Giant paravertebral schwannoma near the lumbar nerve roots with bone destruction

Chen, Hangjun; Xu, Qiang; Zhan, Ping; Liu, Yuan; Dai, Min; Zhang, Bin

doi:10.1097/md.0000000000017341

Cited by 9 publications

(22 citation statements)

References 23 publications

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“…El término "Ancient schwannoma" fue acuñado por Ackerman y Taylor en 1951, para esta forma infrecuente de schwannoma; (5)(6)8,12,14) un subtipo histológico con escasas células tumorales, rodeadas por una matriz hialina, más rasgos de degeneración, asociada a una masa de lento crecimiento; (5,(6)(7)(8)(11)(12)14,16,(20)(21) esto podría sugerir malignidad, (1,3,5,8,11,13,(16)(17)(18)(19) y solo la falta de mitosis aboga por benignidad (5,(22)(23) . Se considera que, cambios degenerativos, formación de quistes, hemorragias, calcificación o hialinización, lleva a clasificarlos como schwannoma antiguo, (5,12) también ciertos cambios nucleares, pleomorfismo, lobulación, hipercromasia, encontrados en estos tumores.…”

Section: Discussionunclassified

“…Se encuentra entre los 20 a 50 años (2,3,5,(7)(8)12,15,(17)(18)22,26,28) o poco más (11,16,27) y solo 5% se diagnostican en la niñez (2,15) . Se refieren más frecuentemente en mujeres (3,5,8,(10)(11)(12)(21)(22) , siendo la relación mujer/hombre de 3:2 (5,8,12,24) . Nuestro paciente era varón, de 37 años.…”

Section: Discussionunclassified

“…El schwannoma maligno sería levemente más común en retroperitoneo (2,18) . Suelen medir entre 8 y 20 cm (1,2,16,21) (5 a 23 con media de 9) (22) . Suelen ser únicos (2,4,6,(16)(17) ; la multiplicidad suele darse en casos asociados a la neurofibromatosis de von Recklinghausen (7,10,17) , al igual que los casos familiares (7,29) .…”

Section: Discussionunclassified

“…Dado su lento crecimiento, estos tumores suelen diagnosticarse cuando alcanzan gran tamaño, por su efecto de masa (6) , o en forma incidental (4,7,10,15,17,19,30) . Las molestias, cuando están presentes, serían dolor vago abdominal, dolor en flancos (1)(2)(3)(4)7,14,17,19,(21)(22)24,26,29,34) , o bien remedar cólicos renales, síntomas compresivos de las vías urinarias (12,14) o desórdenes digestivos (2,15,26) . Suele encontrarse el antecedente de 1 a 6 años de duración; 1,6 algún paciente había notado la tumoración 10 años antes de la cirugía (6) .…”

Section: Discussionunclassified

“…Se han diagnosticado schwannomas en las glándulas adrenales, que se originarían en las cubiertas de las fibras que inervan las glándulas (23) ; los neurilemomas para-adrenales, difícilmente invadan las glándulas (23) . En las imágenes suelen mostrar superficie lisa (16,21) , estructura irregular, con componentes sólidos y quísticos y con calcificaciones periféricas (1)(2)(3)5,11,13,21,25) . Muestran realce con medio de contraste (4,6) , como pudo observarse en nuestro paciente (Figura 1: panel A).…”

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Ancient Schwannoma. A case report

et al. 2021

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Reporte de caso RESUMEN Se presenta un paciente con Schwannoma ancient retroperitoneal, intervenido quirúrgicamente por los autores. Se analizan aspectos de Schwannomas y las características particulares de los Schwannoma ancient. Se analiza la posibilidad de relacionarse con la enfermedad de von Recklinghausen, así como las posibilidades quirúrgicas, haciendo hincapié en la resección completa. Se analiza la escasa frecuencia de este tumor en el retroperitoneo.

