A Case of Incidental Schwannoma Mimicking Necrotic Metastatic Lymph Node from Bladder Cancer

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.

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Surgical excision: an effective initial therapeutic option in the management of giant macrocystic lymphatic malformations in children

Annals of Pediatric Surgery ◽

10.1186/s43159-019-0013-9 ◽

2020 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Moaied A. Hassan ◽

Hasan K. Gatea ◽

Thura K. Ja’afar

Keyword(s):

Therapeutic Option ◽

Surgical Excision ◽

Functional Results ◽

The Body ◽

Lymphatic Malformations ◽

Therapeutic Modalities ◽

Complete Surgical Excision ◽

Cystic Tumors ◽

Cystic Cavity ◽

Embryologic Development

Abstract Background Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results. The study is designed to assess the effectiveness and safety of surgical excision as an initial therapeutic option in the management of these malformations. Results Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them. Conclusion Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.

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Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

Case Reports in Oncological Medicine ◽

10.1155/2014/628538 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Mahendra Singh ◽

Lovekesh Kumar ◽

Rajkumar Chejara ◽

Om Prakash Prasad ◽

Yuvraj Kolhe ◽

...

Keyword(s):

Low Frequency ◽

Surgical Excision ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Postoperative Recovery ◽

Cystic Mass ◽

Imaging Features ◽

Diagnostic Dilemma ◽

Complete Surgical Excision ◽

Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

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Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135117742626 ◽

2018 ◽

Vol 11 (4) ◽

pp. NP129-NP131

Author(s):

Sushil Azad ◽

Nilanjan Dutta ◽

Kuntal Roy Chowdhuri ◽

Tarun Raina Ramman ◽

Nishit Chandra ◽

...

Keyword(s):

Hydatid Cyst ◽

Histopathological Examination ◽

Cardiac Myxoma ◽

Surgical Excision ◽

Interatrial Septum ◽

Left Ventricular ◽

Cardiac Tumors ◽

Complete Surgical Excision ◽

Vascular Proliferation ◽

Cardiac Myxomas

Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma.

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Mucinous cystadenocarcinoma of the oral tongue: malignant transformation from a mucinous cystadenoma?

BMJ Case Reports ◽

10.1136/bcr-2020-235932 ◽

2020 ◽

Vol 13 (10) ◽

pp. e235932

Author(s):

Sofia Dutra ◽

Miguel Rito ◽

Miguel Vilares ◽

Alexandra Borges

Keyword(s):

Salivary Glands ◽

Histopathological Examination ◽

English Literature ◽

Mucinous Cystadenoma ◽

Surgical Excision ◽

Mucinous Cystadenocarcinoma ◽

Low Grade ◽

Minor Salivary Glands ◽

Oral Tongue ◽

Complete Surgical Excision

Mucinous cystadenocarcinoma of minor salivary glands is an extremely rare entity that has only recently been described, with a few published cases in the English literature. A 42-year-old woman with a history of a surgically excised mucinous cystadenoma of the oral tongue, presented with a painful swelling in the oral tongue slowly growing for 1 month. On clinical examination, there was a firm, relatively well-circumscribed mass in the left posterior border of the mobile tongue. Subsequent MRI scan revealed a heterogeneous lesion composed of multiple cysts separated by contrast enhancing septa, in the posterior two-thirds of the left tongue. Imaging findings were similar to those of the previously resected mass, suggesting local relapse of the primary lesion. A complete surgical excision was performed and the histopathological examination revealed typical features of a low-grade mucinous cystadenocarcinoma of minor salivary glands.

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A rare presentation of superficial, inter-muscular, cystic, extra-spinal schwannoma over upper back.

10.21203/rs.3.rs-38097/v2 ◽

2020 ◽

Author(s):

Srinjoy Saha

Keyword(s):

