. Schwannoma of Bone. PORTNotes. In: OrthopaedicsOne - The Orthopaedic Knowledge Network. Created Feb 16, 2009 16:54. Last modified Mar 02, 2012 13:05 ver.5. Retrieved 2019-05-23, from https://www.orthopaedicsone.com/x/UwEjAQ.
DEFINITION AND PATHOGENESIS
- Not of bone origin, but may cause massive bony destruction when of spinal origin, particularly the sacrum
- An important cause of "scalloping from without" (compared to "scalloping from within" by enchondroma)
- Pelvic mass
- ? neurological signs/sxs
- Long hx of pain
- MRI reveals extrapinal extent with smooth, round borders, maintainence of fat planes, and encapsulation, ? necrosis
- Encapsulated, separable from nerves
- Composed of alternating Antoni A (cellular) and Antoni B (hypocellular) regions
- + S-100
DIFFERENTIAL CLINICOPATHOLOGIC DIAGNOSIS
- Chordoma (when in the sacrum or spine)
DISEASE COURSE AND TREATMENT
- Large tumors can undergo central necrosis, secondary infection has been reported
- Debulking to gain vascular control, piecemeal excsion with thorough bony curettage
- Anterior approach when majority of tumor anterior ? omental mobilization
- A variant with cellular Antoni A but no Antoni B areas and without hypocellular Verocay bodies which can be mistaken for malignant schwannoma
Lin PP, Horenstein MG, Healey JH: Sacral mass in a 56-year-old woman. Clin Orthop 344:333-7,41-3,1997.
Mirra, JM: Neurogenous tumors. In Bone Tumors. Clinical, radiologic, and pathologic correlations. JM Mirra (Ed), Lea & Febiger, Philadelphia, 1989, pp 801-867.