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Tsuchiya T, Ikemura M, Miyawaki S, Teranishi Y, Ohara K, Ushiku T, Saito N. Clinical and radiological features of intracranial ancient schwannomas: a single-institution, retrospective analysis. Brain Tumor Pathol 2024; 41:73-79. [PMID: 38578531 PMCID: PMC11052856 DOI: 10.1007/s10014-024-00482-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
Ancient schwannoma (AS) is a subtype of schwannoma characterized by slow progression despite degenerative changes in pathology. Although it is considered a benign tumor, most previous reports have focused on extracranial AS; therefore, the clinical characteristics of intracranial AS is not clear. We included 174 patients who underwent surgery for sporadic intracranial schwannoma, and 13 patients (7.5%) were diagnosed with AS. Cysts were significantly more common in patients with AS than conventional schwannomas (92.3% vs. 44.7%, p < 0.001), as was bleeding (38.5% vs. 6.9%, p = 0.003) and calcification (15.4% vs. 1.3%, p = 0.029). The maximum tumor diameter was also larger in patients with AS (35 mm vs. 29 mm, p = 0.017). The median duration from symptom onset to surgery (7.0 vs. 12.5 months, p = 0.740) did not significantly differ between groups, nor did the probability of postoperative recurrence (p = 0.949). Intracranial AS was strongly associated with cyst formation and exhibited a benign clinical course with a lower rate of recurrence and need for salvage treatment. Extracranial AS is reportedly characterized by a slow progression through a long-term clinical course, whereas intracranial AS did not progress slowly in our study and exhibited different clinical features to those reported for extracranial AS.
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Affiliation(s)
- Takahiro Tsuchiya
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masako Ikemura
- Department of Pathology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Yu Teranishi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenta Ohara
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Srinivas M, Nichkaode P, Sharma B, Haval S. Schwannoma as Extraspinal Swelling Over the Thoracolumbar Region: A Tumor at a Rare Site. Cureus 2024; 16:e58157. [PMID: 38741800 PMCID: PMC11089267 DOI: 10.7759/cureus.58157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
This case report describes an unusual presentation of schwannoma, a typically benign and solitary tumor originating from Schwann cells in peripheral nerves. While the literature on extraspinal schwannomas is limited, this report discusses the case of a 21-year-old female with complaint of a back swelling persisting for two years, causing discomfort during sleep. The oval-shaped swelling, measuring 7x6 cm, was located over the T11-T12-L1 vertebrae, with normal overlying skin, pinchable hardness, and fixation to the vertebrae. The patient had no history of pain or weakness in the lower limbs. Fine-needle aspiration cytology (FNAC) yielded inconclusive results. X-ray imaging of the thoracolumbar spine revealed a soft tissue shadow over the T11-T12-L1 vertebrae. The patient underwent complete surgical excision through a vertical incision, emphasizing the importance of preoperative imaging for accurate diagnosis, optimal surgical planning, and ensuring procedural safety.
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Affiliation(s)
- Manu Srinivas
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Prabhat Nichkaode
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Bijay Sharma
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Shriya Haval
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
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Attia H, Agboola JO, Seong G, Thida A, Chiu E, Agaronov M. Synchronous Pelvic Schwannoma With Metastatic Prostate Cancer: A Rare Case and Pathology Review. Cureus 2024; 16:e52356. [PMID: 38361727 PMCID: PMC10867882 DOI: 10.7759/cureus.52356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Schwannomas are benign tumors arising from well-differentiated Schwann cells of peripheral nerves. They are usually found on the limbs, head, and neck. It is uncommon for schwannoma to occur in the pelvis and when it does, it is often diagnosed late. Pelvic schwannoma when diagnosed are often bigger in size (>5 cm) and may present with local symptoms such as constipation and bladder outlet obstruction. We hereby present a patient with concurrent metastatic prostate carcinoma and pelvic schwannoma. The patient is a 57-year-old man initially diagnosed with prostate cancer and was lost to follow-up. One year later, he presented with metastatic prostate disease and bladder outlet obstruction. Further evaluation revealed a concurrent pelvic mass that was increasing in size. The biopsy of this mass was suggestive of schwannoma. It was decided at the multidisciplinary tumor board conference to offer treatment for his metastatic prostate disease and observe the schwannoma. His obstructive symptoms worsened in the face of clinical evidence of regression of his prostatic disease, and it was decided to resect the pelvic mass. The surgery revealed a huge soft tissue mass within the pelvis that was adherent to the bladder, prostate, and rectum. Morphology and immunohistochemistry studies of the pelvic mass confirmed the diagnosis of ancient schwannoma. We hereby highlight the clinical importance of this presentation and the diagnostic and therapeutic dilemma involved in the management of this patient who presented with two pathologic conditions causing similar symptoms but of different prognostic and therapeutic significance.
