Schwannoma Presenting Research Articles

The Clinical Presentation and Imaging Findings of Intraoral Schwannomas: Three Rare Cases Report

The Clinical Presentation and Imaging Findings of Intraoral Schwannomas: Three Rare Cases Report

Case report: Initial presentation of pancreatic schwannoma as cystic pancreatic mass treated with classic Whipple’s procedure

Case report: Initial presentation of pancreatic schwannoma as cystic pancreatic mass treated with classic Whipple’s procedure

Retroperitoneal ancient schwannoma presenting as left flank pain and moderate unilateral hydronephrosis: A case report and literature review.

Benign ancient retroperitoneal schwannomas (BARS) exhibit abdominal masses and flank pain to incidental findings at more advanced stages. Histopathological and immunohistochemical analysis is essential for confirmation of benign nature. Our patient was misdiagnosed as ureteric colic, highlighting the need to consider BARS in differential diagnosis to prevent complications like hydronephrosis. Ancient schwannomas are usually benign neoplasms that originate from Schwann cells of peripheral nerves. We present a novel case of a 24-year-old young male with left flank pain and nausea which was initially thought to be left ureteric colic. However, in-depth imaging and biopsy revealed a retroperitoneal mass. The definitive diagnosis was narrowed down to Benign Retroperitoneal Ancient Schwannoma (BARS) via immunohistochemistry and histopathological analysis. This often marble-shaped S100 protein-positive tumor is an under-recognized and potential cause of hydronephrosis if localized near the renal structures. In addition, the retroperitoneal location with infrarenal abdominal aortic adherence is another rare peculiarity in the present case that demands prompt diagnosis and surgical excision to avoid any cardiovascular sequelae such as hypotension and abdominal pain, as indicated by the natural history of growth of this benign tumor. Therefore, timely excision of this benign tumor prior to its further proliferation is paramount. We initially planned laparoscopic removal but adopted excision via laparotomy because of the proximity of the vital structures. The postoperative course of the patient was uneventful and subsequently the patient's presenting complaint of left abdominal flank pain greatly improved. The patient was advised to undergo follow-up computed tomography scan of kidney ureter bladder and RFT evaluation 6 months postsurgery which indicated no evidence of recurrence or iatrogenic complications. The diagnosis and management of the present case share valuable experiences for similar future cases worldwide.

A Case of Facial Nerve Schwannoma Presenting as a Rapidly Growing Parotid Gland Tumor

A Case of Facial Nerve Schwannoma Presenting as a Rapidly Growing Parotid Gland Tumor

Rare case of Lingual Nerve Schwannoma Presenting as Submandibular Area Swelling with Parapharyngeal Extension.

Schwannoma is a rare benign encapsulated nerve sheath tumor which originates from Schwann cells. Generally, schwannoma arising from lingual nerve involves the oral tongue and tongue base in the oral cavity. We report a rare case of lingual nerve schwannoma in a 16-year-old girl with complaint of right-side submandibular swelling for last 4-5 years. A diagnosis was established based on computed tomography (CT scan) and fine needle aspiration cytology (FNAC). CT scan showed tumor involving right submandibular region and superiorly reaching up to parapharyngeal space without any intraoral swelling. She underwent excision under general anesthesia (transcervical approach) without any complication. Per operatively, the tumor was found eccentrically placed with relation to the lingual nerve and lingual nerve fibers were splayed over the tumor. The final histopathological results confirmed the diagnosis of schwannoma.

