• Computed tomography
• Imaging
• Masses
• Mediastinum

• Humans
• Mediastinal Diseases/diagnostic imaging
• Tomography, X-Ray Computed/methods
• Mediastinal Neoplasms/diagnostic imaging
• Mediastinum/diagnostic imaging
• Magnetic Resonance Imaging/methods
• Diagnosis, Differential

• TURB
• bladder
• prostate
• schwannoma
• seminal vesicle

• malignant peripheral nerve sheath tumour
• molecular alterations
• multimodality management
• nerve
• neurofibroma
• neurofibromatosis type 1

• giant
• myxoid
• neurofibroma
• sciatic nerve
• solitary

• case report
• metastatic lymph node
• radiological examination
• renal clear cell carcinoma
• schwannoma

• Magnetic resonance imaging
• Multidetector computed tomography
• Neurofibroma
• Retroperitoneal neoplasms
• Schwannoma

• diagnosis
• malignant peripheral nerve sheath tumor
• malignant triton tumor
• ultrasound
• uterus

• Female
• Humans
• Middle Aged
• Neurofibrosarcoma
• Nerve Sheath Neoplasms/pathology
• Neurilemmoma
• Skin Neoplasms
• Uterus/diagnostic imaging
• Uterus/pathology

• intraoperative neurophysiological monitoring
• lumbosacral plexus
• psoas muscle
• schwannoma

• Male
• Humans
• Adult
• Intraoperative Neurophysiological Monitoring/methods
• Psoas Muscles/surgery
• Psoas Muscles/pathology
• Neurosurgical Procedures
• Lumbar Vertebrae/surgery
• Neurilemmoma/surgery
• Neurilemmoma/pathology

• mechanisms of disease
• oncogenesis

• Humans
• Neuroma, Acoustic
• Hearing Loss
• Deafness
• Schwann Cells
• Neuroglia

• Capita Foundation

• amputation neuroma
• benign tumor
• biliary stricture
• cholangiocarcinoma
• cholecystectomy
• traumatic neuroma

• adolescent and young adult (aya)
• adrenal ganglioneuroma
• adrenal glands
• adrenal pheochromocytoma
• adrenalectomy
• ganglioneuroma-retroperitoneal-imaging-pyelonephritis
• hashimoto’s thyroiditis
• histopathology examination
• preventative care

• case series
• colon
• diverticulosis
• ganglioneuroma

• Diagnostic approach
• Education
• International Thymic Malignancy Interest Group
• Mediastinal masses
• Radiologic–pathologic correlation
• Thymoma

• 18F-fluorodeoxyglucose
• canine
• nasal tumour
• neurofibrosarcoma
• positron-emission tomography

• 2022R1A4A1025557 Basic Research Lab Program
• Ministry of Science and ICT

• Brain tumors
• Immunotherapy
• Immunovirothepary
• Pediatric central nervous system tumors
• Pediatric neuro-oncologist

• Humans
• Child
• Quality of Life
• Brain Neoplasms/therapy
• Brain Neoplasms/pathology
• Immunotherapy/methods
• Cerebellar Neoplasms
• Brain/pathology

• R25 NS079188 NINDS NIH HHS

• lower urinary tract synptoms
• minimaly invasive surgery
• peripheral schwannoma
• rare tumors
• seminal vesicle

The differential diagnosis of abdominal masses is somewhat troublesome, especially when there is a malignancy to be evaluated. We report herein a unique case of gastric adenocarcinoma concurrent with a pancreatic schwannoma. Correct assessment of intraoperative findings is essential for adequate tumor staging and to decide the proper management of a concurrent pancreatic lesion.

Computed tomography scan performed for gastric cancer staging revealed a solid and cystic pancreatic mass that had no signs of local invasiveness. Surgical resection of the pancreas was decided preoperatively since a radical approach of the gastric tumor could be performed. There were no signs of distant metastases, and the large pancreatic mass was in contact with the posterior gastric wall. Histopathological study revealed a pancreatic schwannoma, which is an uncommon neoplasm that arises from Schwann cells around peripheral nerves.

Therefore, pancreatic masses deserve special attention regarding the differential diagnosis in patients with gastric cancer. The presence of a large pancreatic mass should not preclude the potentially curative intent of the gastric cancer treatment.

