Benign Schwannoma Research Articles

FDG PET/CT in a Case of Esophageal Schwannoma.

Esophageal schwannoma is very rare. We describe FDG PET/CT findings in a case of benign esophageal schwannoma. Endoscopic ultrasound showed the tumor was located in the muscular layer of the esophagus. FDG PET/CT showed intense FDG uptake with SUV max of 10 of the tumor mimicking malignancy. This case indicates that schwannoma should be included in the differential diagnosis of esophageal FDG-avid lesions.

Balancing risks and outcomes in schwannoma treatment: Case series

Schwannomas are rare benign tumors originating from Schwann cells of peripheral nerve sheaths, occasionally presenting intraosseously in the oral and maxillofacial region. Management decisions for these tumors require careful consideration of their location, size, and impact on surrounding structures. We present two contrasting cases of schwannomas: One involving a non-surgical approach due to extensive involvement and proximity to critical structures and the other necessitating surgical excision for a well-defined intraosseous lesion. The first case, in a 28-year-old female, highlighted the decision to monitor the lesion due to its significant size and location, while the second case, in a 20-year-old female, demonstrated successful surgical removal with histopathological confirmation of a benign schwannoma. These cases underscore the importance of tailored management strategies based on thorough clinical, radiographic, and histopathological assessments to optimize outcomes and minimize risks associated with surgical intervention.

Comprehensive analysis of diagnosis and treatment in 99 cases of abdominal Schwannoma.

Schwannoma is a rare mesenchymal tumor. In this study, we analyzed clinicopathologically 99 schwannomas.This retrospective study delves into the clinical, pathological, and immunohistochemical dimensions of abdominal schwannomas. A cohort of 99 cases, comprising 4 malignant and 95 benign schwannomas, was meticulously examined. Clinical analysis revealed a notable gender distribution (1:1.7, male to female) and an average age of 58.5 years. The majority of cases were asymptomatic. A cohort of 99 cases, comprising 4 malignant and 95 benign schwannomas, was meticulously examined. Clinical analysis revealed a notable gender distribution (1:1.7, male to female) and an average age of 58.5 years. The majority of cases were asymptomatic. Tumor sizes ranged from 0.5 to 30 cm, with distinct locations in the stomach for most benign cases and the abdomen/small intestine for malignancies. Initial misdiagnoses were frequent. Pathological evaluations revealed distinct features, including Antoni A and B patterns, spindle cells, and lymphatic sheath structures in benign schwannomas. Malignant cases exhibited atypical cells, ulcers, and invasive growth. Immunohistochemical markers, such as S100, SOX10, and vimentin, consistently demonstrated positivity by contributing to accurate diagnoses. Treatment outcomes indicated a poor prognosis in malignant cases, with overall survival ranging from 10 to 41 months. Conversely, benign cases displayed no recurrence or metastasis during follow-up, despite atypical behaviors. This study underscores the rarity of abdominal schwannomas and underscores the need for a comprehensive diagnostic morphology and immunohistochemistry. SOX10 emerges as a crucial and specific marker for accurate diagnosis. Further research is imperative to refine diagnostic protocols and enhance our understanding of the clinical behavior of abdominal schwannomas.

Image features and clinical analysis of retroperitoneal pelvic schwannoma: a case report

BackgroundSchwannomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells, and affecting single or multiple nerves. The tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area. Retroperitoneal pelvic schwannomas often present with non-specific symptoms leading to misdiagnosis and prolonged morbidity.Case presentationWe report the case of a 59-year-old woman presenting with a feeling of heaviness in the lower abdomen who was found to have a retroperitoneal pelvic schwannoma originating from the right femoral nerve. She had a history of two resections of peripheral schwannomas at four different sites of limbs. After conducting magnetic resonance imaging, this pelvic schwannoma was misdiagnosed as a gynecological malignancy. The tumor was successfully removed by laparoscopic surgery. Pathological analysis of the mass revealed a benign schwannoma of the femoral nerve sheath with demonstrating strong, diffuse positivity for S-100 protein.ConclusionsAlthough retroperitoneal pelvic schwannoma is rare, it should be considered in the differential diagnosis of pelvic masses, especially in patients with a history of neurogenic mass or the presence of neurogenic mass elsewhere.

