Case analysis: Typical imaging manifestations, pathological basis, and differential diagnosis of retroperitoneal schwannoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SHU Qiang ^1,2 , SHI Hui ³ ,  LU Chunyan ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Medical Imaging, The People’s Hospital of Longhui County, Longhui, Shaoyang, Hunan 422200, P. R. China;
3. Department of Medical Imaging, The People’s Hospital of Longhui County, Longhui, Shaoyang, Hunan 422200, P. R. China;

Corresponding author：

LU Chunyan, Email: luchunyan@wchscu.cn

Keywords：

retroperitoneal; Schwannomas; imaging; pathology

DOI：

10.7507/1007-9424.202408134

Video：

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Schwannomas originating in the retroperitoneal space are relatively rare. The author reported a case of retroperitoneal Schwannoma confirmed by surgery and pathology, presented the typical CT and MRI manifestations of Schwannoma——“target signs”, described the pathophysiological mechanism and image differential diagnosis of the disease, so as to strengthen readers’ understanding of the typical signs of Schwannoma and improve the correct diagnosis rate of the disease.

1.	Dede M, Yagci G, Yenen MC, et al. Retroperitoneal benign schwannoma: report of three cases and analysis of clinico-radiologic findings. Tohoku J Exp Med, 2003, 200(2): 93-97.
2.	Patocskai EJ, Tabatabaian M, Thomas MJ. Cellular schwannoma: a rare presacral tumour. Can J Surg, 2002, 45(2): 141-144.
3.	杨金煜, 唐明杰, 张冠新, 等. 腹膜后神经鞘瘤的临床分析(附3例报道). 中国普外基础与临床杂志, 2012, 19(11): 1242.
4.	Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurgery, 2021, 88(3): 443-456.
5.	Helbing DL, Schulz A, Morrison H. Pathomechanisms in schwannoma development and progression. Oncogene, 2020, 39(32): 5421-5429.
6.	Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
7.	Rajiah P, Sinha R, Cuevas C, et al. Imaging of uncommon retroperitoneal masses. Radiographics, 2011, 31(4): 949-976.
8.	Koga H, Matsumoto S, Manabe J, et al. Definition of the target sign and its use for the diagnosis of schwannomas. Clin Orthop Relat Res, 2007, 464: 224-229.
9.	Bhargava R, Parham DM, Lasater OE, et al. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol, 1997, 27(2): 124-129.
10.	Ko SF, Ng SH, Lee TY, et al. MR imaging of thoracic neurilemmomas. Magn Reson Imaging, 1997, 15(5): 525-533.
11.	Suh JS, Abenoza P, Galloway HR, et al. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology, 1992, 183(2): 341-346.
12.	Varma DG, Moulopoulos A, Sara AS, et al. MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr, 1992, 16(3): 448-453.
13.	Al-Dasuqi K, Irshaid L, Mathur M. Radiologic-pathologic correlation of primary retroperitoneal neoplasms. Radiographics, 2020, 40(6): 1631-1657.
14.	钟婧娇, 詹茜, 张雪凤, 等. 胰腺神经鞘瘤三例的影像学特征并文献复习. 中华胰腺病杂志, 2020, 20(1): 33-40.
15.	郭海南, 张君祥, 石小强, 等. 腹膜后副神经节瘤39例临床分析. 中华普通外科杂志, 2023, 38(12): 894-899.
16.	Marko J, Wolfman DJ. Retroperitoneal leiomyosarcoma from the radiologic pathology archives. Radiographics, 2018, 38(5): 1403-1420.
17.	高金莉. 富于细胞性神经鞘瘤2例临床病理分析. 临床与实验病理学杂志, 2012, 28(3): 341-342.
18.	于泳, 龚沈初, 王睿婷, 等. 14例肠道神经鞘瘤的影像学表现. 复旦学报(医学版), 2024, 51(1): 62-68.
19.	张世辉, 宋涛, 杜晓龙等. 左前臂富细胞性神经鞘瘤I例. 美中国际创伤杂志, 2019, 18(1): 55-56.
20.	Lee NJ, Hruban RH, Fishman EK. Abdominal schwannomas: review of imaging findings and pathology. Abdom Radiol (NY), 2017, 42(7): 1864-1870.
21.	周玲, 李军, 王江涛, 等. 局灶性透明血管型Castleman病的影像学表现与病理特点. 医学影像学杂志, 2018, 28(9): 1493-1496.
22.	曾道兵, 赵新湘, 常婵, 等. 腹盆部局灶性Castleman 病的MRI特征及误诊分析. 临床放射学杂志, 2017, 36(10): 1446-1450.
23.	田彤彤, 胡晓华, 杨国美, 等. 腹部不典型神经鞘瘤的CT表现与病理对照. 临床放射学杂志, 2014, 33(10): 1555-1559.
24.	田彤彤, 杨国美, 胡晓华, 等. 腹膜后囊性神经鞘瘤CT表现. 实用放射学杂志, 2014, 30(6): 1061-1062,1070.

