Degenerated (Ancient) Schwannomas: Unraveling Unusual Locations and Treatment Management

Goksal Gunerhan; Emin Çağıl; Yigit Can Senol; Zeynep Dağlar; Egemen Işıtan; Bekir Tunç; Servet Güreşci; Ali Dalgıç

Makale detayları

Degenerated (Ancient) Schwannomas: Unraveling Unusual Locations and Treatment Management

Yazarlar:

Goksal Gunerhan | Emin Çağıl | Yigit Can Senol | Zeynep Dağlar | Egemen Işıtan | Bekir Tunç | Servet Güreşci | Ali Dalgıç

Yayıncı:

Selcuk University

Ana Başlıklar:

Patoloji | Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.34 Issue 2, pp.195-200

Belge Tipi:

Makale

Yayın Tarihi:

4/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001316099

pISSN:

2602-3741

Anahtar kelimeler:

Özet:

 BackgroundAims:Schwannomas, originating from Schwann cells in peripheral nerve sheaths, exhibit diverse clinical manifestations and unpredictable behavior. Among them, ancient schwannomas, with distinctive degenerative features, present in atypical locations and pose diagnostic challenges. This study explores their unique characteristics and implications for diagnosis and management. Material and Methods: The study was designed as a retrospective analysis of 7 adult patients aged 18 years, diagnosed with paraspinal, presacral, sacral, or para-aortic tumors, all confirmed histologically as ancient schwannomas. Data for analysis were collected from patients treated and followed up at Ankara City Hospital between April 2017 and December 2022. Ethical approval and informed consent were obtained before inclusion in the study. Results: The most common symptoms included the presence of a local lump 71,4 and localized or radiating pain 57,1. Notably, 1 patient 14,2 was incidentally diagnosed during the evaluation process. Surgical intervention played a crucial role in the management of these tumors, with 71,4 of patients undergoing complete resection, while 28,5 underwent subtotal resection. Tumor recurrence occurred in 42,8 of cases, prompting the administration of radiotherapy as part of the treatment strategy. Imaging findings, particularly on MRI, played a crucial role in the accurate identification of ancient schwannomas. These tumors displayed isointensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images, along with distinctive heterogeneous contrast enhancement. Conclusion: Ancient schwannomas exhibit unique histological features and distinctive MRI characteristics, differentiating them from other nerve sheath tumors. Early diagnosis and complete surgical resection offer favorable outcomes. Awareness of this entity is essential for managing peripheral nerve sheath tumors effectively.

 BackgroundAims:Schwannomas, originating from Schwann cells in peripheral nerve sheaths, exhibit diverse clinical manifestations and unpredictable behavior. Among them, ancient schwannomas, with distinctive degenerative features, present in atypical locations and pose diagnostic challenges. This study explores their unique characteristics and implications for diagnosis and management. Material and Methods: The study was designed as a retrospective analysis of 7 adult patients aged 18 years, diagnosed with paraspinal, presacral, sacral, or para-aortic tumors, all confirmed histologically as ancient schwannomas. Data for analysis were collected from patients treated and followed up at Ankara City Hospital between April 2017 and December 2022. Ethical approval and informed consent were obtained before inclusion in the study. Results: The most common symptoms included the presence of a local lump 71,4 and localized or radiating pain 57,1. Notably, 1 patient 14,2 was incidentally diagnosed during the evaluation process. Surgical intervention played a crucial role in the management of these tumors, with 71,4 of patients undergoing complete resection, while 28,5 underwent subtotal resection. Tumor recurrence occurred in 42,8 of cases, prompting the administration of radiotherapy as part of the treatment strategy. Imaging findings, particularly on MRI, played a crucial role in the accurate identification of ancient schwannomas. These tumors displayed isointensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images, along with distinctive heterogeneous contrast enhancement. Conclusion: Ancient schwannomas exhibit unique histological features and distinctive MRI characteristics, differentiating them from other nerve sheath tumors. Early diagnosis and complete surgical resection offer favorable outcomes. Awareness of this entity is essential for managing peripheral nerve sheath tumors effectively.

 BackgroundAims:Schwannomas, originating from Schwann cells in peripheral nerve sheaths, exhibit diverse clinical manifestations and unpredictable behavior. Among them, ancient schwannomas, with distinctive degenerative features, present in atypical locations and pose diagnostic challenges. This study explores their unique characteristics and implications for diagnosis and management. Material and Methods: The study was designed as a retrospective analysis of 7 adult patients aged 18 years, diagnosed with paraspinal, presacral, sacral, or para-aortic tumors, all confirmed histologically as ancient schwannomas. Data for analysis were collected from patients treated and followed up at Ankara City Hospital between April 2017 and December 2022. Ethical approval and informed consent were obtained before inclusion in the study. Results: The most common symptoms included the presence of a local lump 71,4 and localized or radiating pain 57,1. Notably, 1 patient 14,2 was incidentally diagnosed during the evaluation process. Surgical intervention played a crucial role in the management of these tumors, with 71,4 of patients undergoing complete resection, while 28,5 underwent subtotal resection. Tumor recurrence occurred in 42,8 of cases, prompting the administration of radiotherapy as part of the treatment strategy. Imaging findings, particularly on MRI, played a crucial role in the accurate identification of ancient schwannomas. These tumors displayed isointensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images, along with distinctive heterogeneous contrast enhancement. Conclusion: Ancient schwannomas exhibit unique histological features and distinctive MRI characteristics, differentiating them from other nerve sheath tumors. Early diagnosis and complete surgical resection offer favorable outcomes. Awareness of this entity is essential for managing peripheral nerve sheath tumors effectively.