Abstract 1085: Vagal Nerve Schwannoma Presenting As A Syncope In A Young Patient

Introduction: Vagal schwannomas are rare, benign masses that usually develop in the cervical region but can arise anywhere along the vagus nerve. Patients may be asymptomatic; however, in most cases, patients present in their third to sixth decades, with neck swelling, hoarseness or cough. Herein, we discuss a case report of a 26-year-old male who presented after an abrupt syncopal episode with sinus bradycardia and was diagnosed with vagal schwannoma. Case Presentation: A 26-year-old male with a past medical history of bipolar disorder was brought to the hospital after an abrupt syncopal episode while driving. He denied any palpitations or prodromal symptoms prior to loss of consciousness. Inpatient cardiac monitoring revealed persistent sinus bradycardia, without high degree AV block. Treadmill EKG stress test confirmed chronotropic competence. CT head did not reveal other etiology of syncope. CT chest revealed a 2.4 x 2.0 cm left superior mediastinal mass. Cardiothoracic surgery was consulted for concern of thoracic outlet mass/mediastinal mass. Robotic-assisted left thoracoscopy was performed for mediastinal mass excision, which revealed a left vagus nerve schwannoma on frozen section. Discussion: Most vagus nerve schwannomas have been found to arise within the cervical course of the vagus nerve. Intrathoracic vagal schwannomas are rare. These tumors are usually asymptomatic, however varied symptoms such as pain, dysphagia and shortness of breath have been reported. In this case presented, the tumor possibly contributed to the heightened vagal tone and neurogenic syncope (with vasovagal syncope). It is also notable that our patient's resting heart rate normalized following excision of the mass. Of note, with a high reported incidence of peri-perioperative vocal cord paralysis, surgical excision remains a challenging mainstay of treatment in symptomatic patients. Conclusion: Vagal neoplasms should be hence considered as a differential diagnosis in patients with otherwise unexplained bradycardia with history of syncope. Reference: Neurocardiogenic syncope; Carol Chen-Scarabelli, cardiovascular nurse practitioner and Tiziano M Scarabelli, associate professor of internal medicine. BMJ 2004 Aug 7; 329 (7461):336-341.

Compression from a retroperitoneal schwannoma presenting as a subepithelial lesion of the gastric fundus.

Compression from a retroperitoneal schwannoma presenting as a subepithelial lesion of the gastric fundus.

Pediatric Pterygopalatine Fossa Schwannoma Presenting as Vision Loss: A Case Report and Literature Review.

Neurosynovial tumors, originating from Schwann cells within nerve sheaths, are benign entities, with 25% to 45% manifesting in the head and neck region. However, occurrences in the pterygopalatine fossa (PPF) are exceptionally rare, and only a handful of cases have been documented. In this report, we present the unique case of a 6-year-old child exhibiting a sizable soft tissue mass in the left PPF, extending into the inferior orbital fissure. The patient underwent successful intranasal endoscopic removal of PPF schwannoma utilizing the prelacrimal recess approach, with postoperative pathology confirming the diagnosis of schwannoma. Schwannomas within the PPF are particularly uncommon, and instances of such tumors in pediatric patients are even more exceptional. This case highlights the diagnostic and therapeutic challenges associated with PPF schwannomas in children, emphasizing the significance of a multidisciplinary approach for optimal management. In addition, a comprehensive literature review is presented to provide insights into the existing knowledge on this rare entity, further contributing to the understanding of pediatric PPF schwannomas.

Ancient Schwannoma Presenting as Sciatica Mimicker: A Case Report

Ancient Schwannoma Presenting as Sciatica Mimicker: A Case Report

Atypical presentation of an ancient retroperitoneal schwannoma mimicking a renal hydatid cyst: a case report and literature review

Schwannomas are benign neurogenic encapsulated peripheral nerve tumors of Schwann cells that rarely occur in the retroperitoneum. We present a case of a 22-year-old man who presented with right flank pain and was initially diagnosed as hydatid cyst based on the imaging and borderline results of anti-echinococcus (IgG). Albendazole was prescribed and taken for 4 months with no response and later underwent surgical excision of the mass. The diagnosis and morphology confirmed the nature of the schwannoma. Complete surgical excision remains the gold standard for the management of these tumors. The preoperative diagnosis is usually difficult; however, the definitive diagnosis is made upon histopathological examination.Author name: Please confirm if the author name are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: Asad Shahzad, Last name: Hasan.correct

A Case of Brachial Plexus Schwannoma Presenting as a Cystic Neck Swelling

Schwannomas are benign tumours arising from Schwann cells of the neural sheath. They are rarely seen to arise from the brachial plexus. Brachial plexus schwannomas present as a swelling over lateral neck, supraclavicular region or axilla. Symptoms may include pain, sensory changes, weakness etc. Around 5% of these schwannomas may turn malignant. Although rare, cystic neck swellings can be due to cystic degeneration of a schwannoma. A preoperative evaluation is of utmost importance and in cases of neck swellings which are producing symptoms, a pre-operative MRI should be done to reach the diagnosis before taking the patient in the OT. Presented is a case of lateral neck swelling with mild tingling sensation over arm of the same side.

Extended Vestibular Schwannoma Presenting as an External Auditory Canal Mass: Two New Cases and Review of the Literature

This article describes two rare cases of vestibular schwannoma extending to the external auditory canal (EAC). Vestibular schwannomas typically arise from the internal acoustic canal and have a slow growth rate, rarely extending to the middle ear extension and even rarer EAC. The article highlights the importance of considering vestibular schwannoma as a differential diagnosis in patients with masses in the EAC and the need for early diagnosis and treatment to prevent potential complications.