Long-term postoperative outcomes of spinal cellular schwannoma: study of 93 consecutive cases

BACKGROUND CONTEXTCellular schwannoma (CS) is a rare tumor that accounts for 2.8%–5.2% of all benign schwannomas. There is a dearth of up-to-date information on spinal CS in the literature. PURPOSEThe aims of this study were to identify the proportion of CS cases amongst spinal benign schwannoma, describe the clinical features of spinal CS, and identify prognostic factors for local recurrence by analyzing data from 93 consecutive CS cases. STUDY DESIGNRetrospective review. PATIENT SAMPLEWe analyzed 93 PSGCT screened from 1,706 patients with spine CS who were treated at our institute between 2008 and 2021. OUTCOME MEASURESDemographic, radiographic, operative and postoperative data were recorded and analyzed. METHODSWe compared the clinical features of spinal CS from the cervical, thoracic, lumbar and sacral segments. Prognostic factors for local recurrence-free survival (RFS) were identified by the Kaplan-Meier method. Factors with p≤.05 in univariate analysis were subjected to multivariate analysis by Cox regression analysis. RESULTSThe proportion of spinal CS in all benign schwannomas was 6.7%. The mean and median follow-up times for the 93 patients in this study were 92.2 and 91.0 months respectively (range 36–182 months). Local recurrence was detected in 11 cases, giving an overall recurrence rate of 11.7%, with one patient death. Statistical analysis revealed that tumor size ≥5 cm, intralesional resection, and Ki-67 ≥5% were independent negative prognostic factors for RFS in spinal CS. CONCLUSIONSWhenever possible, en bloc resection is recommended for spinal CS. Long-term follow-up should be carried out for patients with tumor size ≥5 cm and postoperative pathological Ki-67 ≥5%.

Shwannoma of the stomach and synchronous cancer of the transverse colon: a clinical case report

With an increase in the frequency of publication of clinical observations with synchronous neoplasms of different histological types, experience is accumulating in the diagnosis and treatment of this cohort of patients. new clinical guidelines and strategies for the treatment of patients with primary multiple neoplasms of the gastrointestinal tract are being developed. A significant number of identified cases of the development of minimally invasive laparoscopic and robotic surgical interventions for primary multiple neoplasms of the gastrointestinal tract, as well as an increasing number of studies demonstrating the integrity and safety of performing minimally invasive endoscopic intraluminal aids in small mesenchymal tumors. The clinical observation presents the data of patient 82 years old with benign schwannoma and adenocarcinoma of the transverse colon.

Giant benign intrathoracic schwannoma: a decade-long progression towards fatality

BackgroundIntrathoracic neurogenic tumors arise from sympathetic nerve trunks and intercostal nerves; more than 90% are benign. Schwannomas are the most common histological variety, but fatalities due to giant schwannomas are rare.Case presentationWe report a case of a 65-year-old woman who presented with chest pain and cough. Computed tomography (CT) revealed a large left chest wall mass of 130-mm in size, and the patient was referred to our department. Tumor biopsy was performed under local anesthesia, and a diagnosis of schwannoma was made. Ten years previously, a 30-mm tumor had been noted in the left third intercostal space by a previous doctor, but follow-up had been interrupted owing to depressive disorder. Although we planned to perform intercostal artery embolization followed by chest wall tumor resection, the patient did not consent to surgery due to uncontrolled depression. After four months, she developed respiratory failure caused by compression due to an enlarged tumor and died. Autopsy also revealed a benign schwannoma with no malignant findings.ConclusionsAlthough schwannomas are benign tumors, there are some very rare cases in which they can become huge and life-threatening. Therefore, a benign tumor should not be neglected, and if surgery is not possible at the time of diagnosis, a regular follow up is necessary, in order not to miss the right timing for surgery.

PET Scanning May Not Distinguish Benign Schwannoma from Metastasis in a Patient with Lung Adenocarcinoma.

Benign schwannomas could show high accumulations on positron emission tomography.Accurate diagnosis of schwannoma using only images is quite challenging.Histological examinations should be considered when asymptomatic lesions are suspected to be metastases.

A rare histopathological variant of Schwannoma with rosette-like arrangements and epithelioid cells: a case report from a histopathologist's perspective.

Schwannomas exhibit histopathological variation that leads to diagnostic dilemmas, although less frequent in the oral cavity. We describe a case with unique histopathology and no relevant clinical history that adds to the breadth of literature on the diversity presented by Schwannoma. A 60-year-old female patient presented with a small dome-shaped, asymptomatic swelling on the alveolar ridge 6 years in duration. Histopathologically, it showed rich cellular pathology with a unique arrangement of tumor cells forming irregular rosettes. Each rosette presented with a central core of fibrincollagenous material and the tumor cells were arranged on the periphery, exhibiting epithelioid change with evidence of mild cellular and nuclear pleomorphism. On immunohistochemical evaluation, the cells were strongly and diffusely positive for S-100 and negative for Ki-67. A diagnosis of benign Schwannoma with a rosette-like arrangement with epithelioid change was made. The case report emphasizes the risk of misdiagnosis and the importance of awareness regarding rare histopathological variants of Schwannoma.