1. Dede M, Yagci G, Yenen MC, et al. Retroperitoneal benign schwannoma: report of three cases and analysis of clinico-radiologic findings. Tohoku J Exp Med, 2003, 200(2): 93-97.
2. Patocskai EJ, Tabatabaian M, Thomas MJ. Cellular schwannoma: a rare presacral tumour. Can J Surg, 2002, 45(2): 141-144.
3. 杨金煜, 唐明杰, 张冠新, 等. 腹膜后神经鞘瘤的临床分析(附3例报道). 中国普外基础与临床杂志, 2012, 19(11): 1242.
4. Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurgery, 2021, 88(3): 443-456.
5. Helbing DL, Schulz A, Morrison H. Pathomechanisms in schwannoma development and progression. Oncogene, 2020, 39(32): 5421-5429.
6. Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
7. Rajiah P, Sinha R, Cuevas C, et al. Imaging of uncommon retroperitoneal masses. Radiographics, 2011, 31(4): 949-976.
8. Koga H, Matsumoto S, Manabe J, et al. Definition of the target sign and its use for the diagnosis of schwannomas. Clin Orthop Relat Res, 2007, 464: 224-229.
9. Bhargava R, Parham DM, Lasater OE, et al. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol, 1997, 27(2): 124-129.
10. Ko SF, Ng SH, Lee TY, et al. MR imaging of thoracic neurilemmomas. Magn Reson Imaging, 1997, 15(5): 525-533.
11. Suh JS, Abenoza P, Galloway HR, et al. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology, 1992, 183(2): 341-346.
12. Varma DG, Moulopoulos A, Sara AS, et al. MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr, 1992, 16(3): 448-453.
13. Al-Dasuqi K, Irshaid L, Mathur M. Radiologic-pathologic correlation of primary retroperitoneal neoplasms. Radiographics, 2020, 40(6): 1631-1657.
14. 钟婧娇, 詹茜, 张雪凤, 等. 胰腺神经鞘瘤三例的影像学特征并文献复习. 中华胰腺病杂志, 2020, 20(1): 33-40.
15. 郭海南, 张君祥, 石小强, 等. 腹膜后副神经节瘤39例临床分析. 中华普通外科杂志, 2023, 38(12): 894-899.
16. Marko J, Wolfman DJ. Retroperitoneal leiomyosarcoma from the radiologic pathology archives. Radiographics, 2018, 38(5): 1403-1420.
17. 高金莉. 富于细胞性神经鞘瘤2例临床病理分析. 临床与实验病理学杂志, 2012, 28(3): 341-342.
18. 于泳, 龚沈初, 王睿婷, 等. 14例肠道神经鞘瘤的影像学表现. 复旦学报(医学版), 2024, 51(1): 62-68.
19. 张世辉, 宋涛, 杜晓龙等. 左前臂富细胞性神经鞘瘤I例. 美中国际创伤杂志, 2019, 18(1): 55-56.
20. Lee NJ, Hruban RH, Fishman EK. Abdominal schwannomas: review of imaging findings and pathology. Abdom Radiol (NY), 2017, 42(7): 1864-1870.
21. 周玲, 李军, 王江涛, 等. 局灶性透明血管型Castleman病的影像学表现与病理特点. 医学影像学杂志, 2018, 28(9): 1493-1496.
22. 曾道兵, 赵新湘, 常婵, 等. 腹盆部局灶性Castleman 病的MRI特征及误诊分析. 临床放射学杂志, 2017, 36(10): 1446-1450.
23. 田彤彤, 胡晓华, 杨国美, 等. 腹部不典型神经鞘瘤的CT表现与病理对照. 临床放射学杂志, 2014, 33(10): 1555-1559.
24. 田彤彤, 杨国美, 胡晓华, 等. 腹膜后囊性神经鞘瘤CT表现. 实用放射学杂志, 2014, 30(6): 1061-1062,1070.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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