• Stomach neoplasms
• Gastric adenocarcinoma
• Schwannoma
• Pancreas
• Case report

• case report
• enucleation
• pancreas
• s-100
• schwannoma

• Aged
• Female
• Humans
• Magnetic Resonance Imaging
• Neurilemmoma/diagnostic imaging
• Neurilemmoma/pathology
• Neurilemmoma/surgery
• Pancreas/diagnostic imaging
• Pancreatic Neoplasms/diagnostic imaging
• Pancreatic Neoplasms/pathology
• Pancreatic Neoplasms/surgery
• Tomography, X-Ray Computed
• Ultrasonography

Localized or isolated neurofibromas are peripheral nerve sheath tumors. They are rare in the orbit and occur without a systemic neurofibromatosis. There are few cases of bilateral tumors reported but none affecting both supraorbital and infraorbital nerves. We report a 45-year-old female who presented an extraconal mass in the right orbit as an incidental finding in a head computer tomography, without ocular symptoms. Magnetic resonance image showed a well-defined oval mass in the right supraorbital and infraorbital nerves, of similar characteristics, as well as smaller masses in the left supraorbital and infraorbital nerves. A progressive increase in size of the left supraorbital and infraorbital tumor motivated their surgical excision. The histological result was compatible with a neurofibroma. These uncommon orbital tumors are slow growing and affect the sensory nerves of the trigeminal nerve. Neurofibromas usually present progressive symptoms due to the orbital mass, proptosis, or visual changes although not in this case. Surgical removal is the only definitive treatment.

Malignant triton tumors are an extremely aggressive form of malignant peripheral nerve sheath tumor that display rhabdomyosarcomatous features. While these tumors are extremely rare, they have a much higher incidence in patients with neurofibromatosis-1. We present a case of a 64-year-old male with neurofibromatosis-1 who presented to the hospital with sudden worsening of shortness of breath and dysphagia to solids. Radiological examination revealed a large mass in the anterior mediastinum causing significant narrowing and displacement of the upper trachea and esophagus. Biopsy of the mass, done by interventional radiology, demonstrated features of an MTT. The mass was subsequently resected but without confirmation of tumor-free margins and the patient underwent adjuvant radiation therapy. Repeat radiological examination approximately four months later revealed growing malignancy and new metastases, which eventually contributed to the patient's death seven months after his presentation to the hospital.

• Computed tomography
• Malignancy
• Mediastinum
• Neurofibromatosis
• Peripheral nerve sheath tumor
• Triton tumor

• Ganglionic cyst
• Lipomatosis
• Magnetic resonance imaging
• Nerve sheath neoplasms
• Neurofibroma
• Peripheral nerve

Ganglioneuroma (GN) is ranked by the International Neuroblastoma Pathology Classification as a benign tumor. It can occur anywhere along the sympathetic nerve chain and surgical excision is the treatment of choice.

An 18-year-old female patient sought medical assistance after 6 months of constant dorsal and back pain radiating from the thoracic region to the right abdominal flank. Magnetic resonance imaging revealed a solid nodular lesion with heterogeneous post-contrast enhancement and lobulated contours, centered on the right foramina of D12–L1, with a projection to the intracanal space, which compressed and laterally displaced the dural sac and had a right paravertebral extension between the vertebral bodies of D11 and superior aspect of L2. Ganglioneuroma was diagnosed using immunohistochemical analysis. It was decided to use a surgical approach in two stages: robot assisted for the anterior/retroperitoneal mass and a posterior hemilaminectomy/microsurgical approach to attempt total resection, avoiding the traditional anterior thoracoabdominal surgical incision and optimizing the patient’s postoperative outcomes. No postoperative adverse events were noted, and the patient was discharged on postoperative day 5.

This retroperitoneal GN presentation was peculiar because it originated at the D12 nerve root, which extended to the retroperitoneal space and inside the spinal canal. We hope that our case report can assist future decisions in similar circumstances.

The online version contains supplementary material available at 10.1186/s12893-021-01146-x.

• Adjunct surgery
• Case report
• Ganglioneuroma
• Retroperitoneal
• Robotic assisted surgery

•

Plexiform schwannomas are exceedingly rare in paediatric populations.

