Abstract:Thirty-five patients with 37 peripheral nerve sheath tumors (NST) (16 schwannomas, 11 neurofibromas, 5 plexiform and 1 diffuse neurofibroma, and 4 malignant NST) were studied respectively. The benign NST usually appeared on CT as well-defined oval, spherical or fusiform masses, centered at the expected anatomic location of a cranial, spinal, autonomic or peripheral nerve with characteristic displacement of adjacent muscles and blood vessels. None of the schwannomas appeared homogeneously hypodense on IV enhanc… Show more
“…A typical image of schwannoma appears as homogeneous on CT before contrast administration and as heterogeneous with ring-shaped enhancement on contrast-enhanced scans [5][6]. Although target and fascicular signs are characteristic radiological features, these are not often observed in abdominal schwannomas.…”
Schwannomas, also known as neurilemmomas, are benign tumours arising from the sheath of peripheral nerves in the soft tissues of head, neck, extremities, mediastinum and retroperitoneum. Schwannomas are relatively slow-growing and mostly benign. Primary mesenteric schwannoma is extremely rare. In this report, we describe a 45-year-old female who presented with a lump in the abdomen caused by a benign schwannoma originating from the mesentery of the small bowel, which was treated with surgical resection and marsupialization of the remnant capsule on the posterior side. A high grade of suspicion is required to diagnose such a tumour. Ultrasonography is generally inconclusive, but histopathological examination can confirm diagnosis. The patient was followed up for six months without evidence of disease recurrence.
“…A typical image of schwannoma appears as homogeneous on CT before contrast administration and as heterogeneous with ring-shaped enhancement on contrast-enhanced scans [5][6]. Although target and fascicular signs are characteristic radiological features, these are not often observed in abdominal schwannomas.…”
Schwannomas, also known as neurilemmomas, are benign tumours arising from the sheath of peripheral nerves in the soft tissues of head, neck, extremities, mediastinum and retroperitoneum. Schwannomas are relatively slow-growing and mostly benign. Primary mesenteric schwannoma is extremely rare. In this report, we describe a 45-year-old female who presented with a lump in the abdomen caused by a benign schwannoma originating from the mesentery of the small bowel, which was treated with surgical resection and marsupialization of the remnant capsule on the posterior side. A high grade of suspicion is required to diagnose such a tumour. Ultrasonography is generally inconclusive, but histopathological examination can confirm diagnosis. The patient was followed up for six months without evidence of disease recurrence.
“…12 Unlike neurofibromas, which are highly associated with von Recklinghausen disease, schwannoma rarely has a malignant potential. 13 Schwannoma presents in various sizes, ranging anywhere from 2 to 20 cm in diameter. 7 Schwannoma is not usually localized in a specific area but can occur anywhere along the peripheral nervous system in the neck, mediastinum, pelvis, retroperitoneum, and upper and lower extremities.…”
Schwannoma is a benign, well-defined, and solitary nerve sheath tumor and accounts for 5% of all soft tissue tumors. It can occur anywhere along the peripheral nervous system. It is a slowly growing tumor and usually presents as a painless, discrete, and firm swelling before being diagnosed, unless it grows in a confined place. Preoperative diagnosis of schwannoma is often difficult. Computed tomography, magnetic resonance imaging, and sonography are useful imaging modalities in the preoperative assessment of nerve sheath tumors. Although imaging may not be reliable in distinguishing nerve sheath tumors from each other, certain imaging characteristics should raise the suspicion of schwannoma.
“…Although many radiological reports deal with the peripheral nerve sheath tumors, only a few include CT [4,11,16,21,24] or MRI findings [1,2,3,5,13,18,22,23,27,28,30] of schwannomas of the brachial plexus.…”
A correct preoperative diagnosis of schwannoma of the brachial plexus may be obtained by MRI, which shows a rather typical aspect; on the other hand, needle aspiration histology and open biopsies should be avoided. The microsurgical treatment with preservation of the neural structures, as for schwannomas of the cranial and spinal nerves, results in good outcome without recurrences.
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