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Affiliation(s)
- Hagar Attia
- Pathology and Laboratory Medicine, Kings County Hospital Center, New York, USA
- Pathology and Laboratory Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - John O Agboola
- Pathology and Laboratory Medicine, Kings County Hospital Center, New York, USA
- Pathology and Laboratory Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Gyuhee Seong
- Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Aye Thida
- Hematology and Oncology, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Edwin Chiu
- Hematology and Oncology, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Maksim Agaronov
- Pathology and Laboratory Medicine, Kings County Hospital Center, New York, USA
- Pathology and Laboratory Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
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Işık K, Odabaşı Z. Proximal median neuropathy due to schwannoma: Two case reports. Turk J Phys Med Rehabil 2023; 69:553-555. [PMID: 38766583 PMCID: PMC11099865 DOI: 10.5606/tftrd.2023.10604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/05/2022] [Indexed: 05/22/2024] Open
Abstract
Although schwannoma is the most common benign tumor of the peripheral nervous system, median nerve schwannomas are extremely rare. These cases are usually silent and may get misdiagnosed. In this article, we presented two cases of schwannoma. They presented with normal electroneuromyography in their routine evaluation, and the provisional clinical diagnosis was median neuropathy. After examining the upper elbow segment, the definitive diagnosis was proximal median neuropathy, which was histopathologically confirmed.
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Affiliation(s)
- Kübra Işık
- Department of Neurology, Suruç State Hospital, Şanlıurfa, Türkiye
| | - Zeki Odabaşı
- Department of Neurology, University of Health Sciences, Gülhane Medical School, Ankara, Türkiye
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Neupane D, Dahal A, Lageju N, Jaiswal LS, Mahat A, Kafle S, Poudel P, Pandit N, Singh SK, Ghimire S, Dhonju K. Median nerve schwannoma with a diagnostic delay of 8 years: a case report. Ann Med Surg (Lond) 2023; 85:5239-5241. [PMID: 37811092 PMCID: PMC10553072 DOI: 10.1097/ms9.0000000000001236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/17/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Schwannomas are benign tumors of the peripheral nerve sheath, and the median nerve is the most commonly involved nerve. These benign tumors of the peripheral nerve sheath are very rare; they are clinically and radiologically similar to most other benign swellings of the hand; thus, they are often misdiagnosed. Case Presentation A 41-year-old lady presented with an 8-year-long history of swelling over the distal forearm. The tumor measured 3.5×3.5×3.5 mm and was located over the flexor aspect of the distal part of her right forearm. Schwannoma was suspected from the clinical presentation and imaging, but the final diagnosis was established only after the surgery and histopathological analysis. At the follow-up after 1 year, the patient is doing well and her symptoms have not recurred. Conclusion Imaging characteristics of schwannoma can be misinterpreted as some other condition, making the preoperative diagnosis very difficult and important. Thus, clinicians should be aware of such swellings, especially those that have been unnoticed or misdiagnosed, and provide optimal diagnoses to confer good outcomes.
