Benign schwannoma in supraclavicular region: a false-positive lymph node recurrence of breast cancer suspected by PET scan

Brachial plexus schwannoma mimicking advanced breast carcinoma

BACKGROUND

Schwannoma is an extremely rare benign tumour of the peripheral nervous system; its association with breast cancer is sporadic, and its association with the brachial plexus is extremely rare.

CASE DESCRIPTION

The authors report a case of a patient with breast cancer associated with nodulation in the left supraclavicular fossa, and due to the clinical and radiological features, it was considered metastatic lymph node disease. The patient underwent neoadjuvant chemotherapy, with partial response of the breast. Surgical treatment included resection of the supraclavicular nodule, which was found to be a supraclavicular fossa schwannoma. The correct diagnosis, influences the radiotherapeutic planning. The unusual presentation led to diagnostic confusion in the present case, a fact that changed the breast treatment.

CONCLUSION

The best of our knowledge it is the third description of brachial plexus schwannoma associated with breast cancer and the first with a synchronous association. The knowledge of this pathology and its potential to alter treatment justify the reporting of the present case.

Hepatic Schwannoma on 18F-FDG PET/CT

Schwannoma is a slow-growing benign tumor, which originates from Schwann cells and is usually asymptomatic. The most common sites of schwannomas are the head, neck, and extremities. However, a schwannoma located in the liver is extremely rare. Here, we report a 53-year-old woman with a hepatic lesion accidentally found by ultrasound. It was highly suggestive of hepatic cholangiocarcinoma by MRI. F-FDG PET/CT could not exclude hepatic malignant tumor due to its high metabolism. Finally, it was confirmed as hepatic schwannoma by postoperative pathology.

Solitary Benign Schwannoma Mimics Residual Malignancy on FDG PET/CT

Schwannomas can be seen in pediatric patients with neurofibromatosis and occur generally in the limbs. Solitary schwannoma rarely occurs in pediatric patients who do not have neurofibromatosis. A 15-year-old girl with Hodgkin lymphoma in the neck underwent follow-up FDG PET/CT scan to monitor the response to the chemotherapy. Although her lesions in the neck were no longer visualized, one focal activity in her left upper back persisted. Excisional biopsy result demonstrated benign schwannoma.

False Positive 18F-FDG Positron Emission Tomography Findings in Schwannoma-A Caution for Reporting Physicians

Schwannoma is a rare source of false-positive 18F-fluorodeoxyglucose (18F-FDG) uptake in Positron-emission tomography (PET/CT), inducing potential errors in staging of several solid cancer, with implications for patient management. This clinical case reports the situation of a patient undergoing an 18F-FDG-PET/CT for initial staging of an ovarian adenocarcinoma. We found a high paramediastinal hypermetabolic mass suspicious of remote extension or secondary synchronous primitive tumor. The biopsy finally reveals a histopathology of Schwannoma, allowing the patient to be eligible for a surgical procedure of her ovarian adenocarcinoma by rejecting the hypothesis of malignancy.