Solitary Lymph Node Metastasis From a Malignant Peripheral Nerve Sheath Tumor of the Thoracic Vertebra Revealed on FDG PET/CT

Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) of bone are rare. It is mainly located in the appendicular skeleton. The lung is the most common site of metastasis. Solitary lymph node metastasis is very rare. Herein, we report the imaging findings of MPNST in the first thoracic vertebra with lymph node metastasis in the left axillary region. On FDG PET/ CT, these lesions had intense FDG uptake. This case highlights that solitary lytic thoracic vertebral lesion with intense FDG accumulation should regard MPNST as a differential diagnosis and that FDG PET/CT has an important role in the initial staging of MPNST.

Solitary Malignant Peripheral Nerve Sheath Tumor of Lumbar Vertebra Mimicking Metastatic Malignancy

“…Finally, a diagnosis of solitary malignant peripheral nerve sheath tumor (MPNST) was made based on the features of pathology. Malignant peripheral nerve sheath tumor can be easily misdiagnosed because of its low incidence and the nonspecific clinical symptom and noncharacteristic imaging sign, especially the spinal MPNST 1–8 . In our case, the solitary bone destruction of the L1 vertebral body and left pedicle was diagnosed initially as bone metastasis based on its morphology and density on CT imaging.…”

“…Malignant peripheral nerve sheath tumor can be easily misdiagnosed because of its low incidence and the nonspecific clinical symptom and noncharacteristic imaging sign, especially the spinal MPNST. [1][2][3][4][5][6][7][8] In our case, the solitary bone destruction of the L1 vertebral body and left pedicle was diagnosed initially as bone metastasis based on its morphology and density on CT imaging. However, PET/CT revealed no evidence of extraosseous primary malignancy, which excluded the possibility of metastasis to a large extent.…”