Two cases of schwannoma with marked cystic changes

Wakoh, Mamoru; Yonezu, Hakubun; Otonari, Takamichi; Sano, Tsukasa; Matsuzaka, Kenichi; Inoue, Tan; Wada, Naohisa

doi:10.1259/dmfr/57066369

Cited by 28 publications

(28 citation statements)

References 23 publications

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“…FNAC in schwannomas may be inconclusive due to haemarhagic aspirate or inadequate cellular materials. 4 In our case FNAC was suggestive of brachial cleft cyst.…”

Section: Discussionsupporting

confidence: 48%

“…It shows low intensity flow void giving characterstic "salt and pepper" appearance and has delayed wash out time on diffusion weighted imaging. 4 CT scans show a homogenous regular hypodense swelling which slightly enhance on contrast.…”

Section: Discussionmentioning

confidence: 99%

“…More than 25 percent of schwannomas are found in head and neck but less than 5 percent are cystic in nature. 1 Rarely these tumors can masqurades as brachial cleft cyst.…”

Section: Introductionmentioning

confidence: 99%

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Cystic schwannoma of cervical sympathetic chain masquerading as type II second branchial cleft cyst

Bihani

Dabholkar

2015

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract"><span lang="EN-US">Brachial cleft cyst is the most common differential diagnosis of benign lateral neck swelling but other cystic swellings like carotid body tumours and cystic schwannomas should be kept in mind. MRI of neck is of great assistance in determining the nature of the swelling as fine needle aspiration cytology will fail in diagnosing such swellings accurately. We present a case of 22 year old female who presented with a slow growing swelling which was diagnosed as brachial cyst on FNAC and CT but turned out to be cystic schwannoma of cervical sympathetic chain which highlights the importance of considering various differentials of lateral neck swelling and limitation of FNAC and importance of pre-operative MRI in such cases.</span></p>

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“…FNAC in schwannomas may be inconclusive due to haemarhagic aspirate or inadequate cellular materials. 4 In our case FNAC was suggestive of brachial cleft cyst.…”

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cystic schwannoma of cervical sympathetic chain masquerading as type II second branchial cleft cyst

Bihani

Dabholkar

2015

Int J Otorhinolaryngol Head Neck Surg

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“…The findings of ECT mimicked metastatic lymph nodes, but no primary tumour was detected by the systemic imaging survey (Figure 2a). Schwannomas with cystic changes have been reported previously, 13,14 so radiologists should consider schwannoma based on their knowledge of the anatomy and the physical characteristics of nearby nerves when a well-defined, circular-type mass with an enhanced wall and cystic components with no invasion of the mass into the adjacent tissues is found by imaging.…”

Section: Discussionmentioning

confidence: 99%

Imaging findings of neurogenic tumours in the head and neck region

Kami¹,

Chikui²,

Okamura³

et al. 2012

Dentomaxillofacial Radiology

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Objective: The aim of this study was to describe the CT, MRI and ultrasonography findings of five cases of neurogenic tumours in the head and neck region. Methods: Five neurogenic tumours were analysed with respect to their CT value, the presence of cystic change, target sign, lobulation, connection to the nerve and vascularity. Results: The contrast-enhanced CT (ECT) of the schwannomas demonstrated either a mass with low enhancement (two out of three cases), which reflected the predominant Antoni B components, or a mass with cystic changes, which was an Antoni A-based schwannoma displaying cystic changes (one out of three cases). On MRI, all tumours showed homogeneous and isointense signals for muscle on T 1 weighted images (T 1 WIs). T 2 weighted images (T 2 WIs) and gadolinium (Gd)-enhanced T 1 WIs demonstrated target sign in both schwannomas. Ultrasound examination showed a well-defined, ovoid or round hypoechoic mass. The direct connection to the nerve was demonstrated in two of the five cases. Lobulation was observed in only one of the five cases and cystic changes were observed in one of the five cases. In all of the cases, no vascularity was seen in power Doppler images (PDIs) obtained percutaneously. Conclusions: Low-enhanced areas on ECTs can be specific for schwannomas, which suggests the predominance of Antoni B components. The target sign on T 2 WIs and Gdenhanced T 1 WIs can be specific, which can be used to differentiate the two different components (Antoni A and Antoni B). The direct connection to the nerve can be a specific finding for neurogenic tumours; however, at present the sensitivity is 40%.

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“…Wakoh et al 34 reported two cases of schwannoma displaying marked cystic changes; one in the temporalis muscle and one in the submandibular space. They concluded that MRI should depict the nerves and allow identification of the origin of a schwannoma.…”

Section: Discussionmentioning

confidence: 99%