Intrapulmonary schwannoma presenting as an asymptomatic lung mass: a case report

BackgroundSchwannomas are solitary well-circumscribed encapsulated benign tumors that exhibit Schwann cell differentiation, and arise directly from myelinated peripheral or central nerves. Although they are usually asymptomatic and found incidentally, schwannomas can cause symptoms due to compression of nearby structures which, depending on the location, can make clinical presentations widely variable. Despite their rarity, schwannomas have been documented in a number of locations including the limbs, cerebellopontine angle, posterior mediastinum, and, far more infrequently, the lungs.Case presentationIn this article, we report an incidental finding of an intrapulmonary schwannoma in a 59-year-old Pakistani woman who was grossly asymptomatic upon presentation to the cardiothoracic surgery clinic. An [18F]fluorodeoxyglucose positron emission tomography/computed tomography scan revealed a lobulated soft-tissue lesion measuring 23 mm × 23 mm in the lower lobe of the right lung. A computed tomography-guided core biopsy of the mass was performed, which revealed a benign spindle cell lesion based on histopathological examination and immunohistochemical staining. The mass was surgically resected via a right lower lobectomy, and subsequently confirmed to be an encapsulated neoplastic lesion composed of well-differentiated Schwann cells. There were no short- or long-term complications, morbidities, or recurrences based on 1-year follow-up.ConclusionThis report underscores the predominantly asymptomatic nature of schwannomas and reemphasizes the efficacy of surgical resection as a safe and curative procedure for a tumor of this nature. Albeit very rare, intrapulmonary schwannomas can be considered a differential diagnosis when encountering solitary asymptomatic pulmonary nodules or masses.

A Wolf in Sheep's Clothing - A Rare Case of an Angiosarcoma Arising from a Schwannoma in the Posterior Mediastinum: A Case Report

Introduction: Schwannoma is one of the benign tumors occurring in the posterior mediastinum. However, angiosarcoma is a malignant tumor of vascular origin and presents as an infiltrating mass. Primary angiosarcoma of the mediastinum is very rare. Few cases have been reported in the atrium, pulmonary vein, and lung and present with chest pain. Angiosarcoma arising from a benign tumor like a schwannoma is very rare; only a handful of cases have been reported in the literature. This case is presented for its rarity and awareness that even a schwannoma presenting as well-circumscribed mediastinal mass can harbor a life-threatening malignancy. Case Report: A 51-year-old male presented with chest pain, and on investigation, there was an extrapulmonary and posterior mediastinal mass in the left paravertebral region with a benign appearance and his serum tumor markers were normal. However, a needle biopsy showed evidence of an angiosarcoma. Hence, with these contradicting results, a surgical exploration was done and since it was well delineated was excised completely. Grossly, it was a well-circumscribed mass measuring 12.5 cm × 9.5 cm × 6.5 cm with a variegated appearance with pale–yellow and hemorrhagic areas. A diagnosis of an epithelioid angiosarcoma arising from a schwannoma was made by light microscopic and immunohistochemical findings. Conclusion: Epithelioid angiosarcoma is a rare malignant transformation occurring in a schwannoma. It can also have a deceptively benign appearance as in our case, and in any symptomatic long-standing posterior mediastinal schwannoma, this differential should be kept in mind when planning surgery and further treatment.

Hypoglossal Nerve Palsy Misdiagnosed as Tongue Tumor: A Rare Case of Calcified Hypoglossal Schwannoma.

The authors hereby present a case of a calcified schwannoma of the hypoglossal nerve, which led to hypoglossal nerve palsy initially misinterpreted as a tongue tumor. This paper reviews the presentation of schwannoma of the hypoglossal nerve and offers a novel perspective on this rare condition. Diagnostic pitfalls and the diagnostic-therapeutic value are also discussed.

Incidence and presentation of vestibular schwannoma: a 3-year cohort registry study.

