Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management
Malignant peripheral nerve sheath tumors (MPNSTs) are rare and aggressive sarcomas often associated with neurofibromatosis type 1 (NF1) or prior radiation therapy. We report the case of a 26-year-old male who presented with a rapidly enlarging, painful mass in the left shoulder initially misdiagnose...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043325004509 |
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| author | Oukassem Siham Abourak Chaimae Sqalli Houssaini Abdelkader Guennouni Asma Moatassim Billah Nabil Ittimad Nassar Imrani Kaoutar Iraqui Iman Derqaoui Sabrine Znati Kaoutar |
| author_facet | Oukassem Siham Abourak Chaimae Sqalli Houssaini Abdelkader Guennouni Asma Moatassim Billah Nabil Ittimad Nassar Imrani Kaoutar Iraqui Iman Derqaoui Sabrine Znati Kaoutar |
| author_sort | Oukassem Siham |
| collection | DOAJ |
| description | Malignant peripheral nerve sheath tumors (MPNSTs) are rare and aggressive sarcomas often associated with neurofibromatosis type 1 (NF1) or prior radiation therapy. We report the case of a 26-year-old male who presented with a rapidly enlarging, painful mass in the left shoulder initially misdiagnosed as an abscess. MRI revealed a large extra-compartmental lesion with heterogeneous enhancement infiltrating the trapezius muscle. Histopathology confirmed MPNST, showing high mitotic activity (16/10 HPF), 10% necrosis, and a Ki-67 index of 40%, with diffuse Sox10 and focal S100 positivity. The patient received neoadjuvant radiotherapy followed by complete surgical excision and defect reconstruction using a pedicled trapezius flap and a split-thickness skin graft. This case highlights the importance of early imaging, multidisciplinary planning, and multimodal treatment in the management of MPNSTs. |
| format | Article |
| id | doaj-art-3efd24882d414c1d865fc5cb8971f8fb |
| institution | OA Journals |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-3efd24882d414c1d865fc5cb8971f8fb2025-08-20T02:36:45ZengElsevierRadiology Case Reports1930-04332025-09-012094417442310.1016/j.radcr.2025.05.018Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal managementOukassem Siham0Abourak Chaimae1Sqalli Houssaini Abdelkader2Guennouni Asma3Moatassim Billah Nabil4Ittimad Nassar5Imrani Kaoutar6Iraqui Iman7Derqaoui Sabrine8Znati Kaoutar9Radiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco; Corresponding author.Radiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoRadiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoRadiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoRadiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoRadiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoRadiology Central Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MoroccoDepartment of Pathology, Ibn Sina University Hospital Center. Mohammed V University, Rabat, MoroccoDepartment of Pathology, Ibn Sina University Hospital Center. Mohammed V University, Rabat, MoroccoDepartment of Pathology, Ibn Sina University Hospital Center. Mohammed V University, Rabat, MoroccoMalignant peripheral nerve sheath tumors (MPNSTs) are rare and aggressive sarcomas often associated with neurofibromatosis type 1 (NF1) or prior radiation therapy. We report the case of a 26-year-old male who presented with a rapidly enlarging, painful mass in the left shoulder initially misdiagnosed as an abscess. MRI revealed a large extra-compartmental lesion with heterogeneous enhancement infiltrating the trapezius muscle. Histopathology confirmed MPNST, showing high mitotic activity (16/10 HPF), 10% necrosis, and a Ki-67 index of 40%, with diffuse Sox10 and focal S100 positivity. The patient received neoadjuvant radiotherapy followed by complete surgical excision and defect reconstruction using a pedicled trapezius flap and a split-thickness skin graft. This case highlights the importance of early imaging, multidisciplinary planning, and multimodal treatment in the management of MPNSTs.http://www.sciencedirect.com/science/article/pii/S1930043325004509MPNSTSoft tissue sarcomaMRISurgical resection |
| spellingShingle | Oukassem Siham Abourak Chaimae Sqalli Houssaini Abdelkader Guennouni Asma Moatassim Billah Nabil Ittimad Nassar Imrani Kaoutar Iraqui Iman Derqaoui Sabrine Znati Kaoutar Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management Radiology Case Reports MPNST Soft tissue sarcoma MRI Surgical resection |
| title | Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management |
| title_full | Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management |
| title_fullStr | Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management |
| title_full_unstemmed | Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management |
| title_short | Malignant peripheral nerve sheath tumor of the shoulder: A rare case highlighting the role of multimodal management |
| title_sort | malignant peripheral nerve sheath tumor of the shoulder a rare case highlighting the role of multimodal management |
| topic | MPNST Soft tissue sarcoma MRI Surgical resection |
| url | http://www.sciencedirect.com/science/article/pii/S1930043325004509 |
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