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Spano M, Davis-Hayes C, Hameed M, Benayed R, Hwang S. NTRK-rearranged spindle cell neoplasm: Initial observation of imaging appearance and clinicopathologic correlation. Clin Imaging 2024; 110:110134. [PMID: 38631176 DOI: 10.1016/j.clinimag.2024.110134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE To explore pre-treatment imaging findings of neurotrophic tyrosine receptor kinase (NTRK)-rearranged spindle cell neoplasm, an emerging group of molecularly defined soft tissue tumors and summarize the clinical course, including TRK inhibitor therapy response. MATERIALS AND METHODS This retrospective study included 8 women and 4 men with NTRK-rearranged spindle cell neoplasm (median age, 35.5 years, range, 0-66). Available pre-treatment MRI, CT, PET, and US imaging were reviewed. Tumor histology and the patients' clinical course were reviewed. RESULTS Primary tumors were located within the soft tissue, lungs, kidney, and breast with soft tissue being the most prevalent site (n = 6). Pre-treatment MRI (n = 4) revealed linear hypointense signal foci and contrast enhancement in all patients with hemorrhage in half of the tumors. A tail sign (n = 1) and fluid levels (n = 1) were less frequent. Ultrasound showed well-marginated hypoechoic masses with internal flow. Primary tumors were all non-calcified on CT (4/4). Metastases were FDG-avid (4/4). Among the 8 patients who developed metastasis, 7 developed pulmonary metastases. All four patients who received NTRK inhibitor therapy showed an initial decrease in tumor size or FDG uptake. CONCLUSION NTRK-rearranged neoplasms may occur as enhancing masses with linear hypointense signal foci on MRI and FDG avid metastases on PET. Pulmonary metastases were frequent in our study. Initial treatment response is observed in most patients.
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Affiliation(s)
- Matthew Spano
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
| | - Cecilia Davis-Hayes
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
| | - Meera Hameed
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
| | - Ryma Benayed
- AstraZeneca, 430 East 29 Street, New York, NY 10016, United States of America.
| | - Sinchun Hwang
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States of America.
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2
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Carone L, Messana G, Vanoli A, Pugliese L, Gallotti A, Preda L. Correlation between imaging and histology in benign solitary retroperitoneal nerve sheath tumors: a pictorial review. Insights Imaging 2024; 15:132. [PMID: 38816511 PMCID: PMC11139841 DOI: 10.1186/s13244-024-01709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 04/26/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. This article reviews the role played by different imaging techniques in assessing RBNSTs and elucidates their typical pathological features with a particular emphasis on the correlation between imaging and histological findings. Furthermore, some examples of retroperitoneal tumors that merit consideration in the process of differential diagnosis based on cross-sectional investigations (CSIs) are reported. The correlation between tissue architecture and appearance on imaging can help increase the accuracy of differential diagnosis with other retroperitoneal neoplasms at CSIs. CRITICAL RELEVANCE STATEMENT This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology. KEY POINTS RBNSTs are challenging to diagnose because they lack specific radiological features. Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex. Surgical removal of RBNSTs is recommended for an accurate diagnosis.
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Affiliation(s)
- Luisa Carone
- Radiology 1 Unit, IRCCS San Matteo Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Gaia Messana
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Viale Brambilla, 74, 27100, Pavia, Italy.
| | - Alessandro Vanoli
- Department of Molecular Medicine, University of Pavia, Viale Camillo Golgi, 19, 27100, Pavia, Italy
- Unit of Anatomic Pathology, IRCCS San Matteo Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Luigi Pugliese
- General Surgery 2 Unit, IRCCS San Matteo Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Anna Gallotti
- Radiology 1 Unit, IRCCS San Matteo Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Lorenzo Preda
- Radiology 1 Unit, IRCCS San Matteo Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Viale Brambilla, 74, 27100, Pavia, Italy
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3
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Shen Y, Wang R, Zhao C, Liu L, Sun D, Chen X. Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:359-367. [PMID: 38264918 DOI: 10.1002/jcu.23639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE To describe the ultrasound characteristics of nodular localized cutaneous neurofibroma (NLCN). MATERIALS AND METHODS Clinical features and ultrasound characteristics of 43 lesions of 40 patients pathologically proven as NLCNs at Peking University Shenzhen Hospital from October 2014 to May 2022 were analyzed retrospectively. The location, length-to-thickness (L/T) ratio, thickness-to-width (T/W) ratio, shape, margin, capsule, echogenicity, echotexture, posterior features, vascularity, and "rat tail sign" were evaluated. RESULTS All ultrasound findings showed almost perfect agreement. More than a half of NLCNs (n = 24, 55.8%, p < 0.001) were located in the subcutaneous fat layer wholly with well-demarcation from dermis and deep fascia. Most of the NLCNs were fusiform shape (n = 27, 62.8%, p < 0.001) in the long axis and oval shape (n = 35, 81.4%, p < 0.001) in the short axis. The other ultrasound findings of NLCNs included well-defined (n = 42, 97.7%, p < 0.001), encapsulated (n = 39, 90.7%, p < 0.001), predominately hypoechoic (n = 34, 79.1%, p < 0.001), homogeneous (n = 39, 90.7%, p < 0.001), posterior enhancement (n = 29, 67.4%, p = 0.033), and avascularity (n = 37, 86.0%, p < 0.001). Only a quarter (n = 11, 25.6%, p = 0.002) of lesions were recognized with the "rat tail sign." CONCLUSION NLCNs present as fusiform shape in long axis and round shape in short axis. The common ultrasound findings of NLCNs are well-defined, encapsulated, predominately hypoechoic, homogeneous lesion with posterior enhancement, and poor blood supply. The "rat tail sign" has low sensitivity in NLCNs.
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Affiliation(s)
- Yuzhou Shen
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Run Wang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Chenyang Zhao
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Li Liu
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Desheng Sun
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xiangmei Chen
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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Debs P, Luna R, Fayad LM, Ahlawat S. MRI features of benign peripheral nerve sheath tumors: how do sporadic and syndromic tumors differ? Skeletal Radiol 2024; 53:709-723. [PMID: 37845504 DOI: 10.1007/s00256-023-04479-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/20/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To compare MRI features of sporadic and neurofibromatosis syndrome-related localized schwannomas and neurofibromas. METHODS In this retrospective study, our pathology database was searched for "neurofibroma" or "schwannoma" from 2014 to 2019. Exclusion criteria were lack of available MRI and intradural or plexiform tumors. Qualitative and quantitative anatomic (location, size, relationship to nerve, signal, muscle denervation) and functional (arterial enhancement, apparent diffusion-weighted coefficient) MRI features of sporadic and syndrome-related tumors were compared. Statistical significance was assumed for p < 0.05. RESULTS A total of 80 patients with 64 schwannomas (sporadic: 42 (65.6%) v. syndrome-related: 22 (34.4%)) and 19 neurofibromas (sporadic: 7 (36.8%) v. syndrome-related: 12 (41.7%)) were included. Only signal heterogeneity (T2W p=0.001, post-contrast p=0.03) and a diffused-weighted imaging target sign (p=0.04) were more frequent with schwannomas than neurofibromas. Sporadic schwannomas were similar in size to syndrome-related schwannomas (2.9±1.2cm vs. 3.7±3.2 cm, p = 0.6), but with greater heterogeneity (T2W p = 0.02, post-contrast p = 0.01). Sporadic neurofibromas were larger (4.6±1.5cm vs. 3.4±2.4 cm, p = 0.03) than syndrome-related neurofibromas, also with greater heterogeneity (T2W p=0.03, post-contrast p=0.04). Additional tumors along an affected nerve were only observed with syndrome-related tumors). There was no difference in apparent diffusion coefficient values or presence of early perfusion between sporadic and syndrome-related tumors (p > 0.05). CONCLUSIONS Although syndrome-related and sporadic schwannomas and neurofibromas overlap in their anatomic, diffusion and perfusion features, signal heterogeneity and presence of multiple lesions along a nerve are differentiating characteristics of syndrome-related tumors.
