masses in the last six years were analysed. Their demographic and clinical features were noted, along with imaging features, preoperative biopsy, surgical procedure, intraoperative difficulties, complications, adjuvant therapy and outcome. Results: There were 14 men and 8 women with a median age of 45 years. Presenting symptoms were abdominal mass, pain, lower urinary tract symptoms, urinary retention and constipation. Imaging was mostly unable to determine the organ of origin of the tumour. Histopathology revealed pelvic fibromatosis (2), chondrosarcoma (1), liposarcoma (1), haemangioendothelioma (1), lymphangioma (2), fibroleiomyoma (1), leiomyosarcoma (3), schwannoma (4), malignant nerve sheath tumour (1), rectal gastrointestinal stromal tumour (1), retrovesical hydatid cysts (3), sacral chordoma (1) and Ewing’s sarcoma (1). In 5 patients complete excision was not possible because of extension into vital structures. Fifteen patients were alive at 1–5 years of follow-up. Conclusions: Urologists, being the ‘gatekeepers of the pelvis’, are usually involved in the management of large pelvic masses. Good outcome can be achieved with careful surgical planning.

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Diagnosis of Peripheral Nerve Sheath Tumors around the Pelvis

Abstract: Central enhancement pattern on imaging studies strongly suggests a benign tumor; in contrast, severe motor weakness suggests malignant lesions. Core needle biopsy was reliable with respect to preoperative diagnosis.

Cited by 44 publications

References 17 publications

Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

Soft tissue sarcoma misdiagnosed as benign peripheral neurogenic tumor

Large Pelvic Masses of Obscure Origin: Urologist’s Perspective

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