Signs And Symptoms ◽

Surgical Excision ◽

The Body ◽

Thoracic Vertebrae ◽

Rare Presentation ◽

Complete Surgical Excision ◽

Rare Tumours ◽

S 100 ◽

Diagnostic Signs ◽

Upper Thoracic

Abstract Schwannomas are rare tumours arising from peripheral nerve sheath and are usually related to the spinal cord and spinal nerves. Contrast magnetic resonance imaging (MRI) usually helps in establishing a pre-operative diagnosis. Rarely, their manifestation may be surprisingly new. Here, a 44-year-old lady came to our clinic with a painless asymptomatic progressively enlarging swelling over her upper back. It was fluctuant, with absent neural signs and symptoms. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling near the upper thoracic vertebrae. However, classical diagnostic signs of schwannoma were absent. Complete surgical excision was performed with smooth dissection through a well-defined plane between the lesion and surrounding muscles. A 6.5x5.0x2.5 cm oval lesion with a glistening whitish-grey capsule was excised, and the deep wound was reconstructed in multiple layers. Interestingly, it was not attached to any identifiable nerves. Histopathology showed typical hallmarks like Antoni A regions and Verocay bodies. Positive S-100 staining during immunohistochemistry established its diagnosis as schwannoma. The postoperative one-and-half-year follow-up period was uneventful. Cystic schwannomas can surprise and confuse clinicians by arising anywhere in the body and with atypical manifestations. Surgeons need to consider it in the differential diagnoses of any undiagnosed slowly-growing swelling, including purely-cystic ones and perform careful surgical dissection to avoid any inadvertent nerve damage.

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Falx cerebri tuberculoma mimicking en plaque meningioma – case report

Romanian Neurosurgery ◽

10.1515/romneu-2016-0032 ◽

2016 ◽

Vol 30 (2) ◽

pp. 209-213

Author(s):

A.I. Cucu ◽

Dana Mihaela Turliuc ◽

Anca Sava ◽

Gabriela Florenţa Dumitrescu ◽

Ş. Turliuc ◽

...

Keyword(s):

Surgical Intervention ◽

Histopathological Examination ◽

Surgical Excision ◽

Antituberculous Therapy ◽

Falx Cerebri ◽

Clinical Imaging ◽

Complete Surgical Excision ◽

Histopathologic Diagnosis ◽

History Of ◽

Cerebral Tuberculosis

Abstract Background: The involvement of falx cerebri in tuberculosis is extremely rare, with only three cases reported so far in the literature. The diagnosis is most often difficult to establish, given the location of the lesion, making surgical intervention necessary for a definite histopathologic diagnosis. Methods: We present the case of a 49-year old female patient who was admitted for a right jacksonian seizure, followed by a right crural monoparesis, without a history of tuberculosis. The lesion mimicked a falx cerebri en plaque meningioma in the imaging tests. Results: A complete surgical excision was performed through a left fronto-parietal parasagittal approach. The histopathological examination revealed a case of cerebral tuberculosis. The surgical treatment was complemented postoperatively with antituberculous therapy. Conclusion: In this article, we emphasize the rarity of the lesion at this level and also presenting similar cases from the literature. Moreover, we also discuss epidemiological, clinical, imaging, therapeutic as well as pathological aspects of en-plaque dural tuberculoma.

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Nasolabial hamartoma: a rare case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202805 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1397

Author(s):

D. Senthamarai Kannan ◽

G. Soundara Rajan ◽

Veerasigamani Narendrakumar ◽

V. K. Sathiya

Keyword(s):

Case Report ◽

Soft Tissue ◽

Rare Case ◽

Surgical Excision ◽

The Body ◽

Nasolabial Fold ◽

Tissue Development ◽

Inborn Errors ◽

Complete Surgical Excision ◽

Rare Case Report

<p class="abstract">Nasolabial cysts are rare, nonodontogenic soft tissue developmental cysts occur in the maxillary lip and nasal alar regions. Patients usually presents with an asymptomatic soft swelling with obliteration of the nasolabial fold. Due to it's origin from entrapped epithelium in an embryonic fusion plane developmentally, this cyst is considered to be a Hamartoma. Hamartomas are non-neoplastic malformations, or inborn errors of tissue development. They are characterized by an abnormal mixture of tissues indigenous to that area of the body. Complete surgical excision is the accepted method of treatment. This report aimed to present a case of nasolabial cyst hamartoma, which is rare in presentation.</p>

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Schwannoma neck: a diagnostic dilemma

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193897 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1422

Author(s):

Babu Manohar ◽

Raees Abdurahiman

Keyword(s):