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Affiliation(s)
- Patrick Debs
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
| | - Rodrigo Luna
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
- Division of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
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NAM DY, JANG SH, YIM SJ, KIM JH, JUNG JY. Malignant peripheral nerve sheath tumor in the kidney of a dog. J Vet Med Sci 2024; 86:312-316. [PMID: 38296525 PMCID: PMC10963088 DOI: 10.1292/jvms.23-0385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/11/2024] [Indexed: 03/19/2024] Open
Abstract
A 12-year-old castrated male poodle presented with vomiting and diarrhea. Ultrasonography and computed tomography revealed a protruding mass at the caudal pole of the left kidney. Grossly, the poorly circumscribed abnormal mass was 1.6 × 1.8 × 1.9 cm in size and had multifocal dark-red foci. Microscopically, it was composed of densely or loosely packed variable-sized short spindle or ovoid cells. These neoplastic cells showed high pleomorphism, mitotic figures, and invasive tendency to the adjacent tissue. Immunohistochemically, the neoplastic spindle cells expressed vimentin, S100, neuron-specific enolase, nerve growth factor receptor, and laminin. Therefore, the mass was diagnosed as a malignant peripheral nerve sheath tumor (MPNST). To our knowledge, this is the first report of primary renal MPNST in a dog.
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Affiliation(s)
- Da-Ye NAM
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Korea
| | | | - So-Jeong YIM
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Korea
| | - Jae-Hoon KIM
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Korea
| | - Ji-Youl JUNG
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, Korea
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Wang Y, Yang S, Li B, Shuai C, Xiong X, Lu J. Epidemiology, risk factors, diagnosis, and treatment of intra-abdominal traumatic neuromas - a narrative review. BMC Gastroenterol 2023; 23:416. [PMID: 38017468 PMCID: PMC10683309 DOI: 10.1186/s12876-023-03049-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
Traumatic neuroma (TN) is a disorganized proliferation of injured nerves arising from the axons and Schwann cells. Although TN rarely occurs in the abdominal cavity, the incidence of TN may be underestimated because of the large number of asymptomatic patients. TN can cause persistent pain, which seriously affects quality of life. TN of the biliary system can cause bile duct obstruction, leading to acute cholangitis. It is difficult to differentiate TN from malignancies or recurrence of malignancy, which results in a number of patients receiving aggressive treatment. We collected cases reports of intra-abdominal TN over the past 30 years form PubMed and cases diagnosed in our medical center over the past 20 years, which is the largest case series of intra-abdominal TN to the best of our knowledge. In this review, we discuss the epidemiology, pathophysiology, risk factors, classification, diagnosis, and management of intra-abdominal TN.
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Affiliation(s)
- Yaoqun Wang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Sishu Yang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Bei Li
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Cunyong Shuai
- Department of Hepatobiliary Surgery, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Forces, Leshan, China.
| | - Xianze Xiong
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Jiong Lu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
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7
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Jayapal P, Alharthi O, Young V, Obi C, Syed AB, Sandberg JK. Magnetic resonance neurography techniques in the pediatric population. Pediatr Radiol 2023; 53:2167-2179. [PMID: 37710037 DOI: 10.1007/s00247-023-05759-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/11/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023]
Abstract
The use of magnetic resonance imaging (MRI) in the evaluation of the central extracranial nervous system, namely the brachial and lumbosacral plexuses, is well established and has been performed for many years. Only recently after numerous advances in MRI, has image quality been sufficient to properly visualize small structures, such as nerves in the extremities. Despite the advances, peripheral MR Neurography remains a complex and difficult examination to perform, especially in the pediatric patient population, in which the risk for motion artifact and compliance is always of concern. Thus, technical aspects of the MR imaging protocol must be flexible but robust, to balance image quality with scan time, in a patient population of varying sizes. An additional important step for reliably performing a successful MR Neurography examination is the non-technical pre-imaging preparation, which includes patient/family education and open communication with referring teams. This paper will discuss in detail the individual technical and non-technical/operational aspects of peripheral MR Neurography, to help guide in building a successful program in the pediatric population.
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Affiliation(s)
- Praveen Jayapal
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA
| | - Omar Alharthi
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA
| | - Victoria Young
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA
| | - Chrystal Obi
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA
| | - Ali B Syed
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA
| | - Jesse K Sandberg
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, 94304, USA.
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8
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Mañón VA, Vigneswaran N, Melville JC, Shum J, Wang XI, Hanna I. Expansile, mandibular lesion in a pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:268-275. [PMID: 36935230 DOI: 10.1016/j.oooo.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Affiliation(s)
- Victoria A Mañón
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas at Houston, Houston, TX, USA.
| | - Nadarajah Vigneswaran
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas at Houston, Houston, TX, USA
| | - James C Melville
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas at Houston, Houston, TX, USA
| | - Jonathan Shum
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas at Houston, Houston, TX, USA
| | - Xiaohong Iris Wang
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Issa Hanna
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas at Houston, Houston, TX, USA
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Bahurupe S, Phatak S, Onkar P, Ambhore AN, Trimukhe D. Chondrosarcoma of Iliac Bone Imaging Spectrum With Histopathological Correlation: A Case Report. Cureus 2023; 15:e45110. [PMID: 37842443 PMCID: PMC10569363 DOI: 10.7759/cureus.45110] [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: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Chondrosarcoma is a rare form of carcinoma that originates in the cells of cartilage, the flexible tissue that cushions the joints and gives structure to various parts of the body. This malignant tumour primarily affects adults and is most commonly found in the bones of the arms, legs, pelvis, and ribs. The severity and prognosis of chondrosarcoma can vary widely depending on factors such as tumour size, location, and grade. We are reporting a case of an 83-year-old male patient who presented with swelling over the left hip joint. A mass was detected on radiograph and ultrasound that was further characterized using contrast-enhanced CT and MRI. Imaging findings suggested chondrosarcoma. The patient was diagnosed on histopathological examination.
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Affiliation(s)
- Suchita Bahurupe
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Suresh Phatak
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Prashant Onkar
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Ashish N Ambhore
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Deepali Trimukhe
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
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10
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Kumar Y, Bhatia A, Ajoy SM, Galagali DA. Rare giant schwannoma of superficial peroneal nerve on the dorsum of foot. BMJ Case Rep 2023; 16:e255118. [PMID: 37474141 PMCID: PMC10360422 DOI: 10.1136/bcr-2023-255118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Schwannoma is a benign tumour of Schwann cells originating from myelin sheath of axons of the nerves. It is usually seen in the vestibular region, very rarely found in extremity regions. Schwannomas are termed 'Giant' when they measure more than five centimetres in a minimum of one dimension. Giant schwannomas in the foot and ankle region are extremely uncommon. Only eight cases of such a condition are reported. This is a case report of a giant schwannoma found arising from the superficial peroneal nerve in the dorsolateral aspect of the foot. This swelling was excised completely and the diagnosis was confirmed by histopathology.