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Affiliation(s)
| | - Alok Dahal
- Department of Surgery, Division of Neurosurgery
| | | | - Lokesh S. Jaiswal
- Department of Surgery, Division of CTVS, B.P. Koirala Institute of Health Sciences, Dharan
| | | | | | - Prabhat Poudel
- Department of Surgery, Nepal Medical College Teaching Hospital
| | - Narendra Pandit
- Department of Surgical Gastroenterology, Birat Medical College, Morang, Nepal
| | | | - Sagun Ghimire
- KIST Medical College and Teaching Hospital, Lalitpur
| | - Kiran Dhonju
- Nepalese Army Institute of Health Sciences, Kathmandu
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Tsuchiya T, Miyawaki S, Shinya Y, Teranishi Y, Tomioka A, Yamazawa S, Shin M, Saito N. Intracranial ancient schwannoma originating from vestibular nerve: A case report and review of the literature. Surg Neurol Int 2022; 13:143. [PMID: 35509536 PMCID: PMC9062893 DOI: 10.25259/sni_71_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Ancient schwannoma (AS) is a subtype of schwannoma with degenerative features, which often progresses slowly over a long period of time. Intracranial AS is a rare benign tumor and there are no detailed reports of AS originating from the vestibular nerve. Case Description: Herein, we present the case of a patient with the right vestibular schwannoma with multiple meningiomas and review three previous cases of intracranial AS. Near-total resection was performed for vestibular schwannoma and the pathological findings were AS (World Health Organization Grade I). Five months postoperatively, gamma knife radiosurgery was performed for a recurrent lesion of the right vestibular schwannoma in the internal auditory meatus. Although AS is known to be a benign pathology, there are cases of rapid growth and early recurrence, as the one presented here. The high Ki-67 index (up to 5%) and the presence of cysts may be related to the rapid progression of intracranial AS. Conclusion: Therefore, careful follow-up is necessary even if adequate removal is achieved. In addition to pathological studies, the genetic background of intracranial AS warrants future investigations. Further accumulation of cases is necessary to clarify the clinical features of intracranial AS.
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Affiliation(s)
- Takahiro Tsuchiya
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Yuki Shinya
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Yu Teranishi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Arisa Tomioka
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Sho Yamazawa
- Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahito Shin
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, and
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Partially intraosseous schwannoma of the distal humerus with increased enhancement after biopsy: Radiologic-pathologic correlation. Radiol Case Rep 2022; 17:1194-1200. [PMID: 35169427 PMCID: PMC8829534 DOI: 10.1016/j.radcr.2021.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 11/20/2022] Open
Abstract
Intraosseous schwannomas are rare benign tumors that most often occur at the mandible or sacrum. We present an unusual case of a bilobed schwannoma of the distal humerus with both intraosseous and extraosseous components. The extraosseous component was non-enhancing on initial MRI and enhanced on a subsequent MRI obtained after biopsy. We hypothesize that this change was attributable to decreased intra-tumoral pressure secondary to biopsy-related disruption of the tumor capsule.
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8
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Moond V, Diwaker P, Golamari R, Jain R. Intramuscular ancient schwannoma of the axillary nerve. BMJ Case Rep 2021; 14:14/5/e239445. [PMID: 34031064 DOI: 10.1136/bcr-2020-239445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We present the case of an adolescent with an intramuscular ancient schwannoma of the axillary nerve which, to the best of our knowledge, has not been reported before. Due to its deep location, intramuscular schwannoma has less clinical signs and hence, is difficult to diagnose. Ancient schwannoma, characterised by degeneration due to long course, is rare and can be mistaken for malignancy due to heterogeneous intensity and degeneration evident on MRI and nuclear atypia on histopathology. It is important to differentiate it from malignancy based on a clinically benign swelling with a long history, well-encapsulated mass on MRI with the split fat sign and absence of significant mitotic activity despite nuclear atypia. The aim of surgery should be enucleation of the tumour while preserving the function of the parent nerve.