Schwannomas are benign, slow-growing nerve sheath tumors of neoplastic Schwann cells. They are the most common peripheral nerve tumors in adults and are typically discovered incidentally due to their asymptomatic presentation. Despite the fact that most schwannomas are unassociated with a syndrome, their etiology is thought to be related to alterations or loss of the neurofibromatosis type two tumor suppressor gene.

We present the case of a fifteen-year-old female who presented with a recurrent lower back/upper buttocks 9 cm mass with imaging suspicious for schwannoma. Needle biopsy revealed an S100 positive cellular schwannoma with patchy Ki-67. During surgical dissection down to the sacrum, no nerve of origin was identified.

Schwannomas have no pathognomonic findings on MRI and may occur at any location that Schwann cells are present; therefore, confirming a diagnosis relies on histopathology. Plexiform schwannomas are defined by a “network-like” intraneural growth pattern and are exceedingly rare in paediatric populations. A location distinct from the spinal canal is also very rare as schwannomas typically originate from the head and neck region.

Paediatric plexiform schwannomas have been rarely reported. Surgical planning relies on multiple factors such as tumor size, tumor location, pathologic features and symptomatic burden. The distinctive features of this case including an unknown nerve origin and a location outside the spinal canal provide a unique opportunity to discuss the diagnosis and management of paraspinal schwannomas and the impact on operative planning when a nerve of origin is not identified.

• Paediatric
• Paraspinal
• Plexiform
• Schwannoma

• radiology
• urological surgery
• urology

• Child
• Diagnosis, Differential
• Humans
• Magnetic Resonance Imaging/methods
• Male
• Neurofibroma, Plexiform/pathology
• Neurofibroma, Plexiform/surgery
• Pelvis/diagnostic imaging
• Pelvis/pathology
• Penile Neoplasms/pathology
• Penis/innervation
• Penis/pathology
• Treatment Outcome

Reports in the literature have presented the feasibility of a minimally invasive resection of retroperitoneal or pelvic schwannomas. However, there are only a few reports in the literature about a robot-assisted nerve-sparing approach towards obturator schwannomas.

We present a case of a concomitant excision of a symptomatic obturator nerve schwannoma in a patient undergoing robot-assisted radical prostatectomy with pelvic lymphadenectomy. The patient complained about an ongoing, low-grade sensory dysfunction in the left proximal thigh area, without loss of muscular function. A preoperative pelvic MRI incidentally showed a thickening of the left obturator nerve of about 1 cm. During pelvic lymphadenectomy, the thickening was identified, an axial incision was made to the nerve sheath, and a small tumor mass (9 mm x 5 mm x 3 mm) was excised, thereby decompressing the nerve fibers and simultaneously preserving the continuity of the obturator nerve. The nerve sheath was closed using a 7-0 monofilament suture. Frozen section biopsy that was undertaken during the surgical procedure excluded the presence of a malignancy.

There were no intra- or postoperative complications. Postoperatively, the patient described a temporary sensory dysfunction of the left inner-thigh area, which regressed completely. The histopathological result confirmed a benign schwannoma of the obturator nerve. In experienced hands, the robot-assisted approach appears safe and feasible as a technique to excise a schwannoma of the obturator nerve, without the need to proceed to a full nerve resection.

• nerve-sparing
• obturator nerve
• pelvic lymphadenectomy
• robot-assisted
• schwannoma

A neurofibroma was excised from the subcutis on the medial side of the left thigh of a 15-year-old Warmblood gelding, which had shown lameness of the left hind limb. No other source of lameness was found. Two weeks after surgery, the horse was sound at a lameness examination.

• horse
• lameness
• neurofibroma
• peripheral nerve sheath tumor

Neurofibroma can be a clinical manifestation of neurofibromatosis, which is a benign neurogenic tumor that occurs sporadically. Neurofibromas in the abdomen usually appear in the retroperitoneal space. Reports on neurofibromas in the abdominal wall are rare, and multiple recurrent neurofibromas in this area have not yet been reported.

This is a case of a 73-year-old man who suffered from multiple recurrent neurofibromas in the abdominal wall for 16 years and received 13 surgical treatments.

We need to pay due attention to its treatment, and primary surgery should be designed thoroughly.