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Affiliation(s)
- Yashavanth Kumar
- Orthopaedics, MS Ramaiah Medical College, Bangalore, Karnataka, India
| | - Aanchal Bhatia
- Orthopaedics, MS Ramaiah Medical College, Bangalore, Karnataka, India
| | - Shiv Manik Ajoy
- Orthopaedics, MS Ramaiah Medical College, Bangalore, Karnataka, India
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Borgheresi A, Agostini A, Pierpaoli L, Bruno A, Valeri T, Danti G, Bicci E, Gabelloni M, De Muzio F, Brunese MC, Bruno F, Palumbo P, Fusco R, Granata V, Gandolfo N, Miele V, Barile A, Giovagnoni A. Tips and Tricks in Thoracic Radiology for Beginners: A Findings-Based Approach. Tomography 2023; 9:1153-1186. [PMID: 37368547 DOI: 10.3390/tomography9030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This review has the purpose of illustrating schematically and comprehensively the key concepts for the beginner who approaches chest radiology for the first time. The approach to thoracic imaging may be challenging for the beginner due to the wide spectrum of diseases, their overlap, and the complexity of radiological findings. The first step consists of the proper assessment of the basic imaging findings. This review is divided into three main districts (mediastinum, pleura, focal and diffuse diseases of the lung parenchyma): the main findings will be discussed in a clinical scenario. Radiological tips and tricks, and relative clinical background, will be provided to orient the beginner toward the differential diagnoses of the main thoracic diseases.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Luca Pierpaoli
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Alessandra Bruno
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Tommaso Valeri
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Ginevra Danti
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Eleonora Bicci
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Maria Chiara Brunese
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149 Genoa, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
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12
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Ferreira KS, Speciali JG. Chronic Unilateral Headache Related to Scar Neuromas. J Med Cases 2023; 14:217-221. [PMID: 37435109 PMCID: PMC10332870 DOI: 10.14740/jmc4087] [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: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Postcraniotomy and posttraumatic headaches can result in scars generating local pain or referred pain following a neuropathic pattern. One hypothesis is that the pain can be caused and maintained by scar neuromas, developed after the nerve injury during the surgical process or trauma. This study reports two patients with chronic unilateral headaches: the first one with a posttraumatic scar in the parietal region and the other with a postsurgical scar in the mastoid region. In both patients, the headache was ipsilateral to the scar, suggesting primary headaches (trigeminal autonomic cephalalgia (TAC), as hemicrania continua and chronic cluster headache). Pharmacological treatment for these conditions failed. Instead, there was complete remission of the headache with anesthetic blockade of scar neuromas (demonstrated by clinical examination in both patients). An active search for traumatic or nontraumatic scars is recommended in all patients with refractory unilateral headaches, and anesthetic blocks for scar neuromas can be effective in treating this pain.
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Affiliation(s)
- Karen S. Ferreira
- Department of Neurology, Suroit Hospital, Salaberry-de-Valleyfield, QC, Canada
| | - Jose G. Speciali
- Department of Neurology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
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13
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Hajihashemi A, Geravandi M. Pelvic neurofibroma in a patient presenting with pelvic pain and urinary frequency: A case report. Radiol Case Rep 2023; 18:2293-2296. [PMID: 37153482 PMCID: PMC10159813 DOI: 10.1016/j.radcr.2023.03.024] [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] [Received: 02/23/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/09/2023] Open
Abstract
Pelvic neurofibromas are benign and uncommon retroperitoneal masses. They arise from Schwann cells. One of the most common types of these benign tumors is intraneural neurofibromas, which are solitary, sporadic, and not associated with neurofibromatosis type 1. Here we discuss a case of pelvic neurofibroma in a 20-year-old male who presented with chronic pelvic pain. He had no positive family history of genetic disorders. On physical exam, just a partly firm mass without mobility in the hypogastric region was detected. Ultrasound and Computed tomography scan showed pelvic retroperitoneal mass superior to the urinary bladder with extension to the rectovesical pouch and invasion of the posterior wall and dome of the bladder. The patient underwent laparotomy revealing an infiltrative retroperitoneal mass with the invasion of the posterior wall, dome, and trigone of the bladder. Histopathological findings showed neurofibroma.
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14
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Zardi EM, Chello C. Multiparametric ultrasound images of three different cases of schwannoma of the peripheral nervous system. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:745-747. [PMID: 36930697 DOI: 10.1002/jcu.23452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 05/03/2023]
Abstract
This case image illustrates the importance of new sonographic applications such as superb microvascular imaging and shear wave elastography; as showed, they improve the diagnostic recognition of peripheral nerve lesion thanks to a better definition of vascularity and measure of stiffness.
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Affiliation(s)
- Enrico Maria Zardi
- Internistic Ultrasound Service, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Camilla Chello
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
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15
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Droubi S, Taja K, Culler A. A Rare and Unusual Presentation of Neurofibromatosis Type 1: Using Available Tools To Distinguish Neurofibromas From Mimicking Pathologies on CT Scan and MRI. Cureus 2023; 15:e39013. [PMID: 37323322 PMCID: PMC10264555 DOI: 10.7759/cureus.39013] [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: 05/14/2023] [Indexed: 06/17/2023] Open
Abstract
Neurofibromatosis type 1 (NF-1) is the most common neurocutaneous syndrome. Despite its more common appearance relative to other phakomatoses, it has a large variety of disease manifestations that can, at times, make swift diagnosis more challenging if not readily recognized, especially when presenting in an atypical manner. Our case reveals an unusual presentation of NF-1. After initially presenting with a bug bite on the lip with progressive swelling and surrounding inflammatory changes despite treatment with oral antibiotics, a CT scan was performed and demonstrated inflammatory changes surrounding the lip with an adjacent inflammatory mass lesion. Due to hypoattenuating lesions within the retropharyngeal space and misinterpretation by the otorhinolaryngologist, aspiration was attempted but unsuccessful, and the patient's condition worsened. Subsequent MRI was able to confirm the presence of numerous neurofibromas. The patient gradually improved on an extended course of antibiotics and was discharged in stable condition. Familiarizing oneself with the more specific imaging characteristics of this relatively common neurocutaneous disorder can help prevent incorrect or delayed diagnosis and ensure proper management. Furthermore, identifying these features on CT scan and MRI can differentiate them from other mimicking pathologies on each modality. Recognition of a scarcely reported infected neurofibroma as an established diagnostic entity could be important to include in the differential of similar cases in the future and subsequently aid in proper diagnosis and management.
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Affiliation(s)
| | - Keinan Taja
- Radiology, University of Toledo, Toledo, USA
| | - Amy Culler
- Radiology, University of Toledo, Toledo, USA
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16
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Aru MG, Davis JL, Stacy GS, Mills MK, Yablon CM, Hanrahan CJ, McCallum R, Nomura EC, Hansford BG. Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves. Skeletal Radiol 2023; 52:649-669. [PMID: 36280619 DOI: 10.1007/s00256-022-04207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 02/02/2023]
Abstract
Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are "do not touch" lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation.
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Affiliation(s)
- Marco G Aru
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Jessica L Davis
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Gregory S Stacy
- Department of Diagnostic Radiology, University of Chicago, 5841 South Maryland Avenue, MC2026, Chicago, IL, 60637, USA
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, 30 N 1900 E, Rm #1A71, Salt Lake City, UT, 84132, USA
| | - Corrie M Yablon
- Department of Diagnostic Radiology, University of Michigan Health System, 1500 E. Medical Center Dr, TC2910Q, Ann Arbor, MI, 48109, USA
| | - Christopher J Hanrahan
- Department of Diagnostic Radiology, University of Utah School of Medicine, Intermountain Healthcare, Salt Lake City, UT, 84132, USA
| | - Raluca McCallum
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Eric C Nomura
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Barry G Hansford
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
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17
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Hegazi TM, Aljamaan YM, Alghamdi SG, Alsaygh JS, Awary KB, Aladel FI, Elazomy MR, Almousa SA. Review of Soft Tissue Masses of the Foot and Ankle: Magnetic Resonance Imaging Features. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:117-125. [PMID: 37252018 PMCID: PMC10211414 DOI: 10.4103/sjmms.sjmms_66_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/13/2022] [Accepted: 09/25/2022] [Indexed: 01/16/2023]
Abstract
A large number of soft tissue masses affect the foot and ankle, with the majority being benign. Benign and malignant soft tissue lesions usually present as lumps, and it is important to differentiate between them to allow for optimal management. Imaging, in particular magnetic resonance imaging (MRI), can contribute to narrow the differential diagnosis of soft tissue masses of the foot and ankle by describing its exact location, internal signal characteristics, presence of enhancement, and its relation to adjacent structures. In this review, we review the literature to describe the most common soft tissue masses around the foot and ankle, focusing on the MRI features of the lesions.
