Endotracheal neurilemoma with a lymphoid cuff. An ultrastructural and immunohistochemical study

Retroperitoneal Gastrointestinal Type Schwannoma Presenting as a Renal Mass

Retroperitoneal schwannomas are extremely rare, and unreported in Urology. Often thought to be malignant from imaging the diagnosis is often delayed until Histology. We report a case of retroperitoneal schwanoma thought to be a malignant renal mass. Seventy three year old lady presented with abdominal pain. Imaging showed a mass attached to the renal pelvis thus she underwent a radical nephrectomy. Histology reported retroperitoneal schwannoma. Malignant forms are rare however treatment for these is surgical excision. Awareness of the existence of these tumors may help in avoiding unnecessary radical surgeries by opting for biopsy preoperatively.

Primary tracheal schwannoma: one case report and a literature review

We report a case of primary tracheal schwannoma causing symptoms of airway obstruction in a 51-year-old woman. There was no history of pulmonary disease. The patient had been coughing and suffering from progressive dyspnea for over 1 year. Medical treatment with bronchodilatators had no effect. Computerized tomography and bronchoscopy demonstrated a polypoid mass located inside the trachea's cervical segment, obstructing 50% of the lumen. A biopsy was not attempted because of the tumor's vascularity to avoid bleeding. Tracheal resection with primary anastomosis was performed. The diagnosis was confirmed with histological analysis. It revealed a benign neurogenic tumor of Schwann's cell origin. Schwannoma of the trachea is extremely rare. Only 23 cases have been reported previously. Most of them occur in adults (19/23, 82.6%) and are located in the lower trachea. They usually have a long natural history, causing symptoms only after they have attained a large size. The treatment of choice is surgical removal.

Extrahepatic biliary schwannoma

Schwannoma (neurilemoma or neurinoma) rarely develops in the biliary tract. We report here a case of extrahepatic biliary schwannoma found in a 47-yr-old Japanese woman presenting with obstructive jaundice. The radiological imaging studies were suggestive of nonepithelial tumor involving the common bile duct. The patient underwent tumor resection. The tumor extended inward and outward from the wall of the common bile duct in the shape of a dumbbell. The extraductal tumor was solid with microcystic changes, while the intraductal lesion presented cystic changes. Microscopically, the tumor was predominantly composed of spindle-shaped cells with nuclear palisading, and it contained lymphoid aggregates. Immunohistochemically, the tumor cells were positive for S-100 protein. The final diagnosis was benign schwannoma of the common bile duct. The tumor differed from usual soft tissue schwannoma and closely resembled gastrointestinal schwannoma.