Schwannomas of the Left Adrenal Gland and Posterior Mediastinum

Abstract

Schwannoma is a rare tumor of neural crest cell origin. Most schwannomas occur in the head, neck, stomach or limbs, with a few cases occurring in the retroperitoneal space. A 30-year-old Taiwanese woman presented with a 1-week history of left anterior chest discomfort and left flank pain. The laboratory findings and endocrine studies were all within normal limits. Chest X-ray revealed masses in the posterior mediastinum. Chest computed tomography and magnetic resonance imaging showed several masses in the left paraspinal region and in the left adrenal region. The patient underwent total excision of the left paraspinal tumors and laparoscopic left adrenalectomy. Pathologic studies showed a picture of benign schwannoma. In conclusion, preoperative differentiation of benign schwannoma from malignant peripheral nerve sheath tumor or other tumors is important for good prognosis. Total excision of benign schwannoma is associated with favourable outcome in patients.

Adrenal Schwannoma: A Rare Type of Adrenal Incidentaloma

“…A metabolic workup typically includes serum electrolytes, cortisol, adrenocorticotropic hormone, aldosterone, renin, urinary catecholamines, metanephrines, vanillylmandelic acid, 17-ketosteroids, and 17-hydroxycorticoids. 2,7 The 1 case with abnormal laboratory findings showed an elevation of urinary catecholamines. 8 Imaging studies performed include abdominal ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI).…”

“…9 On MRI, the schwannoma shows low signal intensity on T1-weighted images and heterogeneous high signal intensity on T2-weighted images. 3,[6][7][8][9][10] The heterogeneous high signal intensity on T2-weighted images can be attributed to the alternating Antoni A and B areas, which will be discussed in more detail in the histopathology section. 9 Both CT and MRI are nonspecific in regard to the diagnosis of adrenal schwannomas.…”

“…None of these cases show evidence of recurrence or metastasis. 4,5,7,13 CONCLUSION Adrenal schwannoma, a type of adrenal incidentaloma, is rare. Correctly classifying this tumor can be challenging because imaging studies are nonspecific and many entities appear similar histologically.…”

Neurilemomma of the adrenal gland

“…Immunohistochemistry of adrenal neurilemomma shows strong and diffuse staining for S-100 .They also display pericellular reactivity for collagen IV, laminin, and show absence of reactivity for keratin, desmin, actin, muscle-related antigens, HMB-45, Melan-A, chro mogranin, synaptophysin, and CD34 [10].…”

Retrospective analysis of ten mediastinum schwannomas cases

“…Vücudun hemen her yerinde rastlanabilen schwannomlar, periferik motor, duyu, kranial sinir veya sempatik sinirlerin kılıflarından kaynaklanabilir (1) . İntratorasik yerleşimli schwannomlar; genellikle posterior mediastene yerleşir ve bu bölgedeki bütün tümörlerin yaklaşık %75'ini oluşturur (2)(3)(4)(5) . Genellikle asemptomatik olması ve çekilen toraks görüntüleme-lerinde düzgün sınırlı soliter kitle şeklinde saptanması nedeniyle farklı ön tanılarla değerlendirilebilmek-tedir.…”