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Affiliation(s)
- Tarek M. Hegazi
- Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yousef M. Aljamaan
- Orthopedic Surgery, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahad G. Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jaffar S. Alsaygh
- Orthopedic Surgery, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khaled B. Awary
- Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fouad I. Aladel
- Department of Radiology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Mohamed R. Elazomy
- Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sulaiman A. Almousa
- Orthopedic Surgery, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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18
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Lefebvre G, Le Corroller T. Ultrasound and MR imaging of peripheral nerve tumors: the state of the art. Skeletal Radiol 2023; 52:405-419. [PMID: 35713690 DOI: 10.1007/s00256-022-04087-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/09/2022] [Accepted: 05/30/2022] [Indexed: 02/02/2023]
Abstract
Peripheral nerve sheath tumors are a heterogeneous subgroup of soft tissue tumors that either arise from a peripheral nerve or show nerve sheath differentiation. On imaging, direct continuity with a neural structure or location along a typical nerve distribution represents the most important signs to suggest the diagnosis. Ultrasound and magnetic resonance imaging are the best modalities to evaluate these lesions. First, it is necessary to differentiate between a true tumor and a non-neoplastic nerve condition such as a neuroma, peripheral nerve ganglion, intraneural venous malformation, lipomatosis of nerve, or nerve focal hypertrophy. Then, with a combination of clinical features, conventional and advanced imaging appearances, it is usually possible to characterize neurogenic tumors confidently. This article reviews the features of benign and malignant peripheral nerve sheath tumors, including the rare and recently described tumor types. Furthermore, other malignant neoplasms of peripheral nerves as well as non-neoplastic conditions than can mimick neurogenic tumor are herein discussed.
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Affiliation(s)
- Guillaume Lefebvre
- Service de Radiologie Et d'Imagerie Musculosquelettique, Centre de Consultation Et d'Imagerie de L'Appareil Locomoteur, CHRU de Lille, Rue Emile Laine, 59037, Lille, France
| | - Thomas Le Corroller
- Radiology Department, APHM, Hôpital Sainte-Marguerite, 270 Bd de Sainte-Marguerite, 13009, Marseille, France. .,ISM UMR 7287, Aix Marseille University, CNRS, Marseille, France.
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19
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Abstract
Continued advancements in magnetic resonance (MR) neurography and ultrasound have made both indispensable tools for the workup of peripheral neuropathy. Ultrasound provides high spatial resolution of superficial nerves, and techniques such as "sonopalpation" and dynamic maneuvers can improve accuracy. Superior soft tissue contrast, ability to evaluate both superficial and deep nerves with similar high resolution, and reliable characterization of denervation are strengths of MR neurography. Nevertheless, familiarity with normal anatomy, anatomic variants, and common sites of nerve entrapment is essential for radiologists to use both MR neurography and ultrasound effectively.
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20
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Thomson L, Putt O, Rennie W, Ashford R, Mangwani J. Benign soft tissue tumours of the foot & ankle: A pictorial review. J Clin Orthop Trauma 2023; 37:102105. [PMID: 36755760 PMCID: PMC9900435 DOI: 10.1016/j.jcot.2023.102105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
The purpose of this pictorial review is to aid the clinician in distinguishing different benign lesions within the foot and ankle. We discuss the typical clinical and radiological findings as well as management options for intra and extra-compartmental lesions. Differentiation between sarcoma and benign lesions is imperative when presented with any mass in the foot or ankle.
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Affiliation(s)
- L. Thomson
- Leicester Institute of Orthopaedics, University Hospitals of Leicester, Gwendolen Road, Leicester, Leicestershire, LE5 4PW, United Kingdom
| | - O. Putt
- Leicester Institute of Orthopaedics, University Hospitals of Leicester, Gwendolen Road, Leicester, Leicestershire, LE5 4PW, United Kingdom
| | - W.J. Rennie
- Department of Radiology, University Hospitals of Leicester, Infirmary Way, Leicester, Leicestershire, LE1 5WW, United Kingdom
| | - R.U. Ashford
- Leicester Institute of Orthopaedics, University Hospitals of Leicester, Gwendolen Road, Leicester, Leicestershire, LE5 4PW, United Kingdom
- Leicester Cancer Research Centre, University of Leicester, United Kingdom
| | - J. Mangwani
- Leicester Institute of Orthopaedics, University Hospitals of Leicester, Gwendolen Road, Leicester, Leicestershire, LE5 4PW, United Kingdom
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21
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Warren D, Koch C, Parsons MS, Pérez-Carrillo GJG, Eldaya RW. Head and Neck Sarcoma Tumor Board Survival Guide for Neuroradiologists: Imaging Findings, History, and Pathology. Curr Probl Diagn Radiol 2023; 52:275-288. [PMID: 36792427 DOI: 10.1067/j.cpradiol.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
Sarcomas of the head and neck carry a poor prognosis as diagnosis is often delayed until a late stage of the disease. Accordingly, it is essential to be familiar with the clinical and imaging features of sarcomas to suggest an appropriate differential diagnosis for collaborating surgeons and pathologists. However, as there are only 1000-1500 cases in the United States annually, many radiologists lack experience with pertinent imaging findings of sarcoma and lack knowledge of both treatment and necessary follow-up. In this review, a brief discussion of WHO definitions and histopathology is included to decode information provided by pathologists. Finally, staging and treatments are illuminated to aid the radiologist with initial imaging staging and follow-up care. This review aims to increase the comprehensive knowledge of a neuroradiologist and further their value to the multidisciplinary tumor board.
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Affiliation(s)
- Daniel Warren
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO.
| | - Cameron Koch
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Matthew S Parsons
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | | | - Rami W Eldaya
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
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22
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Singh A, Kour A. Bizarre parosteal osteochondromatous proliferation – A case report. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_140_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
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23
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Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila LF. Imaging palpable tumors in pediatrics: Part 2. RADIOLOGIA 2023; 65:43-54. [PMID: 36842785 DOI: 10.1016/j.rxeng.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/03/2022] [Indexed: 02/28/2023]
Abstract
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
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Affiliation(s)
- D Llanos
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - I de la Pedraja
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L Campos
- Servicio de Dermatología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - J Armijo
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L F Ávila
- Servicio de Cirugía Pediátrica, Hospital Universitario Clínico San Carlos, Madrid, Spain
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24
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Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila L. Radiología de las tumoraciones palpables en el paciente pediátrico. Parte 2. RADIOLOGIA 2023. [DOI: 10.1016/j.rx.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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25
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Palpable pediatric chest wall masses. Pediatr Radiol 2022; 52:1963-1973. [PMID: 35316339 DOI: 10.1007/s00247-022-05323-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2022]
Abstract
Pediatric chest wall lesions are varied in etiology ranging from normal and benign to aggressive and malignant. When palpable, these lesions can alarm parents and clinicians alike. However, most palpable pediatric chest lesions are benign. Familiarity with the various entities, their incidences, and how to evaluate them with imaging is important for clinicians and radiologists. Here we review the most relevant palpable pediatric chest entities, their expected appearance and the specific clinical issues to aid in diagnosis and appropriate treatment.
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26
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Farma JM, Porpiglia AS, Vo ET. Benign Neurogenic Tumors. Surg Clin North Am 2022; 102:679-693. [PMID: 35952696 DOI: 10.1016/j.suc.2022.04.007] [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: 10/15/2022]
Abstract
Neurogenic tumors arise from cells of the nervous system. These tumors can be found anywhere along the distribution of the sympathetic and parasympathetic nervous system and are categorized based on cell of origin: ganglion cell, paraganglion cell, and nerve sheath cells. Ganglion cell-derived tumors include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. Paraganglion cell-derived tumors include paragangliomas and pheochromocytomas. Nerve sheath cell-derived tumors include schwannomas (neurilemmomas), neurofibromas, and neurofibromatosis. Most of these are benign; however, they can cause local compressive symptoms. Surgery is the mainstay of treatment, if clinically indicated. Nonetheless, a thorough preoperative workup is essential, especially for catecholamine-secreting tumors.