• Neurofibroma
• Abdominal wall surgery
• Multiple
• Recurrent
• Case report

Thoracic dumbbell tumors are relatively uncommon neoplasms that arise from the neurogenic elements. Surgical resection can be challenging as the tumor involves both the spinal canal and thoracic cavity. Historically, thoracotomy and laminectomy were utilized for the resection of these tumors. Although single-stage removal of such tumors has been described recently, there is no prior description of a total minimally invasive single-stage resection of a thoracic dumbbell ganglioneuroma. The current report describes a completely minimally invasive surgical resection for such a tumor performed using the posterior minimally invasive tubular approach to resect the intraspinal component with ligation of the T2 nerve root in conjunction with robotic-assisted thoracoscopic resection of the extraforaminal, intrathoracic component of the tumor. This report illustrates the safety and utility of a completely minimally invasive endoscopic resection of a thoracic dumbbell tumor that can potentially obviate the morbidity associated with open surgical resections for such tumors.

• Dumbbell tumor
• minimally invasive
• robot assisted
• thoracic spine

• Angioleiomyoma
• Tinel’s sign
• hand
• microsurgery
• nerve compression
• numbness
• tumor resection

• Angiomyoma/diagnosis
• Angiomyoma/pathology
• Angiomyoma/surgery
• Contrast Media
• Female
• Hand/pathology
• Hand/surgery
• Humans
• Hypesthesia/diagnostic imaging
• Hypesthesia/physiopathology
• Magnetic Resonance Imaging/methods
• Male
• Middle Aged
• Peripheral Nerve Injuries/diagnostic imaging
• Peripheral Nerve Injuries/surgery

• The National Natural Science Foundation of China

• Bladder
• schwannoma
• transurethral resection

• Adult
• Cystectomy
• Female
• Humans
• Neurilemmoma/diagnosis
• Neurilemmoma/pathology
• Neurilemmoma/surgery
• Urinary Bladder Neoplasms/diagnosis
• Urinary Bladder Neoplasms/pathology
• Urinary Bladder Neoplasms/surgery

Peripheral nerve tumors are relatively uncommon with schwannomas being the most common type. Schwannomas are usually benign encapsulated tumors composed of neoplastic Schwann cells that generally do not transform to malignancy. Many are discovered incidentally as solitary tumors. The cause is unknown. Most occur spontaneously, while some develop in association with genetic disorders such as neurofibromatosis type 2 or schwannomatosis. Schwannomas can occur anywhere in the body. They affect all ages, with peaking incidence between ages 20 and 50 years, without predilection to sex or race. Many are asymptomatic; however, presenting signs and symptoms, such as paresthesia and pain, are due to mass effect and direct nerve invasion. Diagnosing includes combinations of thorough physical examination, imaging modalities such as magnetic resonance imaging and surgical biopsy. Treatment depends on factors such as location of the tumor and severity of symptoms. Asymptomatic patients are treated conservatively while symptomatic patients undergo surgical resection with favorable prognosis.

•

Pancreatic schwannoma arise from sympathetic and Para sympathetic fibers that cross pancreas.

Introduction: Nerve sheath tumors are tumors arising from nerve sheaths or which show nerve sheath differentiation. They are divided as benign and malignant. They are associated with Von Recklinghausen syndrome. Characterised by café-au-lait spots, lisch nodules, acoustic neuromas, pheochromocytomas.

Presentation of case: A 62 year old gentleman came with complaints of Abdominal discomfort for 1month. He also had Left sided abdominal pain, Anorexia, Vomiting, No history of dyspepsia, fever, bowel disturbance. Patient is a known case of diabetes mellitus II. On abdominal examination a large mass of 10*8 cms was palpated in the left hypochondrium, left lumbar, and umbilical region. It had restricted mobility, not moving with respiration, firm in consistency. On palpation of neck, the thyroid gland was found to be enlarged with palpable right lobe.

