Schwannomas of the sciatic nerve: A rare and neglected diagnosis. A review of the literature with two illustrative cases

Telera, Stefano; Raus, Laura; Vietti, Veronica; Pace, Andrea; Villani, Veronica; Galiè, Edvina; Freda, Nicola; Carosi, Maria Antonia; Costantini, Maurizio

doi:10.1016/j.clineuro.2020.105889

Cited by 14 publications

(33 citation statements)

References 30 publications

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“…There is significant overlap between the clinical and radiographic presentations of sciatic lymphomas and schwannomas. Patients with either condition often present with symptoms of sciatica 1 . Distinguishing these entities on imaging is also challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, schwannomas are characterized by alternating Antoni A tissues (highly vascular and hypercellular spindle cells with Verocay bodies) and Antoni B tissues (less cellular, loosely textured myoxid stroma) 1 . These spindle cells stain for Leu-7 and S-100 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Tumor enhancement on T1-weighted magnetic resonance imaging (MRI) and centralized heterogenous hypointensity on T2-weighted MRI may be suggestive of malignancy and can provide important anatomical information for biopsy planning, which remains the diagnostic gold standard 1,7 . The prognosis of lymphoma of the sciatic nerve is poor, likely because of the aggressive nature of the disease, coupled with the limited ability of chemotherapies to penetrate the blood-nerve barrier 2 .…”

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confidence: 99%

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High-Grade B-Cell Lymphoma of the Sciatic Nerve That Mimicked a Schwannoma

Richards

Lee

Gusho

et al. 2022

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Case:A 41-year-old woman with a history of high-grade B-cell lymphoma status-post chemotherapy was evaluated for a painful left posterior thigh mass and significant weakness with sensory changes. Imaging revealed a benign-appearing mass consistent with schwannoma; however, intraoperative frozen section suggested high-grade B-cell lymphoma. Subsequent restaging studies revealed metastatic disease.Conclusion:A history of lymphoma warrants careful investigation of a posterior thigh mass, despite imaging findings consistent with nerve sheath tumor. Surgical removal of lymphomas of the nerve often proves futile, so these lesions are usually managed with medical treatment or radiation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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High-Grade B-Cell Lymphoma of the Sciatic Nerve That Mimicked a Schwannoma

Richards

Lee

Gusho

et al. 2022

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“…They are often solitary, circumscribed and encapsulated by epineurium and grow eccentrically, displacing the nerve root 8,22 . A malignant potential has been reported in less than 5% of cases and the reported incidence of benign schwannoma is estimated to occur in six patients per 100,000 24 . Sporadic schwannomas have no predilection toward sex or race, and often affect patients aged 20-50 years 20 .…”

Section: Introductionmentioning

confidence: 99%

“…Schwannomas of the sciatic nerve, which is the largest nerve of the human body, are uncommon (with a frequency of <1% of all schwannomas) 20 . They could often raise confusion with other known causes of sciatica, such as lumbar degenerative diseases and its diagnosis might be challenging, leading to a late correct diagnosis in many cases 24 .…”

Section: Introductionmentioning

confidence: 99%

A Rare Cause of Sciatica: Sciatic Nerve Schwannoma - A Case Report

Park

Shin

Kim

et al. 2021

Nerve

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Herein we report a rare case of a sciatic nerve schwannoma causing in a 63-year-old female. A sciatic localization is rare accounting for <1% of all schwannomas. They often lead to misdiagnosis or delayed diagnosis owing to confusion with other common causes of sciatica, such as lumbar herniated disc or spinal stenosis. Magnetic Resonance Image (MRI) is a gold diagnostic tool, and the final diagnosis is made by the histological examination. A standard surgical technique with guidance by neurophysiologic monitoring allows in most of the cases an uncomplicated removal of the tumor. Although being a rare occurrence, a thorough clinical and radiological evaluation of the sciatic nerve should be taken into consideration whenever sciatica is not otherwise explained.

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