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Affiliation(s)
- Jeffrey M Farma
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
| | - Andrea S Porpiglia
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Elaine T Vo
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
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27
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Jabbar R, Jankowski J, Pawełczyk A, Szmyd B, Solek J, Pierzak O, Wojdyn M, Radek M. Cervical Paraspinal Chordoma: A Literature Review with a Novel Case Report. J Clin Med 2022; 11:jcm11144117. [PMID: 35887879 PMCID: PMC9325254 DOI: 10.3390/jcm11144117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023] Open
Abstract
Chordomas are rare malignant neoplasms, accounting for 1–4% of all primary bone tumors. Most spinal chordomas occur in the sacrococcygeal region and the base of the skull; however, 6% of chordomas are observed in the cervical spine. In these cases, the lesion is mainly located in the midline. These tumors slowly grow before becoming symptomatic and encase the surrounding vascular and nerve structures. Patients with advanced chordoma have a poor prognosis due to local recurrence with infiltration and destruction of adjacent bone and tissues. Systemic chemotherapy options have not been fully effective in these tumors, especially for recurrent chordomas. Thus, new combinations of currently available targeted molecular and biological therapies with radiotherapy have been proposed as potential treatment modalities. Here, the present paper describes the case of a 41-year-old male with a C2–C4 chordoma located paravertebrally, who underwent surgical resection with a debulking procedure for a cervical chordoma. Computed tomography angiography revealed a paraspinal mass with bone remodeling and the MRI showed a paravertebral mass penetrating to the spinal canal with a widening of the intervertebral C2–C3 foramen. Initially, the tumor was diagnosed as schwannoma based on its localization and imaging features; however, the histopathology specimen confirmed the diagnosis of chordoma. This case study highlights the effectivity of radical surgical resection as a mainstay treatment for chordomas, discusses neuroimaging, diagnosis, and the use of currently available targeted therapies and forthcoming treatment strategies, as alternative treatment options for chordoma.
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Affiliation(s)
- Redwan Jabbar
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Jakub Jankowski
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Agnieszka Pawełczyk
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Bartosz Szmyd
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Julia Solek
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Olaf Pierzak
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Maciej Wojdyn
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Maciej Radek
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
- Correspondence:
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28
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Shamoun F, Shamoun V, Akhavan A, Tuffaha SH. Target Receptors of Regenerating Nerves: Neuroma Formation and Current Treatment Options. Front Mol Neurosci 2022; 15:859221. [PMID: 35866159 PMCID: PMC9295905 DOI: 10.3389/fnmol.2022.859221] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Neuromas form as a result of disorganized sensory axonal regeneration following nerve injury. Painful neuromas lead to poor quality of life for patients and place a burden on healthcare systems. Modern surgical interventions for neuromas entail guided regeneration of sensory nerve fibers into muscle tissue leading to muscle innervation and neuroma treatment or prevention. However, it is unclear how innervating denervated muscle targets prevents painful neuroma formation, as little is known about the fate of sensory fibers, and more specifically pain fiber, as they regenerate into muscle. Golgi tendon organs and muscle spindles have been proposed as possible receptor targets for the regenerating sensory fibers; however, these receptors are not typically innervated by pain fibers, as these free nerve endings do not synapse on receptors. The mechanisms by which pain fibers are signaled to cease regeneration therefore remain unknown. In this article, we review the physiology underlying nerve regeneration, the guiding molecular signals, and the target receptor specificity of regenerating sensory axons as it pertains to the development and prevention of painful neuroma formation while highlighting gaps in literature. We discuss management options for painful neuromas and the current supporting evidence for the various interventions.
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Affiliation(s)
- Feras Shamoun
- Peripheral Nerve Lab, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, United States
| | - Valentina Shamoun
- Department of Biological Sciences, University of Toronto at Scarborough, Scarborough, ON, Canada
| | - Arya Akhavan
- Peripheral Nerve Lab, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, United States
| | - Sami H. Tuffaha
- Peripheral Nerve Lab, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, United States
- *Correspondence: Sami H. Tuffaha,
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Bowman KM, Bennett DD, Hanna AS. Benign eccrine spiradenoma imitating a nerve sheath tumor: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21505. [PMID: 35733843 PMCID: PMC9210272 DOI: 10.3171/case21505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/04/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Benign eccrine spiradenoma is a rare tumor arising from the sweat glands and is a pathology that is almost never encountered in routine neurosurgical practice. Although this is a rare pathology, it is one that should be included in the differential diagnosis for a patient presenting with a painful, subcutaneous mass, because it can guide further treatment considerations. OBSERVATIONS The authors present a case of benign eccrine spiradenoma that mimicked a nerve sheath tumor in clinical presentation, imaging characteristics, and gross appearance. LESSONS Complete local excision of these lesions is the gold standard treatment, because they are painful, and there are reports of local recurrence and malignant degeneration with incomplete resection. For this reason, neurosurgeons should be sure to include this in the differential diagnosis of a patient with a painful, subcutaneous mass, because it may help to guide management decisions.
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Affiliation(s)
| | - Daniel D. Bennett
- Dermatopathology, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
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Gunio D, Babaa A, Bencardino JT. Imaging of Nerve Disorders in the Elbow. Semin Musculoskelet Radiol 2022; 26:123-139. [PMID: 35609574 DOI: 10.1055/s-0042-1743407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Neuropathies of the elbow represent a spectrum of disorders that involve more frequently the ulnar, radial, and median nerves. Reported multiple pathogenic factors include mechanical compression, trauma, inflammatory conditions, infections, as well as tumor-like and neoplastic processes. A thorough understanding of the anatomy of these peripheral nerves is crucial because clinical symptoms and imaging findings depend on which components of the affected nerve are involved. Correlating clinical history with the imaging manifestations of these disorders requires familiarity across all diagnostic modalities. This understanding allows for a targeted imaging work-up that can lead to a prompt and accurate diagnosis.
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Affiliation(s)
- Drew Gunio
- Division of Clinical Radiology, Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York
| | - Ahmad Babaa
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jenny T Bencardino
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Behzad B, Dianat S. Magnetic Resonance Imaging of Nerve Tumors. Semin Musculoskelet Radiol 2022; 26:172-181. [PMID: 35609578 DOI: 10.1055/s-0042-1742704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Nerve tumors are uncommon soft tissue neoplasms predominantly arising from peripheral nerve sheath and Schwann cells. We review the manifestations of benign peripheral nerve sheath tumors, concentrating on distinguishing imaging features of schwannomas versus neurofibromas with an emphasis on treatment implications. Nevertheless, there is often an overlap between the imaging presentation of these two conditions, making the accurate radiologic diagnosis challenging. Therefore, tissue sampling is often needed for a definitive histologic diagnosis. Treatment planning largely depends on symptoms, location of the lesion, and underlying risk factors. Three major syndromes, neurofibromatosis type 1, type 2, and schwannomatosis, predispose patients to peripheral nerve sheath tumors (PNSTs), with particular concern about the malignant subtype expression. In patients with suspected PNSTs, correlation of imaging findings with clinical findings and genetic tests is helpful for a more accurate diagnosis and disease management. Some imaging features on magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography can be helpful to differentiate malignant from benign subtypes.