Schwann Cells ◽

Neck Region ◽

Surgical Excision ◽

Needle Aspiration ◽

The Body ◽

Pathological Examination ◽

Diagnostic Dilemma ◽

Diagnostic Difficulties ◽

Trucut Biopsy ◽

Diagnostic Modalities

<p>Schwannomas are less common benign slow growing tumors originating from Schwann cells. In the head and neck region, schwannomas arise most commonly from the vagus nerve or the sympathetic chain. We present this case as the location of schwannoma is extremely rare and due to the diagnostic difficulties it posed. A 48 year old male presented with right neck swelling and breathing difficulty to our OPD. Patient underwent ultrasonogram of neck, MRI neck and Fine needle aspiration cytology (FNAC) of the lesion. Each of the investigations suggested different pathology which made the diagnosis challenging. During surgery, the lesion was found to arise from right recurrent laryngeal nerve. After excision of the lesion, the patient developed hoarse voice and the pathological examination revealed schwannoma. Schwannomas that originate from Schwann cells can affect any part of the body. MRI, CT, USG and FNAC have been suggested in the literature for diagnosing the lesion. Trucut biopsy should be considered in situations where FNAC becomes inconclusive. Surgical excision is the treatment of choice. Histologically, five variants of schwannomas have been described in the literature namely common, plexiform, cellular, epithelioid and ancient schwannoma. To conclude, schwannoma arising from RLN which masqueraded as a thyroid swelling is a rare entity. The diagnostic modalities suggested in the literature were unable to pin point the diagnosis. Once, FNAC shows an inadequate specimen, a trucut biopsy should be considered as the next investigation modality.</p>

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Early diagnosis and surgical treatment of primary cutaneous marginal zone B-cell lymphomas of the face in an Asian patient

Archives of Craniofacial Surgery ◽

10.7181/acfs.2021.00472 ◽

2021 ◽

Vol 22 (5) ◽

pp. 280-284

Author(s):

Sam Yong Lee ◽

Woo Hyeong Kim ◽

Jun Ho Choi ◽

Kwang Seog Kim ◽

Jae Ha Hwang

Keyword(s):

Early Diagnosis ◽

B Cell ◽

Marginal Zone ◽

Imaging Study ◽

B Cell Lymphoma ◽

Surgical Excision ◽

Diagnosis And Treatment ◽

Asian Patient ◽

Complete Surgical Excision ◽

Patient Reported

Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is an uncommon type of malignant lymphoma that mainly occurs in the trunk and upper extremity, with less frequent incidence observed on the head. Herein, we report the early diagnosis and treatment of a rare case of facial PCMZL in an Asian patient. A 51-year-old man presented with masses on the forehead and nose tip, which he had incidentally discovered 2 months previously. The masses appeared as a papule on the forehead and a patch on the nose. There were no signs of infection or bleeding, and the patient reported no other symptoms. After complete surgical excision, PCMZL was diagnosed based on the permanent biopsy. The histopathological findings revealed lymphoid aggregations with multifocal granulomas. Further treatment and follow-up were conducted at the hematology and oncology department. Despite its rarity in Asian populations, cutaneous lymphoma should be included in the differential diagnosis of facial masses. Early diagnosis and treatment based on a physical examination, imaging study, and excisional biopsy are important for a favorable prognosis.

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Pigmented Paraaxillary Located "Complex" Basal Cell Carcinoma Imitating clinically irritated Melanocytic Lesion - Succesfull Surgical Approach in Bulgarian Patient

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.141 ◽

2017 ◽

Vol 5 (4) ◽

pp. 497-500

Author(s):

Cristiana Voicu ◽

Mara Mihai ◽

Mihai Lupu ◽

James W. Patterson ◽

Nely Koleva ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Histopathological Examination ◽

Surgical Excision ◽

Melanocytic Lesion ◽

Complete Surgical Excision ◽

Axillary Region ◽

The Right ◽

Clinical Subtype

BACKGROUND: Basal cell carcinoma (BCC) is the most frequently encountered neoplasm worldwide. While nodular BCC is the most frequent clinical subtype, other forms of BCC, such as superficial, cystic, morpheiform, infiltrative, and pigmented may also be encountered.CASE PRESENTATION: We present the case of a 67-year-old male with a relatively well-defined infiltrative, pigmented plaque with multiple colours and peripheral growth situated in the right axillary region. The histopathologic examination performed after complete surgical excision of the tumour revealed a complex pigmented BCC with macronodular, fibroepithelioma-like, cystic, focally infiltrative and basosquamous features.CONCLUSION: Uncommon locations of BCCs in sun-protected areas such as the axillary region require a higher degree of suspicion for diagnosis. The complex histology of the presented case, including subtypes with differing biologic attributes, emphasises the importance of histopathological examination in the diagnosis and therapeutic management of BCC.

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