Multiple plexiform schwannomas in the plantar aspect of the foot: case report and literature review

Abstract

BackgroundPlexiform schwannoma (PS) is a rare, peripheral nerve sheath tumor arranged in a plexiform pattern.Case presentationWe report an unusual case of a 19-year-old woman, who complained of pain in the plantar aspect of the left foot. Magnetic resonance image (MRI) demonstrates three solitary nodules of varying sizes in the deep soft tissue of the plantar aspect of the foot that are homogeneously isointense to skeletal muscle on T1-weighted images and hyperintense on T2-weighted fat-suppressed images, especially the rim of the lesion. Subsequent pathological examination confirmed the diagnosis of PS.ConclusionMRI characteristic plays an important role in detecting this rare lesion. A review of the literature on PS is also presented.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-342) contains supplementary material, which is available to authorized users.

Giant plexiform schwannoma in the plantar aspect of the foot: a case report

“…These tumors present as single, soft-to-rubbery, movable, non-tender and sometimes painful nodules [3]. Trauma may play an etiological role in the formation of these lesions [2]. Most PSs are small, with a maximum diameter of approximately 2 cm and originate from superficial nerves [4].…”

“…MRI is a useful tool in the diagnosis of PS; the rims of PS nodules are smooth, and features of the lesions are similar to those of peripheral nerve sheath tumors, including heterogenous hyper- or iso-intensity to subcutaneous fat on T2-weighted MR images. It is reported that multinodular growth patterns in a single lesion and evident cystic degeneration on T2-weighted image are characteristics of PS, which are helpful in the differential diagnosis of these tumors [2]. PS consists of multiple intradermal or subcutaneous nodules composed primarily of cellular Antoni A regions with nuclear palisading and Verocay bodies [2].…”

“…It is reported that multinodular growth patterns in a single lesion and evident cystic degeneration on T2-weighted image are characteristics of PS, which are helpful in the differential diagnosis of these tumors [2]. PS consists of multiple intradermal or subcutaneous nodules composed primarily of cellular Antoni A regions with nuclear palisading and Verocay bodies [2]. In contrast to conventional schwannomas, PS grows in a plexiform pattern consisting of multiple interlacing and interconnecting fascicles and nodules, usually with the Antoni A features of a solitary schwannoma [5], but without Antoni B zones.…”

“…PS predominantly affects young adults aged 30–40 years, and it commonly occurs as a single, slow-growing, asymptomatic nodule in the dermis or subcutaneous tissue of the head, neck, trunk or upper extremities [1]. Until now, only 15 cases of PS in the foot have been reported [2]. Herein, we describe the case of a 53-year-old female with a large PS in the plantar aspect of her right foot.…”

Plexiform Schwannoma of the Tongue in a Pediatric Patient with Neurofibromatosis Type 2: A Case Report and Review of Literature

“…[ 1 , 5 ]. Plexiform schwannoma usually presents as an isolated finding, and although it is unassociated with NF1, it may occur in the setting of NF2 and schwannomatosis [ 3 , 6 – 10 ]. Malignant transformation in plexiform schwannoma has not been described, whereas plexiform neurofibroma carries a significant risk of malignant transformation, especially in NF1 patients, making this distinction important [ 9 , 11 ].…”