Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman

Ancient schwannomas (ASs) are a rare type of schwannomas which arise from the Schwann cells. They are characterized by benign nature and long-standing course. Their histopathological hallmark is hemorrhagic and degenerative changes with nuclear atypia. They can be misdiagnosed as malignant tumors bu...

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Main Authors: Milind A. Deshmukh, Vitaladevuni B. Shivkumar, Niloy R. Datta
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Radiation and Cancer Research
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Online Access:https://journals.lww.com/10.4103/jrcr.jrcr_9_24
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author Milind A. Deshmukh
Vitaladevuni B. Shivkumar
Niloy R. Datta
author_facet Milind A. Deshmukh
Vitaladevuni B. Shivkumar
Niloy R. Datta
author_sort Milind A. Deshmukh
collection DOAJ
description Ancient schwannomas (ASs) are a rare type of schwannomas which arise from the Schwann cells. They are characterized by benign nature and long-standing course. Their histopathological hallmark is hemorrhagic and degenerative changes with nuclear atypia. They can be misdiagnosed as malignant tumors but are differentiated by absence of mitotic activity. The median nerve in the arm is rarely involved. Even rarer is the appearance of ASs away from the main median nerve. We describe a case of AS present in proximity to the median nerve in the midarm of an elderly woman. The tumor grew relatively faster over 1.5 years and the patient presented with pain and swelling in the medial side of the right midarm. Following imaging and histopathological examination (HPE), definitive diagnosis was reached. Surgical excision was done performed and further HPE confirmed AS. The patient was further subjected to external beam radiotherapy (RT; 50 Gy over 5 weeks in 25 fractions) to prevent recurrence. RT was well tolerated, and at 2 months of follow-up, there was absence of any radiological sign of recurrence. The differential diagnoses of AS include sarcomas and tumors of neural origin. History, clinical presentation, imaging, and histopathology findings are critical in arriving at the diagnosis of AS.
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spelling doaj-art-5cbb76b5d85f4a90ace5e119dc2f31b12025-08-20T02:44:13ZengWolters Kluwer Medknow PublicationsJournal of Radiation and Cancer Research2588-92732468-92032025-04-01162939510.4103/jrcr.jrcr_9_24Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly WomanMilind A. DeshmukhVitaladevuni B. ShivkumarNiloy R. DattaAncient schwannomas (ASs) are a rare type of schwannomas which arise from the Schwann cells. They are characterized by benign nature and long-standing course. Their histopathological hallmark is hemorrhagic and degenerative changes with nuclear atypia. They can be misdiagnosed as malignant tumors but are differentiated by absence of mitotic activity. The median nerve in the arm is rarely involved. Even rarer is the appearance of ASs away from the main median nerve. We describe a case of AS present in proximity to the median nerve in the midarm of an elderly woman. The tumor grew relatively faster over 1.5 years and the patient presented with pain and swelling in the medial side of the right midarm. Following imaging and histopathological examination (HPE), definitive diagnosis was reached. Surgical excision was done performed and further HPE confirmed AS. The patient was further subjected to external beam radiotherapy (RT; 50 Gy over 5 weeks in 25 fractions) to prevent recurrence. RT was well tolerated, and at 2 months of follow-up, there was absence of any radiological sign of recurrence. The differential diagnoses of AS include sarcomas and tumors of neural origin. History, clinical presentation, imaging, and histopathology findings are critical in arriving at the diagnosis of AS.https://journals.lww.com/10.4103/jrcr.jrcr_9_24ancient schwannomacase reportmedian nerveschwannoma
spellingShingle Milind A. Deshmukh
Vitaladevuni B. Shivkumar
Niloy R. Datta
Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
Journal of Radiation and Cancer Research
ancient schwannoma
case report
median nerve
schwannoma
title Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
title_full Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
title_fullStr Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
title_full_unstemmed Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
title_short Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman
title_sort ancient schwannoma in proximity to the median nerve in the midarm of an elderly woman
topic ancient schwannoma
case report
median nerve
schwannoma
url https://journals.lww.com/10.4103/jrcr.jrcr_9_24
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AT vitaladevunibshivkumar ancientschwannomainproximitytothemediannerveinthemidarmofanelderlywoman
AT niloyrdatta ancientschwannomainproximitytothemediannerveinthemidarmofanelderlywoman