The Intraosseous Schwannoma of the Upper Extremity

Introduction Schwannomas are benign soft tissue tumors of neural origin, predominantly occurring in the head and neck regions due to their rich innervation. Intraosseous schwannoma (IOS) is an exceedingly rare form of schwannoma. This study aims to enhance the understanding of intraosseous schwan...

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Main Authors: Nandlal Bharwani, Abhijeet Ashok Salunke, Dhruv Patel, Ritesh Suthar, Keval Patel, Ishan Arora, Ashok Govada, Shashank Pandya
Format: Article
Language:English
Published: SJORANM GmbH (Ltd.) 2024-06-01
Series:Swiss Journal of Radiology and Nuclear Medicine
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Online Access:https://sjoranm.com/sjoranm/article/view/34
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author Nandlal Bharwani
Abhijeet Ashok Salunke
Dhruv Patel
Ritesh Suthar
Keval Patel
Ishan Arora
Ashok Govada
Shashank Pandya
author_facet Nandlal Bharwani
Abhijeet Ashok Salunke
Dhruv Patel
Ritesh Suthar
Keval Patel
Ishan Arora
Ashok Govada
Shashank Pandya
author_sort Nandlal Bharwani
collection DOAJ
description Introduction Schwannomas are benign soft tissue tumors of neural origin, predominantly occurring in the head and neck regions due to their rich innervation. Intraosseous schwannoma (IOS) is an exceedingly rare form of schwannoma. This study aims to enhance the understanding of intraosseous schwannoma by reviewing cases affecting the upper extremity bones and providing a detailed analysis of their radiographic and magnetic resonance imaging (MRI) characteristics along with a review of the literature on these rare tumors. Material and Methods A total of three patients with IOS in upper extremity bones were identified and analyzed. Radiographs and MRI scans were available for all patients. A comprehensive literature review was conducted, including case reports, retrospective studies, and reviews of published data. The epidemiology, anatomical distribution, radiographic characteristics, histological findings, and therapeutic outcomes of intraosseous schwannoma were all investigated, identifying 31 documented cases of IOS involving extremity bones. Results Intraosseous schwannomas primarily affect the mandible, followed by the sacrum and vertebrae. Patients frequently present with non-specific symptoms such as localized pain, swelling, or neurological impairments, which can lead to delayed diagnosis. Radiographic evaluation of IOS typically reveals lytic lesions with well-defined, expansile features and thin sclerotic rims. MRI findings showed that IOS lesions appeared low to iso-intense on T1-weighted images and hyper-intense on T2-weighted images. These imaging characteristics are crucial for differentiating IOS from other lytic bone lesions. Histologically, the presence of Antoni A and Antoni B patterns, as well as S-100 protein positivity, confirms the diagnosis. Surgical management, consisting of curettage, provides a favorable prognosis and low recurrence rates. Conclusion Despite its rarity, intraosseous schwannoma should be considered in the differential diagnosis of well-defined, expansile lytic bone lesions, particularly those with thin sclerotic rims. This review provides the most comprehensive analysis to date of IOS affecting extremity bones, emphasizing the importance of recognizing this entity in clinical practice.
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spelling doaj-art-03d83c008b074f81a3d11fc8b2caddb32025-08-20T03:10:57ZengSJORANM GmbH (Ltd.)Swiss Journal of Radiology and Nuclear Medicine2813-72212024-06-019110.59667/sjoranm.v9i1.18The Intraosseous Schwannoma of the Upper ExtremityNandlal Bharwani0https://orcid.org/0000-0002-6152-5287Abhijeet Ashok Salunke1https://orcid.org/0000-0003-0103-8599Dhruv Patel2https://orcid.org/0000-0003-4784-3083Ritesh Suthar3https://orcid.org/0000-0002-9383-069XKeval Patel4https://orcid.org/0000-0001-7464-0332Ishan Arora5https://orcid.org/0000-0002-2828-8611Ashok Govada6Shashank Pandya7https://orcid.org/0000-0002-8432-4293Orthopedic Oncology, Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaConsultant Orthopedic Oncosurgeon & Assistant Professor Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaFellow Orthopedic Oncology, Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaAssistant Professor, Department of Nuclear Medicine, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaDepartment of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, India Second year Resident, Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaSecond year resident,Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, IndiaDirector, Department of Surgical Oncology, The Gujarat Cancer and Research Institute, Ahemdabad, India Introduction Schwannomas are benign soft tissue tumors of neural origin, predominantly occurring in the head and neck regions due to their rich innervation. Intraosseous schwannoma (IOS) is an exceedingly rare form of schwannoma. This study aims to enhance the understanding of intraosseous schwannoma by reviewing cases affecting the upper extremity bones and providing a detailed analysis of their radiographic and magnetic resonance imaging (MRI) characteristics along with a review of the literature on these rare tumors. Material and Methods A total of three patients with IOS in upper extremity bones were identified and analyzed. Radiographs and MRI scans were available for all patients. A comprehensive literature review was conducted, including case reports, retrospective studies, and reviews of published data. The epidemiology, anatomical distribution, radiographic characteristics, histological findings, and therapeutic outcomes of intraosseous schwannoma were all investigated, identifying 31 documented cases of IOS involving extremity bones. Results Intraosseous schwannomas primarily affect the mandible, followed by the sacrum and vertebrae. Patients frequently present with non-specific symptoms such as localized pain, swelling, or neurological impairments, which can lead to delayed diagnosis. Radiographic evaluation of IOS typically reveals lytic lesions with well-defined, expansile features and thin sclerotic rims. MRI findings showed that IOS lesions appeared low to iso-intense on T1-weighted images and hyper-intense on T2-weighted images. These imaging characteristics are crucial for differentiating IOS from other lytic bone lesions. Histologically, the presence of Antoni A and Antoni B patterns, as well as S-100 protein positivity, confirms the diagnosis. Surgical management, consisting of curettage, provides a favorable prognosis and low recurrence rates. Conclusion Despite its rarity, intraosseous schwannoma should be considered in the differential diagnosis of well-defined, expansile lytic bone lesions, particularly those with thin sclerotic rims. This review provides the most comprehensive analysis to date of IOS affecting extremity bones, emphasizing the importance of recognizing this entity in clinical practice. https://sjoranm.com/sjoranm/article/view/34Intra-osseous SchwannomaIOSUpper ExtremityUpper Limb TumorsSchwannoma of Bones
spellingShingle Nandlal Bharwani
Abhijeet Ashok Salunke
Dhruv Patel
Ritesh Suthar
Keval Patel
Ishan Arora
Ashok Govada
Shashank Pandya
The Intraosseous Schwannoma of the Upper Extremity
Swiss Journal of Radiology and Nuclear Medicine
Intra-osseous Schwannoma
IOS
Upper Extremity
Upper Limb Tumors
Schwannoma of Bones
title The Intraosseous Schwannoma of the Upper Extremity
title_full The Intraosseous Schwannoma of the Upper Extremity
title_fullStr The Intraosseous Schwannoma of the Upper Extremity
title_full_unstemmed The Intraosseous Schwannoma of the Upper Extremity
title_short The Intraosseous Schwannoma of the Upper Extremity
title_sort intraosseous schwannoma of the upper extremity
topic Intra-osseous Schwannoma
IOS
Upper Extremity
Upper Limb Tumors
Schwannoma of Bones
url https://sjoranm.com/sjoranm/article/view/34
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