Intrapelvic melanocytic schwannoma resection with computer-assisted navigation

Gerhardt, Caroline A.; Belzarena, Ana C.; Henderson-Jackson, Evita; Mullinax, John E.; Joyce, David M.

doi:10.1016/j.radcr.2020.09.021

Cited by 3 publications

(4 citation statements)

References 13 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PET/CT may be particularly useful to distinguish those with high malignant potential, to rule out occult metastatic disease/recurrence, and to monitor treatment response [14]. The efficacy of adjuvant radiotherapy in melanotic schwannoma is unclear and limited to a few case reports of conventionally fractionated radiotherapy to as high as 60 Gy [2,4,[6][7][8]15]. The role of radiotherapy after margin-positive surgical resection is controversial given the unclear efficacy, particularly given the discordance of early and recent reports on the malignant potential of melanotic schwannomas.…”

Section: Discussionmentioning

confidence: 99%

“…For localized disease, radical resection is preferred as incomplete resection is associated with tumor recurrence [6,8]. However, given these tumors often involve the nerve roots and are infiltrative, acquiring negative margins can be difficult without causing significant morbidity [8]. Radiotherapy and systemic therapy can be considered in these cases; however, robust data demonstrating efficacy are lacking given the rarity of this disease [1,5,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Given the rarity of this tumor, there is a paucity of data to guide optimal treatment. For localized disease, radical resection is preferred as incomplete resection is associated with tumor recurrence [ 6 , 8 ]. However, given these tumors often involve the nerve roots and are infiltrative, acquiring negative margins can be difficult without causing significant morbidity [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Post-operative Stereotactic Radiosurgery of Malignant Melanotic Schwannoma

Hall¹,

Chang²,

Wilson³

et al. 2022

Cureus

View full text Add to dashboard Cite

Melanotic schwannoma is an extremely rare schwannoma variant with malignant potential, demonstrating high local and distant recurrence. Given the paucity of data, recommended treatment with localized disease is radical resection, with the unclear benefit of adjuvant therapy. We present a case of an 18-year-old female with no past medical history or genetic syndromes who underwent margin-positive resection of an S1 nerve root melanotic schwannoma followed by adjuvant stereotactic radiosurgery (SRS). SRS was delivered without acute or late toxicity by 2.5 years post-treatment. She remains without evidence of recurrent disease, although longer follow-up is needed given the risk of late recurrence. Our case adds to the limited literature documenting the efficacy of adjuvant radiotherapy in melanotic schwannoma and is the first to describe the successful use of SRS for this rare disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post-operative Stereotactic Radiosurgery of Malignant Melanotic Schwannoma

Hall¹,

Chang²,

Wilson³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Laparoscopy is the current established approach for treating retroperitoneal and especially adrenal lesions due to lower postoperative pain and hospital stay, complication rate and comparable operative results [ 17 ]. Clinically, integration of intraoperative computer-guided navigation can decrease incidents of positive resection lines and therefore local recurrence rate [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Malignant psammomatous melanotic schwannoma mimicking adrenal cyst: case report

et al. 2022

View full text Add to dashboard Cite

Background Melanotic schwannoma is a melanin producing nerve sheath tumors. Rarely, it can be associated with psammoma bodies, called psammomatous melanotic schwannoma. Psammomatous melanotic schwannomas are associated in up to 10% of the cases with Carney’s syndrome. The rarity of the lesion, which may present at different localizations create difficulty in placing a correct initial diagnosis. Definitive diagnosis is made after complete tumor excision and pathomorphological evaluation. The prognosis depends on the anatomical localization, local invasion and presence of a high mitotic index. The main pathomorphological differential diagnosis includes schwannomas and other melanin producing tumors as melanoma. Case presentation We present a case of an 11-year-old female with cystic lesion adjacent to right adrenal gland, mimicking adrenal cyst. Ultrasound guided biopsy was undertaken due to the cystic appearance of the formation and the lack of certain diagnosis from the non-invasive diagnostic tests. No signs of cellular and nuclear atypism were observed. The diagnosis of benign endothelial cyst with spontaneous hemorrhage was suggested. The patient underwent transabdominal laparoscopic adrenalectomy en-bloc with the cyst to prevent spillage of the cyst content due to the intimate adhesion of the lesion to the adrenal gland and vena cava inferior. Pathomorphological examination revealed malignant psammomatous melanotic schwannoma. The adrenal gland was intact with no tumor infiltration. The patient was followed up on the 1st and 2nd month afterwards the surgery by MRI with no signs of local recurrence and postoperative complications. Conclusion Psammomatous melanotic schwannoma near adrenal gland are rare and present difficulty with exact preoperative diagnosis. Complete resection should always be provided. Laparoscopic surgery is feasible if radical excision is not compromised. Long-term follow-up and Carney’s syndrome surveillance after complete excision are recommended especially in young patients.

show abstract

Surgical management of sacral schwannomas: a 21-year mayo clinic experience and comparative literature analysis

et al. 2022

View full text Add to dashboard Cite

Introduction: Sacral and presacral schwannomas are rare and account for a minority of spinal schwannomas. We aim to present our institution's experience surgically treating sacral schwannomas over twenty-one years. Additionally, we assess the literature for surgical cases of sacral schwannomas to compare tumor characteristics and outcomes following resection.Methods: Data on demographics, presenting symptoms, lesion characteristics, surgical management, and outcomes were collected for 27 patients treated surgically for sacral or presacral schwannoma between 1997 and 2018 at all Mayo Clinic locations and compared to those of patients found in the literature.Results: We identi ed 31 studies in the literature containing 93 patients with sacral schwannoma treated surgically. Our patients and those in the literature experienced similar symptoms, with the most common symptom being pain and the least common being sexual dysfunction, and age at diagnosis. Most of our patients (59.3%) reported full recovery from preoperative symptoms, while a minority reported a partial recovery (33.3%) and no recovery (11.1%). A smaller percentage of patients found in the literature experienced full recovery (31.9%) and partial recovery (29.8%) but also no recovery (1.1%). Our patients experienced fewer complications (14.8% versus 25.5%). Conclusion:Outcomes of patients with sacral or presacral schwannomas vary based on patient demographics, tumor characteristics, symptoms, and surgical treatment. Among the range of symptoms experienced by these patients, the most common is pain. Prognosis improves and overall survival rate is high when the surgical approach towards sacral schwannomas is prepared and executed appropriately.

show abstract

Intrapelvic melanocytic schwannoma resection with computer-assisted navigation

Cited by 3 publications

References 13 publications

Post-operative Stereotactic Radiosurgery of Malignant Melanotic Schwannoma

Post-operative Stereotactic Radiosurgery of Malignant Melanotic Schwannoma

Malignant psammomatous melanotic schwannoma mimicking adrenal cyst: case report

Surgical management of sacral schwannomas: a 21-year mayo clinic experience and comparative literature analysis

Contact Info

Product

Resources

About