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Affiliation(s)
- Vishali Moond
- Medicine, University College of Medical Sciences, Delhi, Delhi, India
| | - Preeti Diwaker
- Department of Pathology, University College of Medical Sciences, Delhi, Delhi, India
| | - Reshma Golamari
- Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Rohit Jain
- Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
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Unnithan AKA, Joseph A. Schwannoma of median nerve: Case report and review of literature. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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10
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Coulibaly O, Salloum C, Potelon P, Lerintiu F, Mortada J, Srour R. Femoral nerve schwannoma misdiagnosed as an inguinal herniation: A case report and review of the literature. Neurochirurgie 2019; 65:100-102. [PMID: 30905384 DOI: 10.1016/j.neuchi.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 11/17/2018] [Accepted: 12/27/2018] [Indexed: 11/25/2022]
Affiliation(s)
- O Coulibaly
- Department of neurosurgery, hôpitaux civils de Colmar, 68000 Strasbourg, France; Department of neurosurgery, hôpital du Mali, Bamako, Mali.
| | - C Salloum
- Department of neurosurgery, hôpitaux civils de Colmar, 68000 Strasbourg, France
| | - P Potelon
- Department of neuroradiology, hôpitaux Civils de Colmar, 68000 Strasbourg, France
| | - F Lerintiu
- Department of neuropathology, hôpitaux civils de Colmar, 68000 Strasbourg, France
| | - J Mortada
- Department of neurosurgery, hôpitaux civils de Colmar, 68000 Strasbourg, France
| | - R Srour
- Department of neurosurgery, hôpitaux civils de Colmar, 68000 Strasbourg, France
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Aref H, Abizeid GA. Axillary schwannoma, preoperative diagnosis on a tru-cut biopsy: Case report and literature review. Int J Surg Case Rep 2018; 52:49-53. [PMID: 30316135 PMCID: PMC6187017 DOI: 10.1016/j.ijscr.2018.09.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 12/26/2022] Open
Abstract
Although Axillary Schwannoma is a rare condition, physicians should recognize it as a part of their differential diagnosis of an axillary swelling. Preoperative utilization of Tru-cut biopsy in diagnosing this condition will further help surgeons to plan proper surgical treatment. The author recommends utilizing an intraoperative nerve stimulator to facilitate nerve preservation during excision; aiming to provide optimal management and better outcome.
Introduction Schwannoma is a benign encapsulated tumor of the peripheral nervous system which is mainly located in the head and neck. However, axillary Schwannoma is rare. In this article, the author presents an interesting case of a right axillary Schwannoma, where the diagnosis was preoperatively made on a Tru-cut biopsy. Case presentation We report a case of an enlarged right axillary swelling in a sixty-year-old male. Proper radiologic workup was performed. Furthermore, a Tru-cut biopsy was taken which revealed evidence of schwannoma. Having such symptomatic lesion, operative excision was done with the use of a nerve stimulator, which aided in preserving nerve function. Conclusion With such non-specific presentation, axillary Schwannoma may be easily missed and mismanaged. A Tru-cut biopsy may provide great help in expert hands, aiding operative planning; likewise in the case we are presenting. Furthermore, utilizing an intraoperative nerve stimulator will facilitate nerve preservation.
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Affiliation(s)
- Hager Aref
- Department of Surgery, International Medical Center, P.O. Box 1716, Jeddah 21441, Saudi Arabia.
| | - Georges A Abizeid
- Department of Surgery, International Medical Center, P.O. Box 1716, Jeddah 21441, Saudi Arabia.
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12
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Paulo D, Semonche A, Tyagi R. Surgical Management of Lumbosacral Giant Invasive Spinal Schwannoma: A Case Report and Literature Review. World Neurosurg 2018; 114:13-21. [DOI: 10.1016/j.wneu.2018.02.146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 11/15/2022]
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Abstract
Primary tumors of the brachial plexus are a rare cause of an axillary swelling. Schwannomas are benign tumors arising from Schwann cells. Most of the schwannomas occur in the head and neck region and in the flexor aspect of the limbs. We present a case of a 60-year-old female who presented with pain in the left axilla radiating to the left upper limb since 2 years and a painful swelling in her left axilla for 3 months. The diagnosis is made by fine needle aspiration cytology and magnetic resonance imaging, and confirmed by histopathological examination as schwannoma.
