« Back
An interesting case of peripheral nerve sheath tumour presenting with acute onset progressive quadriparesis
Poster Title: An interesting case of peripheral nerve sheath tumour presenting with acute onset progressive quadriparesis
Submitted on 23 Sep 2019
Author(s): Sumit Kumar, Prateek Luthra, Rahul Dev
This poster was presented at -
Poster Views: 78
View poster »

Poster Information
Abstract: INTRODUCTION: Peripheral nerve cervical root neurofibromas represents an important clinical problem. Peripheral nerve sheath tumors have been divided into benign and malignant types.
Transforaminal schwannomas are more commonly seen than neurofibromas at cervico-vertebral junction along lower cervical nerve roots.

OBJECTIVE: Differentiating the peripheral nerve sheath tumors on magnetic resonance imaging.

MATERIAL AND METHOD: A 45year old male who presented with pain in the neck for 4 weeks and progressive quadriplegia for 3weeks with bowel/bladder incontinence for 3days. Conventional radiographs, non- contrast Computed Tomography with 64 slices, CEMRI at 3T and histopathological correlation with immunohistochemistry were done to make the final diagnosis.

RESULTS: Eccentric, fusiform, dumbbell-shaped, T2 hyperintense lesion which is all around surrounded by the CSF is seen at transforaminal C5-C6 neural foraminal level on right side suggestive of extradural and intramedullary compartment origin. Imaging diagnosis of benign peripheral nerve sheath tumor was made. Histopathological findings were favoring both neurofibroma and schwannoma. Immunohistochemistry staining with S-100 was negative, so the diagnosis of neurofibroma was made. The patient was operated and the tumor was excised. The postoperative scan was suggestive of complete excision and patient symptoms improved significantly.

CONCLUSION: MR imaging is a non-invasive modality that can differentiate between the benign and malignant nerve sheath tumors by various imaging characteristics and the pathognomic signs but sometimes it is not so. Histopathology and Immunohistochemistry can help in these cases. MRI can also provide precise roadmap and information for 3D model printing which helps the surgeons for their intricate surgeries and reduces the intraoperative complications significantly.
Summary: Peripheral and malignant peripheral nerve sheath tumors can be differentiated on MR imaging but sometimes, the imagings are not pathognomic, so histopathology with immunohistochemistry play a major role in diagnosing these cases. References: 1.Exhibit, E. Costanzo, V. Belfiore, G. Granata, G. Milone, P. Ruggieri, M. Palmucci, S. (2018). Malignant Peripheral Nerve Sheath Tumors ( MPNSTs ): clinical features and radiologic-pathologic correlation, 1–19.
2.Kakkar, C. Shetty, C. M. Koteshwara, P. & Bajpai, S. (2015). Telltale signs of peripheral neurogenic tumors on magnetic resonance imaging, 25(4), 5-10.
Report abuse »
Ask the author a question about this poster.
Ask a Question »

Creative Commons

Related Posters

Etiological diagnostics of cardiomyopathies in the cardiology unit of the HUEH internal medicine department during the period from 8 January 2014 to 14 June 2014
*Axler JEAN PAUL; **Lesly Ed. ARCHER; *Raema Mimrod JEAN; *Gerald VERNELUS; *Rodolph MALEBRANCHE

Medical Student: Move over Stem Cells – Exosomes are Here! What are Exosomes & their role in Regenerative Medicine?
Amartej Singh Deol MD4 & Advisor: Shivinder S. Deol MD

Briand Bounkeu MD; Ravi Shekarappa MD; La Toya Jackson DO, FAAFP; Chinedu Ivonye MD, FACP; Cristal Kudiwu MD

Chronic Recurrent Multifocal Osteomyelitis Involving the Mandible
Alamoudi, A*; Panneer Selvam, N; Hansen, M; Ruprecht, A; Kashtwari, D

Striving for Equity in Surgical, Anesthesia, and Obstetric Research in Haiti: A Multi-Partner, International Research Training Collaboration
Dr. Jean Alouidor*, Dr. Frédéric Barau Déjean*, Dr. Louis-Franck Télémaque, Dr. Ronald Eveillard, Dr. Laëlle Mangurat, Dr. Isaac Martineau, Dr. Chartelin Jean Isaac, Dr. Darlène Rochelin Paultre, Carine Réveil Jean-Baptiste, Dr. Lucile Louis Riché, Dr. Jordan Pyda, Rolvix Patterson III, Dr. Blake Alkire, Dr. Eunice Dérivois-Mérisier (*Co-First Authors)