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Affiliation(s)
- Barzin Behzad
- Department of Radiology, Division of Musculoskeletal Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Saeed Dianat
- Department of Radiology, Division of Musculoskeletal Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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YILMAZ TF, TOPRAK H, ATASOY B, SÖNMEZ FC, ARALAŞMAK A, GÜRKAN V. Radiological Appearences of Benign Soft-tissue Tumors of the Hand and Wrist with Special Emphasis on MRI. BEZMIALEM SCIENCE 2022. [DOI: 10.14235/bas.galenos.2021.6398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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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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Riley GM, Kwong S, Steffner R, Boutin RD. MR Imaging of Benign Soft Tissue Tumors. Radiol Clin North Am 2022; 60:263-281. [DOI: 10.1016/j.rcl.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fodor D, Rodriguez-Garcia SC, Cantisani V, Hammer HB, Hartung W, Klauser A, Martinoli C, Terslev L, Alfageme F, Bong D, Bueno A, Collado P, D'Agostino MA, de la Fuente J, Iohom G, Kessler J, Lenghel M, Malattia C, Mandl P, Mendoza-Cembranos D, Micu M, Möller I, Najm A, Özçakar L, Picasso R, Plagou A, Sala-Blanch X, Sconfienza LM, Serban O, Simoni P, Sudoł-Szopińska I, Tesch C, Todorov P, Uson J, Vlad V, Zaottini F, Bilous D, Gutiu R, Pelea M, Marian A, Naredo E. The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound - Part I: Extraarticular Pathologies. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:34-57. [PMID: 34479372 DOI: 10.1055/a-1562-1455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.
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Affiliation(s)
- Daniela Fodor
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Vito Cantisani
- Department of Radiological, Oncological and Anatomo-pathological Sciences, "Sapienza" University, Rome, Italy
| | - Hilde B Hammer
- Department of Rheumatology, Diakonhjemmet Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Wolfgang Hartung
- Clinic for Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach, Germany
| | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Section Head Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Carlo Martinoli
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Fernando Alfageme
- Dermatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - David Bong
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Angel Bueno
- Department of Musculoskeletal Radiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Paz Collado
- Rheumatology Department, Transitional Care Clinic, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Maria Antonietta D'Agostino
- Istituto di Reumatologia Università Cattolica del Sacro Cuore, UOC Reumatologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | | | - Gabriella Iohom
- Department of Anaesthesiology and Intensive Care Medicine, Cork University Hospital and University College Cork, Cork, Ireland
| | - Jens Kessler
- Department of Anaesthesiology, Division of Pain Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuela Lenghel
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Clara Malattia
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI) University of Genoa, Genoa, Italy
| | - Peter Mandl
- Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | | | - Mihaela Micu
- Rheumatology Division, 2nd Rehabilitation Department, Rehabilitation Clinical Hospital Cluj-Napoca, Romania
| | - Ingrid Möller
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Aurelie Najm
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Riccardo Picasso
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Athena Plagou
- Ultrasound Unit, Private Radiological Institution, Athens, Greece
| | - Xavier Sala-Blanch
- Department of Anaesthesiology, Hospital Clinic, Department of Human Anatomy, Faculty of Medicine, University of Barcelona, Spain
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano Italy
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - Oana Serban
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paolo Simoni
- Paediatric Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | | | - Plamen Todorov
- Department of Internal Disease Propaedeutic and Clinical Rheumatology, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Jacqueline Uson
- Department of Rheumatology Hospital Universitario Móstoles, Universidad Rey Juan Carlos, Madrid, Spain
| | - Violeta Vlad
- Sf. Maria Hospital, Rheumatology Department, Bucharest, Romania
| | - Federico Zaottini
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Diana Bilous
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Gutiu
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Pelea
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anamaria Marian
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Esperanza Naredo
- Department of Rheumatology, Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Díaz, IIS Fundación Jiménez Díaz, and Universidad Autónoma de Madrid, Madrid, Spain
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Sultan Abdul Kader MI, Abdullah A, Mohamad Yunus MR, Jaafar MN, Kew TY. Preoperative Challenges in Managing Intraparotid Schwannoma. Cureus 2022; 14:e21392. [PMID: 35198300 PMCID: PMC8856645 DOI: 10.7759/cureus.21392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/05/2022] Open
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Waknin R, Evens AL, Phillips LG, Kucera JN. Fibrolipomatous hamartoma of the foot with associated macrosyndactyly: a case report. Radiol Case Rep 2022; 17:638-640. [PMID: 35027987 PMCID: PMC8715131 DOI: 10.1016/j.radcr.2021.11.058] [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: 11/12/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 11/07/2022] Open
Abstract
Fibrolipomatous hamartoma is a rare benign congenital overgrowth of fibroadipose tissue in the nerve sheath. While usually affecting the median nerve, the digits of the hands and feet are sometimes affected and may result in macrodactyly, which is referred to as macrodystrophia lipomatosa. We present a rare case of fibrolipomatous hamartoma in a 6-week-old female's foot with macrodactyly and syndactyly and discuss its presentation and radiologic features.
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Affiliation(s)
- Roy Waknin
- Department of Radiology, University of South Florida, Morsani College of Medicine, 2 Tampa General Circle, STC 6102, Tampa, FL, USA
| | - Ashley Lynn Evens
- Department of Radiology, Mayo Clinic Hospital in Florida, 4500 San Pablo Rd, Jacksonville, FL, USA
| | - Lee Garritt Phillips
- Department of Orthopedics, Johns Hopkins All Children's Hospital, 501 6th Ave S St, Saint Petersburg, FL, USA
| | - Jennifer Neville Kucera
- Department of Radiology, University of South Florida, Morsani College of Medicine, 2 Tampa General Circle, STC 6102, Tampa, FL, USA.,Department of Radiology, Johns Hopkins All Children's Hospital, 501 6th Ave S St, Saint Petersburg, FL, USA
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El Ghazoui A, Allaoui M, El Asraoui L, Zaddoug O. Unusual presentation of lateral sural cutaneous nerve schwannoma: An exceptional case report. Int J Surg Case Rep 2022; 90:106603. [PMID: 34973628 PMCID: PMC8728400 DOI: 10.1016/j.ijscr.2021.106603] [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: 10/17/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Schwannoma is the most common benign nerve sheath tumor. Peripheral nerves of the lower extremity are rarely involved and usually asymptomatic. Case presentation We report the case of a misleading clinical presentation of lateral sural cutaneous nerve schwannoma. Discussion To the best of our knowledge, no case has been reported about the location of schwannoma in the lateral sural cutaneous nerve. MRI and anatomopathologic assessment, after microscopic enucleation, are required to confirm diagnosis. Conclusion Care must be taken to not miss a schwannoma of lateral sural cutaneous nerve by meticulous clinical examination and appropriate imaging using MRI in unexplained L5 sciatica. Schwannoma is the most common benign nerve sheath tumor Peripheral nerves of the lower extremity are rarely involved and usually asymptomatic MRI shows isointense or decreased signal relative to the skeletal muscle on T1-weighted images and heterogeneously increased signal intensity on T2-weighted images Microscopic enucleation is treatment of choice
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Affiliation(s)
- A El Ghazoui
- Department of Orthopedics and Trauma Surgery "I", Military Hospital of Instruction Mohammed V, FAR Avenue, 10100 Rabat, Morocco.