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Affiliation(s)
- Prem A Kumar
- Department of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Biju Islary
- Department of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Ramya Ramachandra
- Department of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Thippeswamy Naik
- Department of General Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Luzar B, Tanaka M, Schneider J, Calonje E. Cutaneous microcystic/reticular schwannoma: a poorly recognized entity. J Cutan Pathol 2015; 43:93-100. [PMID: 26350054 DOI: 10.1111/cup.12624] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/19/2015] [Accepted: 08/02/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Microcystic/ reticular schwannoma is exceptionally rare yet distinctive morphological variant of schwannoma with predilection for visceral sites lacking association with neurofibromatosis. AIMS To further delineate clinicopathological features of cutaneous microcystic/reticular schwannoma and to discuss its differential diagnosis. RESULTS We analyzed three cutaneous microcystic/reticular schwannomas, occurring in two males and one female (mean age: 37.6 years). The tumors presented as a non-painful slightly raised papule (mean: 0.7 cm) on upper arm (n = 2) and back (n = 1). No recurrences were observed despite marginal excision (mean follow up: 42 months). Histopathologically, a multilobular proliferation was present in the dermis composed of bland tumor cells forming distinctive microcystic, reticular, lace-like or pseudoglandular structures, containing abundant myxoid/mucinous material. By immunohistochemistry, tumor cells lining microcystic structures corresponded to Schwann cells (diffuse S100 positive, variable GFAP positivity). A discontinuous EMA-positive perineurium was present at the periphery of some of the lobules. CONCLUSION Cutaneous microcystic/reticular schwannoma expands the spectrum of benign peripheral nerve sheath tumors with reticular morphology encountered in the skin. Other tumors in this group include reticular perineurioma and hybrid tumors with reticular morphology, e.g. reticular perineurioma/schwannoma and reticular perineurioma/neurofibroma.
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Affiliation(s)
- Boštjan Luzar
- Institute of Pathology, Medical Faculty University of Ljubljana, Ljubljana, Slovenia
| | - Maiko Tanaka
- Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Johann Schneider
- Division of Anatomical Pathology at University of Stellenbosch, Cape Town, South Africa
| | - Eduardo Calonje
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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15
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16
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Results of surgical treatment of schwannomas arising from extremities. BIOMED RESEARCH INTERNATIONAL 2015. [PMID: 25793198 DOI: 10.1155/2015/547926.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low.
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17
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Affiliation(s)
- Satyaswarup Tripathy
- Department of Plastic Surgery, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jerry R John
- Department of Plastic Surgery, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abizer Kapadia
- Department of Plastic Surgery, Post-graduate Institute of Medical Education and Research, Chandigarh, India
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18
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Results of surgical treatment of schwannomas arising from extremities. BIOMED RESEARCH INTERNATIONAL 2015; 2015:547926. [PMID: 25793198 PMCID: PMC4352496 DOI: 10.1155/2015/547926] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/20/2014] [Accepted: 11/20/2014] [Indexed: 02/06/2023]
Abstract
Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low.
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19
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Fiaschi P, Pacetti M, Secci F, Gennaro S. A rare case of first motor branch of median nerve schwannoma. Neurol Sci 2015; 36:659-61. [PMID: 25586696 DOI: 10.1007/s10072-015-2068-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Pietro Fiaschi
- Department of Neurosurgery, San Martino-IST University Hospital (IRCCS), Largo Rosanna Benzi 10, 16132, Genoa, Italy,
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Boufettal M, Azouz M, Rhanim A, Abouzahir M, Mahfoud M, Bardouni AE, Berrada MS, Yaacoubi ME. Schwannoma of the median nerve: diagnosis sometimes delayed. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2014; 7:71-3. [PMID: 25125990 PMCID: PMC4125423 DOI: 10.4137/ccrep.s16686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/15/2014] [Accepted: 06/27/2014] [Indexed: 11/21/2022]
Abstract
Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.
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Affiliation(s)
- Monsef Boufettal
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Mohamed Azouz
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Abdelkarim Rhanim
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Mohamed Abouzahir
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Mustapha Mahfoud
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Ahmed El Bardouni
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Mohamed S Berrada
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Moradh El Yaacoubi
- Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
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