 Amaç: Periferik sinir kılıflarındaki Schwann hücrelerinden kaynaklanan Schwannomlar, çeşitli klinik belirtiler ve öngörülemeyen davranışlar sergilerler. Bunlar arasında, belirgin dejeneratif özelliklere sahip olan eski schwannomlar atipik lokasyonlarda bulunur ve tanısal zorluklar oluşturur. Bu çalışma, bunların benzersiz özelliklerini ve tanı ve yönetim için etkilerini araştırmaktadır. Gereç ve Yöntemler: Çalışma, paraspinal, presakral, sakral veya para-aortik tümör tanısı konan ve histolojik olarak antik schwannom olduğu doğrulanan 18 yaşındaki 7 yetişkin hastanın retrospektif analizi olarak tasarlanmıştır. Analiz için veriler, Nisan 2017 ile Aralık 2022 tarihleri arasında Ankara Şehir Hastanesinde tedavi ve takip edilen hastalardan toplanmıştır. Çalışmaya dahil edilmeden önce etik onay ve bilgilendirilmiş onam alınmıştır. Bulgular: En sık görülen semptomlar lokal bir kitlenin varlığı 71,4 ve lokalize veya yayılan ağrı 57,1 idi. Özellikle, 1 hastaya 14,2 değerlendirme sürecinde tesadüfen tanı konuldu. Cerrahi müdahale bu tümörlerin yönetiminde önemli bir rol oynamış, hastaların 71,4üne tam rezeksiyon, 28,5ine ise subtotal rezeksiyon uygulanmıştır. Vakaların 42,8inde tümör nüksü meydana gelmiş ve bu da tedavi stratejisinin bir parçası olarak radyoterapi uygulanmasını gerektirmiştir. Görüntüleme bulguları, özellikle de MRG, eski schwannomların doğru tanımlanmasında çok önemli bir rol oynamıştır. Bu tümörler T1 ağırlıklı görüntülerde izointensite ve T2 ağırlıklı görüntülerde heterojen hiperintensite ve belirgin heterojen kontrast artışı göstermiştir. Sonuç: Antik schwannomlar benzersiz histolojik özellikler ve ayırt edici MRG özellikleri sergileyerek diğer sinir kılıfı tümörlerinden ayrılırlar. Erken tanı ve tam cerrahi rezeksiyon olumlu sonuçlar sağlamaktadır. Bu antitenin farkında olmak, periferik sinir kılıfı tümörlerini etkili bir şekilde yönetmek için gereklidir.

Makale detayları

Degenerated (Ancient) Schwannomas: Unraveling Unusual Locations and Treatment Management

Yazarlar:

Goksal Gunerhan | Emin Çağıl | Yigit Can Senol | Zeynep Dağlar | Egemen Işıtan | Bekir Tunç | Servet Güreşci | Ali Dalgıç

Yayıncı:

Selcuk University

Ana Başlıklar:

Patoloji | Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.34 Issue 2, pp.195-200

Belge Tipi:

Makale

Yayın Tarihi:

4/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001316099

pISSN:

2602-3741

Schwannoma

Ancient

Benign tumor

neural tumors

Schwann cells.Schwannoma

Antik

Benign tümör

nöral tümörler

Schwann hücreleri.

Sayı

Makale detayları

Yazarlar: Goksal Gunerhan | Emin Çağıl | Yigit Can Senol | Zeynep Dağlar | Egemen Işıtan | Bekir Tunç | Servet Güreşci | Ali Dalgıç

Yayıncı: Selcuk University

Ana Başlıklar: Patoloji | Klinik Tıp Bilimleri (Diğer)

Dergi: Genel Tıp Dergisi Vol.34 Issue 2, pp.195-200

Belge Tipi: Makale

Yayın Tarihi: 4/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001316099

pISSN: 2602-3741

Sayı

Yazarlar:

Goksal Gunerhan | Emin Çağıl | Yigit Can Senol | Zeynep Dağlar | Egemen Işıtan | Bekir Tunç | Servet Güreşci | Ali Dalgıç

Yayıncı:

Selcuk University

Ana Başlıklar:

Patoloji | Klinik Tıp Bilimleri (Diğer)

Dergi:

Genel Tıp Dergisi Vol.34 Issue 2, pp.195-200

Belge Tipi:

Makale

Yayın Tarihi:

4/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001316099

pISSN:

2602-3741