Vestibular schwannoma (VS) is the most common benign tumour arising in the lateral skull base. Reported incidence rates of VS vary across geographical locations and over time. There is scarce updated evidence over the past decade on the epidemiology and mode of presentation of VS. To describe the epidemiology and mode of presentation of VS in the East of England between 2013 and 2016. A retrospective epidemiological analysis of data from a national VS registry and electronic patient records was conducted, including all newly diagnosed adult patients in a UK tertiary referral centre, between April 1st, 2013, and March 31st, 2016. There were 391 new cases identified resulting in an overall mean incidence of 2.2 VS cases per 100,000 person-year. The incidence rate for all patients in the <40 age group ranged between 0.3 and 0.7 per 100,000 person-year, increasing to a range of 5.7 to 6.1 per 100,000 person-year in the 60-69 age group. The top three combinations of symptoms on presentation per patient were hearing loss and tinnitus (97, 24.8%), hearing loss alone (79, 20.2%) and hearing loss, tinnitus, and balance symptoms (61, 15.6%). The median duration of symptoms was 12 months, with a wide range from 1.4 to 300 months. Age was negatively correlated with tumour size (r = -0.14 [-0.24 to -0.04], p=0.01) and positively correlated with symptom duration (r = 0.16 [0.03-0.29], p=0.02). The incidence of vestibular schwannoma has increased compared to previous studies in the UK and is similar to incidence rates reported in other countries during the past decade. It peaks in the seventh decade of life, mainly because of an increase in the diagnosis of small tumours with a long duration of audio-vestibular symptoms in older patients, compared to earlier studies.

Bilateral vision loss as first presentation of vestibular schwannoma

Abstract Vestibular schwannoma is a benign, slow-growing tumor of the vestibular nerve, located at cerebellopontine angle. It is derived from the Schwann cells of the myelin sheath of cranial nerve eight. We present here a unique case of vestibular schwannoma, who visited us with a primary complaint of bilateral decreased vision. Detailed examination revealed bilateral papilloedema associated with right-sided cranial nerve five and eight involvements. Patient was operated for the right-sided cerebellopontine angle tumor under intraoperative neuromonitoring. Postoperatively, patient showed significant improvement, both symptomatically and clinically.

Autoimmune Gastritis Accompanied by a Schwannoma Presenting as a Subepithelial Tumor

Autoimmune gastritis (AIG), a chronic inflammatory disease occurs as a result of a complex interaction between host-related and environmental factors. AIG may progress to severe atrophic gastritis secondary autoimmune-mediated parietal cell destruction in the stomach. AIG can be diagnosed based on anti-parietal cell antibody tests and endoscopy, which reveals widespread gastric corpus atrophy in patients with low serum pepsinogen I levels, a low pepsinogen I/II ratio, and elevated serum gastrin levels on serological testing. Tissue biopsy findings, which include mucosal atrophy and lymphocytic infiltration of the lamina propria may be useful for diagnostic confirmation. Decreased gastric acid secretion causes hypergastrinemia and enterochromaffin-like (ECL) cell proliferation, which can lead to neuroendocrine tumor development. Additionally, an autoimmune response results in parietal and chief cell injury, and proliferating ECL cells are detected in the deep mucosal layers in patients with AIG. Therefore, this condition may easily be misdiagnosed as a subepithelial tumor, and establishing a differential diagnosis for other types of subepithelial tumor accompanied by AIG is challenging. We present the case of a 54-year-old woman who was diagnosed with AIG with a concomitant subepithelial tumor based on serologic tests and biopsy findings and underwent wedge resection, which confirmed diagnosis of a schwannoma.

A rare case of a juxta-adrenal schwannoma presenting as an adrenal mass

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Differential Diagnosis of Lateral Neck Masses

Introduction: The neck and parapharyngeal space are one of the most vital regions in the body, encompassing multiple major blood vessels, nerves, spine and the airway itself. Lateral neck masses that present to an ENT practitioner may not only include a wide variety of differentials, but may present as emergencies in case of an airway compromise. In such situations, decision making and arriving at the diagnosis becomes important not only from a curative perspective but also from a lifesaving one. Here we discuss a few cases of lateral neck masses that had presented to us with unusual presentation or had a rare diagnosis, along with the line of management that was followed.&#x0D; Cases: We present a case of a giant pleomorphic adenoma presenting with stridor, an adult onset cystic hygroma, a schwannoma presenting with dyspnea, an isolated infiltrating lipoma and 2 other cases of schwannoma.&#x0D; Conclusion: Tumours of the neck and parapharyngeal region have a wide variety as this region contains almost every kind of tissue. Diagnosis of any lesion should be done with caution, using the appropriate history, examination and investigative tools available. Not only the common presentation, but also outliers and uncommon presentations of common tumours should be kept in mind.