Malignant schwannoma

Summary A rare case of a malignant schwannoma presenting as a central fracture-dislocation of the acetabulum is reported. Histological examination showed a high-grade sarcoma. A pleural metastasis was present. A local reconstructive procedure consisting of local tumor excision with an acetabular prosthetic replacement and adjunctive radiation therapy was elected for the patient, who had a short-term prognosis.

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Zusammenfassung Es wird über einen seltenen Fall eines malignen Schwannoms berichtet, welches unter der Form einer zentralen Fraktur-Dislokation des Acetabulums auftrat. Die histologische Untersuchung zeigte ein Sarkom hohen Malignitätsgrades. Pleurale Metastasierung war vorhanden. Man wählte eine lokale rekonstruktive Behandlung, bestehend aus lokaler Tumorexzision mit prothetischem Acetabulumersatz und adjuvanter Radiotherapie für einen Patienten mit schlechter Prognose.

     

Malignant vestibular schwannoma

A 61-year-old woman underwent a translabyrinthine resection of a right intracanulicular acoustic neuroma, which had been detected in the work-up of sudden hearing loss. At the time of surgery, the tumor was roughly twice as large as indicated by the magnetic resonance scan taken only 2 months previously. The tumor eroded the vertical and transverse crests and extended well into the cerebellopontine angle. It was impossible to distinguish the facial nerve proximal to the geniculate ganglion. All visible tumor was resected, along with the facial nerve. Histological evaluation showed a highly cellular tumor, with many mitoses and areas of necrosis, meeting the criteria for malignant schwannoma. The patient has no stigmata of neurofibromatosis, and has no known relatives with that condition. This case is only the fourth reported of a malignant vestibular schwannoma. The relationships between vestibular schwannoma, neurofibromatosis, and malignancy are discussed.     

Malignant retroperitoneal schwannoma

We present an uncommon case of retroperitoneal malignant schwannoma diagnosed accidentally. The clinical, diagnostic and therapeutic features are discussed.     

Malignant metastatic perirenal schwannoma

Only seven cases of malignant renal or perirenal schwannomas have previously been reported in the literature. Herein we report the case of a 74-year-old female with a previous history of malignant subcutaneous schwannoma and breast ductal adenocarcinoma who presented with a renal mass that was preoperatively diagnosed as a metastatic schwannoma. This is the first case of malignant perirenal schwannoma of metastatic origin.     

Malignant juxtadrenal schwannoma.

We believe we report the first case of malignant juxtadrenal schwannoma. This rare tumor was discovered incidentally in a patient who presented with fever, mental confusion, weight loss, leukocytosis, and elevated erythrocyte sedimentation rate. Preoperative radiographic and endocrine evaluations were suggestive of a nonfunctioning adrenal tumor. Its suprarenal location was unequivocally demonstrated by CT scan, sonography, angiography, and magnetic resonance imaging studies. Angiography revealed that the tumor derived its blood supply from the adrenal and renal vessels. The final diagnosis and its juxtadrenal origin was confirmed by histologic and immunohistochemical studies. A review of the literature on retroperitoneal schwannoma is included.     

Malignant schwannoma of facial nerve

The occurrence of malignant schwannoma in children is rare. A search of English language literature did not reveal involvement of cranial nerve among children.     

Malignant schwannoma of the breast

Zusammenfassung Das maligne Schwannom (MS) stellt einen Tumor der Schwann'schen oder Nervenscheidenzellen dar, der am hdufigsten im Bereich der unteren und oberen Extremität, Stamm and Kopfregion auftritt. Wir berichten über den dritten Fall eines in der Mamma lokalisierten MS. Der tastbare, 1,2 cm im Durchmesser große Tumor fand sich im oberen inneren Quadranten der rechten Brust einer 27j dhrigen Fran. Nach sonographischer und mammographischer Darstellung, sowie Feinnadelbiopsie wurde der Tumor chirurgisch entfernt.

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Malignant schwannoma of the breast

Malignant schwannoma (MS) is a tumor of the Schwann or nerve sheath cells, most frequently occurring in the lower and upper extremities, trunk and head region. We report the third known case of MS of the breast, which occurred in a 27-year-old woman. The palpable tumor, about 1.2 cm in diameter, was localized in the upper inner quadrant of the right breast. After ultrasonography, mammography and fine needle aspiration cytology, the tumor was removed surgically.

     

Malignant intestinal schwannoma. Case report

Malignant schwannoma of the small intestine is rare and diagnosis often late. Histologic distinction from fibrosarcoma and leiomyosarcoma may require electron microscopy. The primary treatment is surgical. Close postoperative observation is recommended because of the tendency to recurrence. Remission after chemotherapy has been reported, but without controlled studies. The 5-year survival rate is unknown. Two cases are presented.     

Malignant schwannoma of the trigeminal nerve

Malignant schwannomas are rare in the head and neck, even though benign schwannomas of this area are common. A case of a malignant schwannoma of the fifth cranial nerve with symptoms of otalgia and serous otitis media is described. About 20 such cases have been reported in the literature.     

Malignant schwannoma of kidney capsule.

This report is of a malignant schwannoma originating in the capsule of the right kidney. Using sonography, nephroangiography, cavography, computer tomography, and bone scanning, metastases in the kidney or a retroperitoneal tumor could be diagnosed. After transperitoneal exploration, the right kidney and mesenteric metastases were removed. Due to tumor infiltration into the liver and tumor masses in the retroperitoneum, only nephrectomy and palliative excision of retroperitoneal metastases were done. Pulmonary metastases developed postoperatively, and the patient died three months after the operation.     

Malignant parapharyngeal schwannoma (neurilemmoma)

A malignant parapharyngeal neurilemmoma developed in a 45-year-old woman who had had a benign solitary neurilemmoma removed from the same area nine years previously. Incomplete excision was achieved through a mandibulotomy approach. Malignant schwannoma usually is associated with neurofibromatosis and has a poor prognosis, spreading along the nerve of origin or by blood stream. Small localized tumors should be treated aggressively by surgery. The possibility that a previously benign schwannoma underwent malignant transformation must be considered.     

Malignant schwannoma in the posterior tibial nerve

Our group have studied a patient affected by a malignant schwannoma in the posterior tibial nerve. Schwannomas are uncommon neoplasms that originate from the Schwann cells of the peripheral nerves: the most common forms are benign. Malignant transformation is rarer. The therapy is surgical and the operation undertaken, if possible, should be the amputation. Alternatively, where amputation is not possible due to the specific localisation or due to patient refusal, the alternative must be the largest and most radical excision possible.