Schwannoma: A Rare Case of Submucosal Gastric Tumor.

Schwannoma is a tumor that originates from the Schwann cells that surround a neuron's axon. This tumor is very rare in the gastrointestinal tract and develops submucosally from intestinal nerve plexuses. The most common location for gastrointestinal schwannomas is the stomach, where they account for only 0.2% of gastric tumors. We present the case of a 56-year-old asymptomatic patient who was diagnosed, following a routine ultrasound examination, with an abdominal tumor. An abdominal MRI confirmed the gastric origin of the tumor. Although a subsequent upper-digestive endoscopic ultrasound was performed, a definitive diagnosis could not be established. Thus, a laparoscopic wedge resection of the stomach was performed. The immunohistochemical examination of the tumor established the diagnosis of benign schwannoma. Despite the availability of advanced endoscopy and imaging techniques, the diagnosis of gastric schwannoma is very rarely preoperative. The immunohistochemical identification of S-100 on the surgical specimen confirmed the diagnosis.

An ancient schwannoma misdiagnosed as a dermoid cyst on ultrasound examination: a case report

Ancient schwannomas are benign, long-standing schwannomas of the neural sheaths. This schwannoma subtype is characterized by cystic and hemorrhagic changes. These degenerative changes are thought to result from the tumor’s long-term progression and have the potential to be misdiagnosed as other soft tissue tumors or sarcomas. A 37-year-old female patient presented to our department with discomfort caused by a mass on the anterior side of her forearm. Approximately 2 weeks prior to her visit, an excisional biopsy was attempted under local anesthesia, but the patient experienced severe tingling sensations up to the wrist during surgery, preventing successful removal of the mass. Ultrasonography and magnetic resonance imaging (MRI) were performed for further differential diagnosis. An excisional biopsy was performed under general anesthesia, and histologic analysis revealed typical degenerative features of ancient schwannoma. A thorough examination, including MRI, is necessary to identify these tumors, prevent potential misdiagnosis, and ensure appropriate treatment.

Solitary Extremity Schwannoma: A 20-Year Review of Outcomes.

Background: Reports on benign peripheral nerve sheath tumour extirpation over the last number of decades describe varying patient outcomes. We present our outcomes following excision of solitary extremity schwannoma over a 20-year period. Methods: A regional histopathology review was conducted for, "benign nerve sheath tumour" and schwannoma between 2000 and 2020. This search provided 131 histologically confirmed schwannomas that were excised from the extremities of 123 patients. Individual charts were reviewed retrospectively to establish presenting features and post-operative outcomes. Results: One hundred and twenty three patients underwent schwannoma excision, including 8 patients with synchronous tumours. The mean age at presentation was 49 years (range 11-92 years). The most common presenting symptoms were the following: palpable mass (88%), pain (70%), paraesthesia (21%), numbness (13%), and motor deficit (4%). Post-operative follow-up ranged from 1 to 168 months (mean 12.3 months) (N = 99). Fifty-eight cases reported complete resolution of symptoms by end of outpatient follow-up (59%). The remaining reported either residual or new numbness (21%), paraesthesia (11%), pain (10%), weakness (4%), hypertrophic or keloid scar (3%), or a combination. Thirty patients (30%) developed new symptoms post-operatively including numbness (13%), paraesthesia (10%), pain (2%), and weakness (2%). There was a trend towards higher risk of post-operative pain, numbness or paraesthesia in patients undergoing excision of schwannomas on larger mixed nerves than in patients undergoing excision on smaller sensory nerves (P = .0531). Conclusion: Surgical excision of benign schwannomas is a successful procedure, especially for pain management, however, complete symptom resolution cannot be guaranteed, and the risk of new or persisting numbness, paraesthesia, pain, and weakness should be highlighted to patients during the consent process.