| | - M Allaoui
- Department of Anatomopathology, Military Hospital of Instruction Mohammed V, FAR Avenue, 10100 Rabat, Morocco
| | - L El Asraoui
- Department Nuclear Medicine, Military Hospital of Instruction Mohammed V, FAR Avenue, 10100 Rabat, Morocco
| | - O Zaddoug
- Department of Orthopedics and Trauma Surgery "I", Military Hospital of Instruction Mohammed V, FAR Avenue, 10100 Rabat, Morocco
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39
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Debs P, Fayad LM, Ahlawat S. MR Neurography of Peripheral Nerve Tumors and Tumor-Mimics. Semin Roentgenol 2022; 57:232-240. [DOI: 10.1053/j.ro.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/11/2022]
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40
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Maldonado AA, Planchard RF, Jack MM, Smith BW, Carter JM, Spinner RJ. Lipomatosis of the Nerve and Neuromuscular Choristoma: Two Rare Entities and Their Call for an Animal Model to Understand and Mitigate Nerve-Territory Sequelae. World Neurosurg 2021; 159:56-62. [DOI: 10.1016/j.wneu.2021.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
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41
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Locklin J, Bhatt AA. Incidental Breast Mass in a Male Patient. JOURNAL OF BREAST IMAGING 2021; 3:740-741. [PMID: 38424926 DOI: 10.1093/jbi/wbab019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 03/02/2024]
Affiliation(s)
- Jasmine Locklin
- Mayo Clinic, Department of Breast Imaging and Intervention, Rochester, MN, USA
| | - Asha A Bhatt
- Mayo Clinic, Department of Breast Imaging and Intervention, Rochester, MN, USA
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Lee JY, Kim JH, Yeon EK, Hwang I, Yoo RE, Kang KM, Yun TJ, Choi SH, Sohn CH. Computed tomography complements ultrasound for the differential diagnosis of traumatic neuroma from recurrent tumor in patients with postoperative thyroid cancer. Eur Radiol 2021; 32:2760-2768. [PMID: 34665316 DOI: 10.1007/s00330-021-08321-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/27/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Traumatic neuromas (TNs) mimic recurrent tumors in US after total thyroidectomy (TT) and lateral neck dissection (LND) for thyroid cancer. We aimed to evaluate whether CT could complement US in the differential diagnosis of TNs from recurrent thyroid cancer in the dissected neck. MATERIAL AND METHODS We retrospectively included a total of 97 consecutive US-detected lesions (28 TNs and 69 recurrent tumors) in patients with a previous history of TT and LND for thyroid cancer. The lesions were classified as benign, indeterminate, or suspicious according to the presence of benign or suspicious features on US and CT. Imaging features and categories on US and CT were compared between TNs and recurrent tumors. The diagnostic performances of US and CT for differentiating between TNs and recurrent tumors were calculated. RESULTS On US, most TNs and recurrent tumors showed internal hyperechogenicity without hilar echogenicity or hilar vascularity and were categorized as suspicious lesions (23/28, 82.1% vs. 53/69, 76.8%). On CT, all TNs lacked strong enhancement without hilar fat or hilar vessel enhancement and were categorized as indeterminate lesions (28/28, 100%). In contrast, most recurrent tumors showed strong enhancement and were categorized as suspicious lesions (63/69, 91.3%). The addition of CT to US corrected 23 false-positive diagnoses in 28 TNs and 10 false-negative diagnoses in 69 recurrent tumors. CONCLUSIONS CT complements US for the correct differentiation of TNs from recurrent tumors in postoperative thyroid cancer patients. The addition of CT to US may prevent unnecessary painful biopsy or surgery. KEY POINTS • In the dissected neck, traumatic neuromas could mimic US suspicious LNs owing to its internal hyperechogenicity. • CT effectively differentiated traumatic neuromas from recurrent thyroid cancers by demonstrating significantly different enhancement patterns. • CT could complement US and may prevent unnecessary painful biopsy or surgery for US-detected lesions after thyroidectomy and neck dissection.
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Affiliation(s)
- Ji Ye Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea.
| | - Eung Koo Yeon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Tae Jin Yun
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul, 03080, Korea
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Mohindra M, Verma S, Kang MS, Goel B, Kumar AP, Manchanda GV. Analysis of Clinical, Radiographic, and Treatment Profile of 10 Cases of Neurogenic Tumors and Tumor-Like Lesions of the Oral and Maxillofacial Region: An Observational Study. J Pharm Bioallied Sci 2021; 13:S68-S71. [PMID: 34447045 PMCID: PMC8375877 DOI: 10.4103/jpbs.jpbs_539_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Soft tissues of the head and neck areas are a very frequent site of occurrence of certain benign tumors of the peripheral nerve sheath, especially the neurofibromas. Hence, the present study was conducted for assessing clinical, radiographic, and treatment profile of 10 cases of neurogenic tumors and tumor-like lesions of the oral and maxillofacial region. Materials and Methods: Data records of a total of 10 patients who were diagnosed with tumors of neurogenic origin were enrolled in the present study. Data files were analyzed over a time period of 2 years, and complete clinical and radiographic details were evaluated. All the patients in which incomplete information was present in the record files were excluded from the present study. The assessment of the histopathologic reports was done, and final diagnosis was recorded separately in the master chart. Results: Neurofibroma was the diagnosis in two cases. In another set of two cases, final diagnosis of traumatic neuroma was achieved. A single case Schwannoma of mandible depicting multilocular radiolucency was present. Granular cell tumor was present in three cases. It was present clinically in the form of swelling, ulcerative nodule, and nodular growth in the three respective cases. Surgical excision was carried out in all the cases, and follow-up records did not depict any case of recurrence of complication posttreatment. Conclusion: Neurogenic tumors of oral and maxillafacial region are a rare phenomenon and mainly present in the form of benign neoplasm. However, careful recognition and diagnosis of these lesions are necessary to rule any possible malignant changes.
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Affiliation(s)
- Mohit Mohindra
- Department of Neurosurgery, Medanta Institute of Neurosciences, Gurugram, Haryana, India
| | - Sumit Verma
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Manraj Singh Kang
- Department of Radiation Oncology, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Bhavneesh Goel
- Department of Oral and Maxillofacial Surgery, Genesis Institute of Dental Sciences and Research, Firozpur, Punjab, India
| | - Anjali Pawan Kumar
- Department of Oral and Maxillofacial Surgery, SMBT Institute of Dental Sciences and Research, Ghoti, Nashik, Maharashtra, India
| | - Gunjan Virendra Manchanda
- Department of ENT, SMBT Institute of Medical Science and Research Centre, Nashik, Maharashtra, India
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Kumar P, Sengar M, Mohta A. Atypical scrotal masses: Surgical surprise. Trop Doct 2021; 52:116-119. [PMID: 34369826 DOI: 10.1177/00494755211036588] [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: 11/15/2022]
Abstract
We present three unusual cases of atypical scrotal lesions in children. The first was a firm left scrotal mass with the testis indistinguishable. The second with apparently a large hydrocoele, which was a cyst, and the third with multiple nodular lesions, pushing the left testis into the right hemiscrotum. These turned out to be a pigmented neuroectodermal tumour, a lymphatic malformation and neurofibromas respectively. Paediatric surgeons should be aware of such surgical surprises.
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Affiliation(s)
- Parveen Kumar
- Assistant Professor, Department of Paediatric Surgery, Chacha Nehru Bal Chikitsalya, New Delhi 110031, India
| | - Mamta Sengar
- Professor, Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, New Delhi 110031, India
| | - Anup Mohta
- Director Professor, Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, New Delhi 110031, India
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45
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Yang CM, Li JM, Wang R, Lu LG. Malignant peripheral nerve sheath tumor in an elderly patient with superficial spreading melanoma: A case report. World J Clin Cases 2021; 9:6457-6463. [PMID: 34435012 PMCID: PMC8362584 DOI: 10.12998/wjcc.v9.i22.6457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/06/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant peripheral nerve sheath tumor (MPNST) is a type of spindle cell sarcoma originating from the peripheral nerve, which usually results in the corresponding nerve sign on magnetic resonance imaging (MRI). Patients with MPNST may also have neurofibromatosis type 1.
CASE SUMMARY A 78-year-old male was admitted to the hospital due to a tumor in his left knee. He had a previous history of superficial spreading melanoma on the left thigh. Color Doppler ultrasonography showed a hypoechoic mass in the subcutaneous soft tissues of the medial left knee with an abundant rich blood flow. Computed tomography scanning did not show obvious signs of bone destruction, but the skin adjacent to the tumor was slightly thickened. MRI examination revealed that the hypervascular lesion was well-circumscribed, lobulated, invaded the surrounding soft tissues and demonstrated heterogeneous enhancement but lacked an entering and exiting nerve sign. The MRI result indicated the invasiveness of the tumor. The patient underwent a left knee joint mass expanded resection and the first histopathological examination showed a MPNST with positive surgical margins. Therefore, the second extended resection was performed, and the patient had a good outcome in the short term.
