Schwannoma of the Lower Leg with Malignant Transformation. A Case Report

  • Oana Serban University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca
  • Laura Irina Poanta University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca
  • Florin Mihaileanu University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca
  • Daniela Fodor University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca

Keywords

Schwannoma, malignant transformation, MPNST, malignant peripheral nerve sheath tumor

Abstract

Background: Peripheral nerve sheath tumours are benign or malignant. Schwannoma is a benign peripheral nerve sheath tumour originating from Schwann cells that slowly grows eccentrically to the nerve axis. Malignant transformation of a schwannoma is rare.

Case presentation: A 73-year-old woman who presented to our medical service with other medical problems was diagnosed with a tumour of the lower leg (a small mass neglected by the patient for about 10 years). The ultrasound features of the tumour suggested it was a schwannoma. The tumour was resected and histopathological assessment revealed a schwannoma with areas of malignant peripheral nerve sheath tumour transformation.

References

  • Sundaram C, Mahadevan A. Tumours of cranial and peripheral nerves. Ramamurthi and Tandon's Textbook of Neurosurgery. Vol. 2. 3rd ed. New Delhi: Jaypee Brothers Medical Publisher; 2012. p. 1446–1452.

  • Mrugala MM, Batchelor TT, Plotkin SR. Peripheral and cranial nerve sheath tumors. Curr Opin Neurol 2005;18:604–610.

  • Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol 2012;123:295–319.

  • Woertler K. Tumors and tumor-like lesions of peripheral nerves. Semin Musculoskelet Radiol 2010;14:547–558.

  • Knight DM, Birch R, Pringle J. Benign solitary schwannomas: a review of 234 cases. J Bone Joint Surg Br 2007;89:382–387.

  • Canella C, Costa F, Klumb E, Aymore IL, Marchiori E. Ancient schwannoma. Arthritis Rheum 2013;65:2036.

  • Nascimento G, Nomi T, Marques R, Leiria J, Silva C, Periquito J. Ancient schwannoma of superficial peroneal nerve presenting as intermittent leg pain: a case report. Int J Surg Case Rep 2015;6C:19–22.

  • Thway K, Fisher C. Malignant peripheral nerve sheath tumor: pathology and genetics. Ann Diagn Pathol 2014;18:109–116.

  • Evans DG, Baser ME, McGaughran J, Sharif S, Howard E, Moran A. Malignant peripheral nerve sheath tumours in neurofibromatosis 1. J Med Genet 2002;39:311–314.

  • Beer TC. Malignant peripheral nerve sheath tumor (MPNST): an overview with emphasis on pathology, imaging and management strategies. 2012. Jefferson Hospital Staff Papers and Presentations. Paper http://jdc.jefferson.edu/tjuhpapers/12.

  • Chee DWY, Peh WCG, Shek TWH. Pictorial essay: imaging of peripheral nerve sheath tumours. Can Assoc Radiol J 2011;62:176–182.

  • Tsai WC, Chiou HJ, Chou YH, Wang HK, Chiou SY, Chang CY. Differentiation between schwannomas and neurofibromas in the extremities and superficial body: the role of high-resolution and color Doppler ultrasonography. J Ultrasound Med 2008;27:161–166.

  • Reynolds DL, Jr., Jacobson JA, Inampudi P, Jamadar DA, Ebrahim FS, Hayes CW. Sonographic characteristics of peripheral nerve sheath tumors. AJR Am J Roentgenol 2004;182:741–744.

  • Kolberg M, Holand M, Agesen TH, Brekke HR, Liestol K, Hall KS, et al. Survival meta-analyses for >1800 malignant peripheral nerve sheath tumor patients with and without neurofibromatosis type 1. Neuro Oncol 2013;15:135–147.

  • Porter DE, Prasad V, Foster L, Dall GF, Birch R, Grimer RJ. Survival in malignant peripheral nerve sheath tumours: a comparison between sporadic and neurofibromatosis type 1-associated tumours. Sarcoma 2009;2009:756395.

  • Amankwah EK, Conley AP, Reed DR. Epidemiology and therapies for metastatic sarcoma. Clin Epidemiol 2013;5:147–162.
  • Published: 2015-07-31

    Issue: Vol 2 No 5 (2015) (view)

    Section: Articles

    How to cite:
    Serban, O., Poanta, L. I., Mihaileanu, F., & Fodor, D. (2015). Schwannoma of the Lower Leg with Malignant Transformation. A Case Report. European Journal of Case Reports in Internal Medicine, 2(5). https://doi.org/https://doi.org/10.12890/2015_000236