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Schwannoma of bone

Summary

Schwannoma, or neurilemmoma, is a rare benign tumor of bone

Schwannomas are found at all ages but most commonly between age 20 and 50.
Most lesions are asymptomatic.
Radiologically, schwannomas present as well-circumscribed lytic, expansile lesions with sclerotic borders.
Most lesions may be observed without surgery. Curettage is effective for symptomatic or large lesions.
Complete Information on this Tumor
Introduction and Definition: 

Schwannoma, or neurilemmoma, is a rare benign tumor of bone. It accounts for less than 0.1%1 of all bone neoplasms. It occurs most often in the head, neck, and flexor surfaces of upper and lower extremities.

Incidence and Demographics: 
Schwannomas are found at all ages but most commonly between age 20 and 50.
Symptoms and Presentation: 

Most lesions are asymptomatic.

X-Ray Appearance and Advanced Imaging Findings: 
Radiologically, schwannomas present as well-circumscribed lytic, expansile lesions with sclerotic borders.
Laboratory Findings: 
On gross examination, a schwannoma as is a soft pink to yellow encapsulated mass less than five centimeters in size. The lesion may have cysts or calcification.
Histopathology findings: 
Histologically, schwannomas have two distinct components. The Antoni A regions are highly ordered and cellular with spindle shaped Schwann cells that have poorly defined eosinophilic cytoplasm and basophilic nuclei. Verocan,T bodies are configurations of palisading cells that alternate with acellular eosinophilic areas. The Antoni B regions are much less cellular and are characterized by large thin walled vessels surrounded edematous stroma. Schwannomas stain positive for S100 and vimentin.
Treatment Options for this Tumor: 
Most lesions may be observed without surgery. Curettage is effective for symptomatic or large lesions.
Suggested Reading and Reference: 
1 Huvos, Andrew, Bone Tumors:Diagnosis. Treatment and Prognosis, W.B. Saunders, Co., 1991. Fletcher, Christopher, Diagnostic Histopathology of Tumors, Churchill Livingstone, 1995. 1/22/98
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