ObjectiveTo investigate the sonographic characteristics and diagnostic value of color Doppler sonography for patients with renal schwannoma. MethodsTen patients with pathologically confirmed renal schwannoma dimensional ultrasonography treated between January 2008 and May 2014 were included in this study. We analyzed and summarized their color flow distribution characteristics. ResultsThe ultrasound of the 10 patients showed substantial hypoechoic mass with clear boundary and complete capsule; color Doppler flow imaging displayed mass within the probe and a small amount of dotted blood flow information or no obvious blood flow information. Four patients were suspected to have schwannoma before surgery by ultrasound diagnosis, while the remaining 6 cases only showed benign lesions without clear diagnosis. All the patients underwent surgery subsequently under laparoscope, and resection of the tumor was performed with the integrity of normal kidney tissue retained. Postoperative recovery was good, and follow-up did not detect any recurrence. ConclusionColor Doppler ultrasound has a certain specificity on the diagnosis of renal schwannoma. Combined with other examination methods, it can not only give the clinicians a good suggestion, but avoid laparotomy.
Objective To summarize the research progress of gastric schwannoma (GS). Methods GS related researches and case reports were collected to make a review on general clinical manifestations, pathology characteristics, auxiliary examinations, differential diagnosis, and treatment. Results GS is rare in clinical reports, and it is lack of tissue specificity. Diagnosis is rely mainly on the expressions of S-100 protein and glial fibrillary acidic protein (GFAP). All kinds of auxiliary examinations, such as gastrointestinal angiography, ultrasound, endoscope, CT, an so on, could not independently as a diagnostic basis. Identification between GS and other gastric tumors is difficult, and GS is not sensitive to radiation and chemotherapy, the main treatment is surgery. Conclusions GS is a kind of rare tumor which occurs in gastric mucosa, immunohistochemistry is the most main examination for the diagnosis of GS. The surgical excision is the main treatment for GS, but the safety and efficacy of combination therapy of laparoscopy and endoscopy remains to be study.
Microsurgery has always been the main treatment for large vestibular schwannomas. With the progress of microsurgical technique and neuroimaging, the application of the intraoperative physiological monitoring technology, as well as the popularization of the concept of minimally invasive neurosurgery, the current development trend of surgery for vestibular schwannomas is to realize both the maximal tumoral resection and the maximal preservation of facial nerve function, which puts more emphasis on the improvement of quality of life. It is still a challenge for neurosurgeons to resect the tumor to the maximum extent and preserve the nerve function as well. In view of this background, the strategy of " near-total resection” and " subtotal resection” combined with stereotactic radiotherapy has been more and more accepted in the past years. However, as a neurosurgeon, the ultimate goal should be " gross-total resection of tumor” and preservation of the nerve function as well. For those tumors severely adherent to neurovascular structure, " near total resection” might be a rational choice. Meanwhile, long-term follow-up should be conducted to clarify the biological behavior of tumor residues, as well as the necessity and long-term effect of stereotactic radiotherapy.
ObjectiveTo summarize the clinicopathological features of microencapsulated/reticular schwannoma.MethodsTwo cases of microencapsulated/reticular schwannoma treated in West China Hospital of Sichuan University were retrospectively collected. The histological and immunohistochemical features were summarized, and the related literatures were reviewed.ResultsTwo cases of microcystic/reticular neurilemmoma diagnosed and treated in West China Hospital of Sichuan University were male. The clinical manifestations were “dull pain in the right lower abdomen” and “mass of left index finger”. Microscopically, the characteristic reticular or cribriform structures were found in all cases, and lymphocytic sheath was seen in 1 case. Immunohistochemical staining showed S-100, glial fibrillary acidic protein (GFAP) and calretinin positive. By February 2020, only 41 cases were reported in the literatures （there were no cases of this group),there was no significant gender difference, the median age was 55 years (11–93 years), and the median size of the lesion was 2.1 cm (0.4–13.0 cm). Most of them were found by accident, without obvious symptoms and signs, and no history of neurofibromatosis type 1 or 2. Microencapsulated/reticular schwannoma in this patients mainly occurs in the viscera, especially in the gastrointestinal tract (mostly in the the colorectal of lower gastrointestinal tract ), most of them were solitary nodular masses without capsule. Microscopically, the boundary was clear, and the characteristic microcapsules and reticular structures were seen. The tumor cells were diffusely expressing S-100 protein, and GFAP and calretinin were expressed in varying degrees. Electron microscopy showed the characteristics of Schwann cells.ConclusionsMicrocystic/reticular schwannoma is a rare subtype of schwannoma, which needs to be differ-entiated from multiple benign and malignant neoplasms. The diagnosis of the tumor is a challenge for the pathologist.