An unexpected case of lower lip benign Schwannoma: diagnosis, management and review of literature

Schwannoma also known as neurinomas of verocay is a benign, slow growing, nerve sheath tumor arising from the Schwann cells of the nerve. Around 25-40% of the schwannoma arises from the soft tissues of head and neck areas. Out of which, only <1% arises from the oral cavity. The most common intra-oral site is the tongue and the least common site being the lips. Moreover, Schwannoma in the lower lip are excessively rare during childhood and adolescence. Due to its rarity in lower lip, it’s diagnosis is usually overlooked during the primary examination. Complete surgical excision of the tumor is the treatment of choice. Recurrence cases and malignant degeneration are extremely rare. Here, we reported a case of a 17 year old female with peripheral Schwannoma of the lower lip, presented to the Otorhinolaryngology department, Indira Gandhi Hospital, Dwarka, Delhi with complaints of painless swelling in the lower lip causing cosmetic deformity for the patient. She underwent complete enucleation of the mass and is being follow-up in the outpatient department.

Giant schwannoma masquerading as other soft tissue tumors: A series of three cases

Schwannoma is a benign peripheral nerve sheath tumor. It commonly occurs in head and neck region, upper extremities and dorsolumbar spine. The giant schwannoma as such is a rare occurring tumor. We present a series of three cases of giant schwannoma in unusual locations, masquerading as other soft tissue tumors.: Case 1: A 40-year-old male presented with a large exophytic ulcerated growth on his left thigh. The lesion was deep dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and immunohistochemistry (IHC) revealed the diagnosis of Benign Schwannoma with ancient changes. A 30-year-old woman presented with mid back ache and a mass in paravertebral location at T8 to T10 levels from last 2 years. The lesion was dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and IHC confirmed the diagnosis of Schwannoma with ancient changes. A 24-year-old male, presented with a 6x6 cm lesion over the scalp. It was well circumscribed, partially encapsulated with solid and cystic areas. Histologically, it turned out to be a Schwannoma. Giant schwannoma is a rare tumor which occasionally presents at unusual locations and poses a diagnostic challenge to both, the operating surgeon and the pathologist. These lesions clinically may mimic dermatofibroma, dermatofibrosarcoma and even trichilemmal tumors. These cases are being presented for their unusual presentation.

OptImal Gamma kNife lIghTnIng sOlutioN (IGNITION) score to characterize the solution space of the Gamma Knife FIP optimizer for stereotactic radiosurgery.

The objective of this study is to evaluate the user-defined optimization settings in the Fast Inverse Planning (FIP) optimizer in Leksell GammaPlan® and determine the parameters that result in the best stereotactic radiosurgery (SRS) plan quality for brain metastases, benign tumors, and arteriovenous malformations (AVMs). Thirty patients with metastases and 30 with benign lesions-vestibular schwannoma, AVMs, pituitary adenoma, and meningioma-treated with SRS were evaluated. Each target was planned by varying the low dose (LD) and beam-on-time (BOT) penalties in increments of 0.1, from 0 to 1. The following plan quality metrics were recorded for each plan: Paddick conformity index (PCI), gradient index (GI), BOT, and maximum organ-at-risk (OAR) doses. A novel objective score matrix was calculated for each target using a linearly weighted combination of the aforementioned metrics. A histogram of optimal solutions containing the five best scores was extracted. A total of 7260 plans were analyzed with 121 plans per patient for the range of LD/BOT penalties. The ranges of PCI, GI, and BOT across all metastatic lesions were 0.58-0.97, 2.1-3.8, and 8.8-238 min, respectively, and were 0.13-0.97, 2.1-3.8, and 8.8-238 min, respectively, for benign lesions. The objective score matrix showed unique optimal solutions for metastatic lesions and benign lesions. Additionally, the plan metrics of the optimal solutions were significantly improved compared to the clinical plans for metastatic lesions with equivalent metrics for all other cases. In this study, FIP optimizer was evaluated to determine the optimal solution space to maximize PCI and minimize GI, BOT and OAR doses simultaneously for single metastatic/benign/non-neoplastic targets. The optimal solution chart was determined using a novel objective score which provides novice and expert planners a roadmap to generate the most optimal plans efficiently using FIP.

A rare case of schwannoma of the mandibular nerve extending to parapharyngeal space managed with a preauricular trans mandibular approach

Schwannoma also referred to as neurilemmoma or neurinomas arise from the Schwann cells of the autonomic nerves, peripheral nerves and cranial nerves except optic and olfactory nerves. Head and neck schwannomas account for 25 to 45% of schwannomas and the most common being vagal schwannomas and cervical sympathetic chain schwannomas. Schwannomas arising from the trigeminal nerve are rare and this case report consists of a schwannoma presenting as a left preauricular swelling involving the region of parotid extending from foramen ovale through the infratemporal fossa up to the parapharyngeal space. A combined preauricular trans mandibular approach enabled a complete excision of the tumor. Histopathological confirmation of a benign schwannoma was obtained and the patient is feeling well with minimal postoperative facial palsy with no trismus, occlusion abnormalities and no signs of recurrence on follow up.