CONCLUSION MRI is a useful technique for revealing the biological characteristics of MPNST and provides clinical support for evaluation of the surgical area before operation.
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Affiliation(s)
- Chong-Miao Yang
- Department of Medical Imaging, Zhuhai Hospital Affiliated with Jinan University, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
- Zhuhai Hospital Affiliated with Jinan University, Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Jia-Min Li
- Department of Medical Imaging, Zhuhai Hospital Affiliated with Jinan University, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
- Zhuhai Hospital Affiliated with Jinan University, Jinan University, Guangzhou 510000, Guangdong Province, China
| | - Rui Wang
- Department of Pathology, Zhuhai Hospital Affiliated with Jinan University, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
| | - Li-Gong Lu
- Zhuhai Interventional Medical Center, Zhuhai Precision Medical Center, Zhuhai People’s Hospital of Jinan University, Zhuhai 519000, Guangdong Province, China
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Pressney I, Khoo M, Khan R, Abernethy P, Hargunani R, Saifuddin A. Morphology of the entering and exiting nerve as a differentiating feature of benign from malignant peripheral nerve sheath tumours of the brachial plexus. Skeletal Radiol 2021; 50:1557-1565. [PMID: 33410965 DOI: 10.1007/s00256-020-03689-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify if morphology of the entering and exiting nerve involved by a nerve sheath tumour in the brachial plexus can help differentiate between benign (B) and malignant (M) peripheral nerve sheath tumours (PNSTs). MATERIALS AND METHODS Retrospective review of 85 patients with histologically confirmed primary PNSTs of the brachial plexus over a 12.5-year period. Clinical data and all available MRI studies were independently evaluated by 2 consultant musculoskeletal radiologists blinded to the final histopathological diagnosis assessing for maximal lesion dimension, visibility and morphology of the entering and exiting nerve, and other well-documented features of PNSTs. RESULTS The study included 47 males and 38 females with mean age 46.7 years (range, 8-81 years). There were 73 BPNSTs and 12 MPNSTs. The entering nerve was not identified in 5 (7%), was normal in 17 (23%), was tapered in 38 (52%) and showed lobular enlargement in 13 (18%) BPNSTs compared with 0 (0%), 0 (0%), 2 (17%) and 10 (83%) MPNSTs respectively. The exiting nerve was not identified in 5 (7%), was normal in 20 (27%), was tapered in 42 (58%) and showed lobular enlargement in 6 (8%) BPNSTs compared with 4 (33%), 0 (0%), 2 (17%) and 6 (50%) MPNSTs respectively. Increasing tumour size, entering and exiting nerve morphology and suspected MRI diagnosis were statistically significant differentiators between BPNST and MPNST (p < 0.001). IOC for nerve status was poor to fair but improved to good if normal/tapered appearance were considered together with improved specificity of 81-91% for BPNST and sensitivity of 75-83%. CONCLUSIONS Morphology of the adjacent nerve is a useful additional MRI feature for distinguishing BPNST from MPNST of the brachial plexus.
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Affiliation(s)
- I Pressney
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
| | - M Khoo
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - R Khan
- Department of Radiology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - P Abernethy
- Department of Radiology, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - R Hargunani
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - A Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
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Al-Dasuqi K, Irshaid L, Mathur M. Radiologic-Pathologic Correlation of Primary Retroperitoneal Neoplasms. Radiographics 2021; 40:1631-1657. [PMID: 33001785 DOI: 10.1148/rg.2020200015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
An earlier incorrect version of this article appeared in print. The online version is correct.
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Affiliation(s)
- Khalid Al-Dasuqi
- From the Department of Radiology and Biomedical Imaging (K.A.D., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
| | - Lina Irshaid
- From the Department of Radiology and Biomedical Imaging (K.A.D., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
| | - Mahan Mathur
- From the Department of Radiology and Biomedical Imaging (K.A.D., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
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Schwannoma of the abdominal wall: updated literature review. Eur Surg 2021. [DOI: 10.1007/s10353-021-00720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Summary
Background
Schwannoma is a benign tumor arising from Schwann cells of the peripheral nerves. It is often asymptomatic and can develop in the retroperitoneum, mediastinum, head and neck region, and upper and lower extremities. Schwannoma of the abdominal wall is extremely rare, but differential diagnosis with malignant neoplasms is important to reduce the risk of undertreatment.
Methods
A narrative review of abdominal wall schwannoma was performed using PubMed, EMBASE, and Web of Science database and the search terms “schwannoma”, “neurinoma”, “neurilemmoma”, “soft tissue tumors”, “neurogenic tumor”, “rectus abdominis mass”, “abdominal wall”. In addition, the hospital charts were reviewed to report the personal experience.
Results
Only 9 single case-reports of benign schwannoma of the abdominal wall were found in the English medical literature over the past decade. None of the patients received preoperative biopsy and all were resected with clear margins. In addition to the literature review, we report the case of a 58-year-old man referred for a palpable mass in the left upper abdominal quadrant. Ultrasonography and magnetic resonance imaging revealed a solid and well-encapsulated mass inside the left rectus abdominis muscle. A core biopsy of the lesion provided the diagnosis of cellular schwannoma and this was confirmed by histopathologic examination of the surgical specimen.
Conclusions
Benign schwannoma of the abdominal wall is extremely rare. Percutaneous core needle biopsy is important for the differential diagnosis with more common and biologically more aggressive malignancies, such as desmoid tumors and sarcomas, and may be relevant for planning the most appropriate management.
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Teh J, Shahabpour M, Drape JL, Feydy A, Sudoł-Szopińska I, Vanhoenacker FM. Hand Masses. Semin Musculoskelet Radiol 2021; 25:216-231. [PMID: 34082448 DOI: 10.1055/s-0041-1724017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hand and wrist soft tissue masses may be classified as pseudotumors, benign neoplasms, or malignant neoplasms. The vast majority of hand lesions are benign. Consideration of the location of the lesion and its imaging characteristics often leads to a specific diagnosis. Pseudotumors discussed in this article are ganglion cysts, accessory muscles, and inflammatory lesions. True tumors are described according to their tissue type: nerve sheath tumors, adipocytic tumors, so-called fibrohistiocytic tumors, pericytic tumors, and vascular lesions. We also outline the imaging features of masses encountered in the hand and wrist.
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Affiliation(s)
- James Teh
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Headington, Oxford, United Kingdom
| | - Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Antoine Feydy
- Department of Radiology, Cochin Hospital, Paris, France
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Majumder A, Ahuja A, Chauhan DS, Paliwal P, Bhardwaj M. A clinicopathological study of peripheral schwannomas. Med Pharm Rep 2021; 94:191-196. [PMID: 34013190 PMCID: PMC8118219 DOI: 10.15386/mpr-1708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/27/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022] Open
Abstract
Aim and objective Schwannomas are benign neoplasms of neural origin with sporadic or syndromic occurence. They are commonly seen in cranial nerves. Peripheral schwannomas occur rarely and may have unique presentations. The aim of this study is to evaluate the clinico-pathological characteristics of peripheral schwannomas. Methods A retrospective cross sectional study of peripheral schwannomas excluding head neck region was conducted. The study group consisted of 18 cases which were recorded over a period of seven years. The corresponding data were collected from the archives of the Department of Pathology. Results Male to female ratio was 1:1. The average age of the cases was 47 years. The most common site was the upper limbs (55.55%) followed by lower limbs, chest and penis. The lesions mostly presented as painless swellings (62%). Histopathological examination revealed classic features of schwannoma. Secondary changes included cystic degeneration, foam cells, epitheloid cells, hyalinization, microcystic change and collection of plasma cells. All cases were confirmed by positive S100 staining. Conclusion Peripheral schwannomas may be missed due to its rarity and atypical presentations. Both clinicians and pathologists should be aware of this common entity at unusual sites for the proper management of the patients. Surgery is usually the treatment of choice.
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Affiliation(s)
- Ankur Majumder
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - D S Chauhan
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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