Giant schwannoma masquerading as other soft tissue tumors: A series of three cases

Siddhartha Sharma, N. Sood
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Abstract

Schwannoma is a benign peripheral nerve sheath tumor. It commonly occurs in head and neck region, upper extremities and dorsolumbar spine. The giant schwannoma as such is a rare occurring tumor. We present a series of three cases of giant schwannoma in unusual locations, masquerading as other soft tissue tumors.: Case 1: A 40-year-old male presented with a large exophytic ulcerated growth on his left thigh. The lesion was deep dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and immunohistochemistry (IHC) revealed the diagnosis of Benign Schwannoma with ancient changes. A 30-year-old woman presented with mid back ache and a mass in paravertebral location at T8 to T10 levels from last 2 years. The lesion was dermal in location. It was well circumscribed, partially encapsulated with extensive areas of hemorrhage and cystic change. Histopathology and IHC confirmed the diagnosis of Schwannoma with ancient changes. A 24-year-old male, presented with a 6x6 cm lesion over the scalp. It was well circumscribed, partially encapsulated with solid and cystic areas. Histologically, it turned out to be a Schwannoma. Giant schwannoma is a rare tumor which occasionally presents at unusual locations and poses a diagnostic challenge to both, the operating surgeon and the pathologist. These lesions clinically may mimic dermatofibroma, dermatofibrosarcoma and even trichilemmal tumors. These cases are being presented for their unusual presentation.
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伪装成其他软组织肿瘤的巨大神经鞘瘤:连续三例
神经鞘瘤是一种良性周围神经鞘肿瘤。常见于头颈部、上肢及背腰椎。巨大神经鞘瘤是一种罕见的肿瘤。我们提出了一系列的三例巨大神经鞘瘤在不寻常的位置,伪装成其他软组织肿瘤。病例1:一名40岁男性,左大腿有一大块外生性溃疡生长。病灶位于真皮深部。它边界分明,部分被广泛的出血和囊性改变所包裹。组织病理学和免疫组化(IHC)显示诊断为良性神经鞘瘤,具有古老的改变。一位30岁的女性,在过去的2年里表现为中背部疼痛和椎旁位置T8至T10的肿块。病变部位为真皮。它边界分明,部分被广泛的出血和囊性改变所包裹。组织病理学和免疫组化证实了神经鞘瘤的诊断与古老的改变。24岁男性,头皮上有一个6x6厘米的病变。边界清楚,部分被实性和囊性区域包裹。从组织学上看,这是一个神经鞘瘤。巨型神经鞘瘤是一种罕见的肿瘤,偶尔出现在不寻常的位置,对手术医生和病理学家都提出了诊断挑战。这些病变在临床上可能与皮肤纤维瘤、皮肤纤维肉瘤甚至毛突肿瘤相似。这些案例的呈现方式不同寻常。
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