Contrast enhanced computed tomography showed large lobulated heterogenously enhancing mass with internal necrosis and calcifications in the left hypochondrium, in the region of distal body and tail of pancreas. There were no other foci of metastasis in abdomen or chest. Chest X-ray of patient was normal. Ultrasound of neck revealed a suspicious nodule in right lobe of thyroid measuring 1*1 cms with no nodal enlargement. Fnac of thyroid nodule was done under image guidance which was suggestive of papillary carcinoma of thyroid. As image guided biopsy of abdominal tumour could not be done patient was planned for laparotomy. The tumor was resected en bloc - distal pancreatectomy and splenectomy. Post opereative biopsy showed irregular spindle shaped cells with nuclei exhibiting “a wavy, buckled appearance” malignant peripheral nerve sheath tumor. Patient was reviewed after a period of 2 months. Positron emission tomography was done which revealed para aortic nodes and 2 mesenteric nodes. It also revealed a metabolically active nodule in thyroid with cervical nodal metastasis. Patient was taken up for total thyroidectomy with functional neck dissection. Histopathology confirmed papillary carcinoma of thyroid with positive lymph nodes. Patient was advised to undergo a radioactive iodine scan showed 0.3% uptake. Patient was started on chemotherapy for para aortic nodes with a regimen of paclitaxel, adriamycin, ifosumide and mesma.

Discussion: Pancreatic schwannoma arise from sympathetic and Para sympathetic fibers that cross over pancreas. Patients Present with abdominal pain and weight loss commonly. Macroscopically they are well circumscribed, encapsulated lesions, homogenous lesions. Microscopically they show Antoni A & B areas. They demonstrate S100, vimentin, CD56 positivity. Most common differential diagnosis are cystic mucinous / serous neoplasms of pancreas. Malignant transformation is extremely rare with only 8 reported cases till now. Treatment is simple enucleation, but a accurate pre-operative diagnosis is difficult to make hence a oncollogically margin negative resection is done. Adjuvant radiotherapy can be given to reduce the tumor load. Chemotherapy can be given with ifosumide and doxorubicin.

Conclusion: Malignant pancreatic nerve sheath tumours are very rare to be found, but have very poor prognosis, hence in cases of pancreatic tumour its better to keep the diagnosis of nerve sheath tumour also a differential diagnosis. In conclusion pancreatic tumours are to be identified at the earliest and surgery should be done for those cases

• MPNST of pancreas
• Malignant peripheral nerve she
• Pancreatic tumour
• Schwanomma
• ath tumour

• Cancer stem cells
• Embryonic
• Hierarchy
• Markers
• Schwannoma
• Stem cells
• Tumour

• Neurofibromas
• Pediatric population
• Peripheral nerve tumors
• Schwannomas

• Adolescent
• Child
• Child, Preschool
• Humans
• Infant
• Infant, Newborn
• Neurilemmoma/therapy
• Neurofibroma/therapy
• Pediatrics/methods
• Peripheral Nerve Injuries/therapy
• Peripheral Nervous System Neoplasms/therapy

• general surgery
• radiology
• surgical oncology

Laryngeal schwannomas are extremely uncommon. We present a case of bulky supraglottic schwannoma with involvement of the preepiglottic and superior paraglottic spaces. Clinical findings, computed tomography and magnetic resonance images are presented. These characteristics are typical, however not specific to schwannomas. For definitive diagnosis, histology and immunohistochemistry are necessary. We present an external mini-invasive approach that allowed us to both obtain diagnosis and provide definitive treatment for this kind of voluminous laryngeal tumour.

• Mini-invasive approach
• Nerve sheath tumours
• Neurilemmoma
• Schwannoma
• Supraglottic larynx

• Abdominal Pain/diagnosis
• Abdominal Pain/etiology
• Diagnosis, Differential
• Humans
• Low Back Pain/diagnosis
• Low Back Pain/etiology
• Male
• Middle Aged
• Neurilemmoma/complications
• Neurilemmoma/diagnosis
• Neurilemmoma/pathology
• Neurilemmoma/surgery
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Pancreatic Neoplasms/complications
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/pathology
• Pancreatic Neoplasms/surgery
• Pancreaticoduodenectomy
• S100 Proteins/metabolism
• Tomography, X-Ray Computed
• Ultrasonography

• 81571750 National Natural Science Foundation of China
• 2014A030311018, 2015A030313043 Natural Science Foundation of Guangdong Province
• 2014A020212125 Guangdong Science and Technology Department

• CK7 = cytokeratin 7
• TENS = transcutaneous electrical nerve stimulation
• eccrine spiradenoma
• neuroma
• neuropathic pain
• peripheral nerve