Malignant peripheral nerve sheath tumour transformation of histological benign vestibular schwannoma after stereotactic radiosurgery in patients without neurofibromatosis

Stereotactic radiosurgery (SRS) poses a minimal but important risk for tumour transformation, typically occurring 8–10 years after the treatment. Malignant peripheral nerve sheath tumour (MPNST) is the most common tumour arising from a vestibular schwannoma treated with SRS, with only 14 cases previously reported. We present the fifteenth case and describe its evolution and clinical course. A 56-year-old man without a history of neurofibromatosis was diagnosed 9 years prior with a vestibular schwannoma. SRS to the residual tumour was given 3 months later. During the current hospitalisation, he was reoperated where histology confirmed a MPNST. All 15 MPNST cases were analysed, showing a 77% female predominance presenting a malignant transformation at a mean age of 51. The diagnosis was made at a mean time of 74 months after SRS. The mean survival time after diagnosis was 16 months. MPNST arising from benign vestibular schwannoma after SRS treatment is an uncommon but devastating complication.

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Malignant peripheral nerve sheath tumour of thyroid: a diagnostic dilemma

BMJ Case Reports ◽

10.1136/bcr-2020-234374 ◽

2020 ◽

Vol 13 (4) ◽

pp. e234374

Author(s):

Muhammad Hassan Danish ◽

Muhammad Wasif ◽

Nasir Ud Din ◽

Muhammad Sohail Awan

Keyword(s):

Peripheral Nerve ◽

Neck Mass ◽

Diagnostic Dilemma ◽

Airway Compression ◽

Nerve Sheath Tumour ◽

Neck Masses ◽

Nerve Sheath ◽

Appropriate Treatment ◽

History Of ◽

Peripheral Nerve Sheath Tumour

Malignant peripheral nerve sheath tumours of thyroid are rare entities that can present a diagnostic dilemma. We present the case of a patient who presented with neck mass with a history of multiple neck surgeries and airway compression. The patient’s previous histopathology was mistaken for Riedel’s thyroiditis in an outside hospital, which delayed appropriate treatment leading to suffering on part of the patient and frustration on part of the physician. We emphasise that rare malignancies should be considered in rapidly growing neck masses that are causing airway compression, and histopathology of such tumours should be reported by expert pathologists.

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Small intestinal peripheral nerve sheath tumour in a cat

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116917710394 ◽

2017 ◽

Vol 3 (1) ◽

pp. 205511691771039 ◽

Cited By ~ 1

Author(s):

Ariadna Ribas ◽

Rachel Miller ◽

Roberta Rasotto

Keyword(s):

Peripheral Nerve ◽

Clinical Investigation ◽

Immunohistochemical Analysis ◽

Nerve Sheath Tumour ◽

Mesenchymal Neoplasms ◽

Case Summary ◽

Nerve Sheath ◽

History Of ◽

Small Intestinal ◽

Peripheral Nerve Sheath Tumour

Case summary A 5-year-old female spayed Chinchilla cat presented with a 4 week history of weight loss and inappetence. A thorough clinical investigation confirmed the presence of a distal jejunal mass. Histopathological and immunohistochemical analysis was consistent with a small intestinal peripheral nerve sheath tumour. Relevance and novel information To the best of our knowledge, this is the first reported case of a small intestinal peripheral nerve sheath tumour in a cat. This case report demonstrates the use of immunohistochemistry in differentiating this entity from other mesenchymal neoplasms. The veterinary literature available in this field is very limited and this report adds a new differential diagnosis to feline patients presenting with an intestinal mass.

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