Lumbar spinal malignant peripheral nerve sheath tumor arising from a benign neurofibroma

Abstract

We present the case of a 27-year-old man who had a soft-tissue lumbar spine mass causing back, abdominal, and groin pain. Imaging showed the lesion filling the right neural foramen, invading the anterior L2 vertebral body and both pedicles, and protruding into the central canal, causing compression of the thecal sac. The final pathologic diagnosis was a malignant peripheral nerve sheath tumor, with histologic evidence of a precursor neurofibroma. The patient did not have an underlying diagnosis of neurofibromatosis.

Solitary Malignant Peripheral Nerve Sheath Tumor of Lumbar Vertebra Mimicking Metastatic Malignancy

“…Finally, a diagnosis of solitary malignant peripheral nerve sheath tumor (MPNST) was made based on the features of pathology. Malignant peripheral nerve sheath tumor can be easily misdiagnosed because of its low incidence and the nonspecific clinical symptom and noncharacteristic imaging sign, especially the spinal MPNST 1–8 . In our case, the solitary bone destruction of the L1 vertebral body and left pedicle was diagnosed initially as bone metastasis based on its morphology and density on CT imaging.…”

“…Malignant peripheral nerve sheath tumor can be easily misdiagnosed because of its low incidence and the nonspecific clinical symptom and noncharacteristic imaging sign, especially the spinal MPNST. [1][2][3][4][5][6][7][8] In our case, the solitary bone destruction of the L1 vertebral body and left pedicle was diagnosed initially as bone metastasis based on its morphology and density on CT imaging. However, PET/CT revealed no evidence of extraosseous primary malignancy, which excluded the possibility of metastasis to a large extent.…”