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Ancient Schwannoma. A case report

et al. 2021

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Large lumbosacral schwannoma in a young female- a case report from Afghanistan

Monawary¹,

Zahid²,

Wardak³

et al. 2022

Annals of Medicine &Amp; Surgery

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Introduction Mobile Schwannoma is a rare soft tissue tumor that commonly involves the elderly population. It has no cellular material and grows as solitary, firm, oval, encapsulated benign tumors from the sensory (dorsal) nerve root. If multiple, they are usually associated with Neurofibromatosis type 2 (NF-2). The initial sign and symptoms include segmental pain and paresthesia. It may lead to myelopathy if the tumor expands. Case presentation We present a twenty-year-old female with chronic lower backache radiating to the ipsilateral thigh with no urinary or fecal incontinence. On physical examination, the ankle reflex was hypoactive on the left side, and the straight leg raise test was positive. A large 32 × 15 × 14 mm heterogeneous enhancing focal lesion was found on the posterior side of L5 and S1 vertebrae with severe central canal stenosis. A diagnosis of nerve sheath tumor was made based on contrast MRI pre-operatively. The underlying cause was a nerve sheath tumor. A total bilateral laminectomy at the L1-S5 level and mass excision was performed, preserving nerve roots. The postoperative period was uneventful, and no tumor re-growth was noticed. Clinical discussion Schwannoma is a slow-growing tumor; benign; usually, less than 8 cm in diameter tumor, commonly found in the head and neck region. It is the 3rd most common soft tissue tumor and the 2nd most common intradural extramedullary tumor. In our report, a young, non-Caucasian female patient is diagnosed with schwannoma, which is quite rare. In our case, a larger tumor of size 32 × 15 × 14 mm was noted, affecting the posterior body of L5 and S1 vertebrae in the left lateral recess with impingement of the left S1 traversing nerve root. Around 29% of spinal root nerve tumors are schwannomas. As the tumor grows slowly, the diagnosis may be delayed. Conclusion Schwannoma is a slow-growing solitary, firm, oval, encapsulated benign tumor arising from the sensory (dorsal) nerve root. Histopathology plays a vital role in diagnosis, and overall, the disease has a favorable prognosis. Therefore, an appropriate approach is necessary to rule out the disease.

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Giant schwannoma masquerading as other soft tissue tumors: A series of three cases

Sharma¹,

Sood

2023

IJPO

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Schwannoma is a benign peripheral nerve sheath tumor. It commonly occurs in head and neck region, upper extremities and dorsolumbar spine. The giant schwannoma as such is a rare occurring tumor. We present a series of three cases of giant schwannoma in unusual locations, masquerading as other soft tissue tumors.: Case 1: A 40-year-old male presented with a large exophytic ulcerated growth on his left thigh. The lesion was deep dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and immunohistochemistry (IHC) revealed the diagnosis of Benign Schwannoma with ancient changes. A 30-year-old woman presented with mid back ache and a mass in paravertebral location at T8 to T10 levels from last 2 years. The lesion was dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and IHC confirmed the diagnosis of Schwannoma with ancient changes. A 24-year-old male, presented with a 6x6 cm lesion over the scalp. It was well circumscribed, partially encapsulated with solid and cystic areas. Histologically, it turned out to be a Schwannoma. Giant schwannoma is a rare tumor which occasionally presents at unusual locations and poses a diagnostic challenge to both, the operating surgeon and the pathologist. These lesions clinically may mimic dermatofibroma, dermatofibrosarcoma and even trichilemmal tumors. These cases are being presented for their unusual presentation.

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Giant paravertebral schwannoma near the lumbar nerve roots with bone destruction

Cited by 9 publications

References 23 publications

Ancient Schwannoma. A case report

Ancient Schwannoma. A case report

Large lumbosacral schwannoma in a young female- a case report from Afghanistan

Giant schwannoma masquerading as other soft tissue tumors: A series of three cases

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