Recurrent Benign Solitary Intraosseous Schwannoma of the Tibia

Ang, Wan Mei; Yates, Piers; Robbins, Peter A.; Wood, David L.

doi:10.3928/01477447-20080201-03

Cited by 9 publications

(3 citation statements)

References 13 publications

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“…In previous reports, after performing only curettage, curettage and bone grafting, or en block resection, local recurrence only occurred in 2 cases. 16,17 These authors did not refer to the reason for local reference, but recurrence of the tumor is not evidence of malignant transformation. In our case, there was no evidence of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Intraosseous neurilemmoma of the proximal ulna

Kito¹,

Yoshimura²,

Isobe³

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONNeurilemmoma is a benign nerve sheath neoplasm commonly located in the soft tissue. Intraosseous neurilemmoma is rare, constituting less than 1% of primary bone tumors.PRESENTATION OF CASEA 21 year-old woman was presented with left elbow pain of 1-month duration. Plain radiographs showed a well-defined, lytic and expansile lesion of the proximal ulna. Computed tomography revealed cortical destruction and soft tissue extension. Because the tissue of origin for the tumor was uncertain, an open biopsy was performed. The specimens demonstrated a benign spindle cell tumor suggestive of a neurilemmoma, similar to a soft tissue neurilemmoma. The diagnosis of intraosseous neurilemmoma was established. Marginal excision of the soft tissue component and curettage of the lesion in the bone were performed. After 3.5 years of follow up, there is no clinical or radiographic finding to suggest any recurrence.DISCUSSIONThe major site of intraosseous neurilemmoma is the mandible. Occurrence in the long bone is particularly rare. Only two cases of intraosseous neurilemmoma involving the bones around the elbow have been reported to our knowledge; these cases arose in the distal humerus. We describe the first case of intraosseous neurilemmoma of the proximal ulna of the left elbow. The recommended treatment is conservative resection and bone grafting, as malignant change is extremely rare.CONCLUSIONAlthough very rare, intraosseous neurilemmoma should be taken under consideration in the differential diagnosis of painful, radiographically benign-appearing osseous tumor around the elbow.

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Section: Discussionmentioning

confidence: 99%

Intraosseous neurilemmoma of the proximal ulna

Kito¹,

Yoshimura²,

Isobe³

et al. 2014

International Journal of Surgery Case Reports

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“…Of these, the majority have been described in the skull, including the mandible. Outside the skull, they have been described in the vertebrae and sacrum [3, 9]. The frequency of intraosseous schwannomas in the head and neck has been explained by the high density of sensory nerves in these locations, from which schwannoma are recognized to arise.…”

Section: Discussionmentioning

confidence: 99%

“…Only approximately 20 cases of intraosseous schwannoma involving the long bones have been reported in the literature including tibia [1, 9, 13–15], humerus [2, 16], radius [17], ulna [18], and fibula [1, 19]. Only four cases have been reported in the femur [4–7].…”

Section: Discussionmentioning

confidence: 99%

Large schwannoma of the femur – a common tumor at an unusual site: a case report and review of the literature

2017

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BackgroundSchwannomas are benign nerve sheath tumors and are most frequently encountered as soft tissue tumors of peripheral nerves of the head and neck or the extensor extremities. Osseous involvement is very uncommon with fewer than 200 cases described in the world literature, the majority of which arise in the skull (including mandible), vertebrae, and sacrum. Long bone involvement is highly unusual and of the approximately 20 cases described thus far, only five have been documented to arise in the femur. We describe an unusually large schwannoma of the femur which was discovered incidentally and was diagnosed only after biopsy, given the rarity of this tumor at that particular site. Following prophylactic internal fixation and bone grafting, our patient remains well and disease-free, 2.5 years later.Case presentationA 56-year-old Sri Lankan woman was discovered to have a large lytic lesion in her lower femur on routine X-ray following a fall. A history and physical examination, along with selective imaging and tissue sampling, were necessary to arrive at the diagnosis of schwannoma of the femur. The clinical presentation, radiology, pathology, and surgical management are discussed and contrasted with the other five cases documented in the literature. The tumor was successfully treated with evacuation through a lateral surgical approach and internal fixation. She remains well and disease-free 2.5 years later.ConclusionsWe present the case of an unusually large lytic lesion found incidentally in the femur of a 56-year-old woman, which was subsequently diagnosed to be a schwannoma on biopsy. Its exceptional rarity in long bones makes it less likely to be considered in an initial differential diagnosis, and we stress the importance of tissue biopsy for diagnosis.

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Intraosseous schwannoma in schwannomatosis

et al. 2013

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This study investigates the clinical, radiological, and pathological features of two cases of intraosseous schwannoma that arose in patients with multiple soft tissue schwannomas. In both cases, the patients were adult females and the tibial bone was affected. Vestibular schwannomas were not identified, indicating that these were not cases of neurofibromatosis 2 (NF2). Radiographs showed a well-defined lytic lesion in the proximal tibia; in one case, this was associated with a pathological fracture. Histologically, both cases showed typical features of benign schwannoma. Molecular analysis of one of the excised tumors showed different alterations in the NF2 gene in keeping with a diagnosis of schwannomatosis. Our findings show for the first time that intraosseous schwannomas can occur in schwannomatosis.

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Recurrent Benign Solitary Intraosseous Schwannoma of the Tibia

Cited by 9 publications

References 13 publications

Intraosseous neurilemmoma of the proximal ulna

Intraosseous neurilemmoma of the proximal ulna

Large schwannoma of the femur – a common tumor at an unusual site: a case report and review of the literature

Intraosseous schwannoma in schwannomatosis

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