Massive spontaneous hemothorax caused by benign solitary schwannoma

Massive spontaneous hemothorax caused by benign solitary schwannoma

Large schwannoma of the median nerve at the distal forearm

Introduction. Schwannoma, also known as neurilemmoma, is a rare but one of the most common tumors of the peripheral nerves. It originates from Schwann cells of the peripheral nerve sheaths. Schwannoma mostly occurs in adults between 20 to 70 years of age. The regions where the tumor most commonly occurs are the head and neck, but it can occur almost anywhere in the body or the organs. Schwannomas are usually up to 2.5 cm in size but may grow to 4?5 cm. In this study, the rare case of large schwannoma of the median nerve in the distal part of the forearm is presented. Case report. A 46-year-old male patient was referred to a plastic surgeon with a diagnosis of lipoma on the anterior side of the distal third of the left forearm. Ultra-sound and magnetic resonance imaging were done, and the surgery was performed after that. An encapsulated tumor of the median nerve was found, and the tumor was completely removed without nerve damage. Histological analysis showed a benign schwannoma of cellular type and biphasic shape. In the postoperative course, there was transient paresthesia. One year after surgery, no tumor recurrence nor neurological deficit was recorded. Conclusion. Schwannoma is the most common benign tumor of peripheral nerves. Schwannomas over 5 cm in size are extremely rare. Appropriate physical examination, pre-operative imaging studies, and histological verification are required for the final diagnosis. The method of choice in treating large schwannomas is complete surgical excision.

Studying the tumor microenvironment under pressure

Meenal Datta is an assistant professor in the Department of Aerospace and Mechanical Engineering at the University of Notre Dame. Prof Datta received her PhD in Chemical and Biological Engineering from Tufts University in 2018, after which she completed a postdoctoral fellowship at Harvard Medical School and Massachusetts General Hospital. Her research focuses on deciphering the atypical tumor microenvironment that drives disease progression and treatment resistance in incurable cancers. By understanding and overcoming the biological, chemical, electrical, and mechanical abnormalities found in solid tumors, new therapeutic approaches can be discovered. Prof. Datta specializes in multidisciplinary and mechanism-based preclinical research that has the potential to be rapidly translated to improve treatment approaches in the clinic. She has spent her time as a researcher deciphering and reprogramming abnormal tissue microenvironments that present in a variety of diseases ranging from virulent tuberculosis to benign schwannoma to deadly glioblastoma that, surprisingly, share unifying features: abnormal blood vessels, abundant extracellular matrix, immunosuppression, and mechanopathologies. During her PhD, Dr Datta normalized the aberrant blood vasculature found in pulmonary tuberculosis granulomas to improve drug delivery. In her postdoctoral training, Dr Datta re-engineered the immunosuppressive brain tumor microenvironment to improve glioblastoma response to immunotherapy. As the director of the Tumor Immune Microenvironment & Mechanics Lab at Notre Dame (the TIME lab). Prof Datta’s research group is applying engineering fundamentals and problem-solving approaches to explore mechano-immunological phenomena in the tumor microenvironment and discover novel biophysical targets of interest.

Schwannoma at the sinonasal tract and pterygopalatine fossa: Experience at a tertiary care teaching hospital in Eastern India

Abstract Background: Schwannomas are neoplasms that are rarely found in the sinonasal tract and pterygopalatine fossa (PPF). The objective of this study is to evaluate the schwannoma in the sinonasal tract and PPF including its effectiveness of endoscopic surgical excision of the lesion. Methods: This retrospective study was done between March 2018 and April 2022. There were nine cases of benign schwannomas found in the nasal cavity, the nasal ethmoid and the PPF. All patients had undergone endoscopic endonasal removal of the tumour. Results: All the patients successfully underwent endonasal endoscopic excision of the schwannoma from the sinonasal tract and PPF. Out of nine patients, one showed recurrence after 1 year during follow-up check-ups. None of the patients showed any major vascular complications during surgery. At follow-up, one patient presented with a persistent sensory deficit in the facial area. Conclusions: The endonasal endoscopic approach for schwannoma at the sinonasal tract and PPF is a safe and effective method for biopsy and treatment. This approach is highly effective for visualisation and has the potential to reduce complications. Pre-operative imaging is an important step before successful treatment by endoscopic endonasal removal of the schwannoma.