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LETTER TO EDITOR Table of Contents   
Year : 2008  |  Volume : 51  |  Issue : 3  |  Page : 455-456
Synchronous schwannomas not associated with neurofibromatosis


Department of Pathology, Kasturba Medical College, Manipal - 576 104, Karnataka, India

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How to cite this article:
Mathew M, Valiathan M. Synchronous schwannomas not associated with neurofibromatosis. Indian J Pathol Microbiol 2008;51:455-6

How to cite this URL:
Mathew M, Valiathan M. Synchronous schwannomas not associated with neurofibromatosis. Indian J Pathol Microbiol [serial online] 2008 [cited 2019 Dec 15];51:455-6. Available from: http://www.ijpmonline.org/text.asp?2008/51/3/455/42531


Sir,

Schwannomas are exclusively solitary tumors unless associated with neurofibromatosis. [1] We report a unique case of synchronous adrenal and lung schwannomas with no evidence of neurofibromatosis.

A 58-year-old male presented with a history of easy fatigability of 5 months' duration. Clinical examination was unremarkable. He had no evidence of neurofibromatosis. CT scan revealed two masses. The first mass was a well-defined, heterogeneously enhancing lesion in the lower lobe of the left lung measuring 11 9 8.3 cm, abutting the descending aorta medially and extending laterally to the left lateral chest wall. The second mass was seen in the region of and not separate from the left adrenal gland measuring 5 5 4.5 cm. An explorative laprotomy and left thoracotomy were done.

On gross examination, the left lower lobe mass weighed 420 gms and measured 12 9 7 cm. Cut section showed a single cyst filled with hemorrhagic fluid and surrounded by solid gray-white and yellow areas.

The adrenal mass weighed 57 gms and measured 7 4 4 cm. Cut section showed yellow and gray-white areas [Figure 1].

Histologically, both the masses showed tumors composed predominantly of bland, spindle-shaped cells arranged in a palisading fashion (Antoni A areas), with occasional Verocay bodies surrounding the hyalinized blood vessels. Focal areas of edema with numerous foamy histiocytes and ancient change were seen [Figure 2]. Both these tumors were immunoreactive for S-100 protein.

Benign schwannoma arising in the lung is extremely rare and infrequent cases have been documented. [2],[3] Adrenal schwannomas, on the other hand, have been documented; [4],[5] however, only 10 cases have been reported in the literature. Synchronous schwannomas are even rarer lesions and when they occur, are usually associated with neurofibromatosis. In our case, the patient had no evidence of neurofibromatosis. To the best of our knowledge, synchronous schwannoma of the lung and the adrenal gland has not been reported in the literature. This case is documented for its rarity.

 
   References Top

1.Seppala MT, Sainio MA, Haltia MJ, Kinnunen JJ, Setδlδ KH, Jδδskelδinen JE. Multiple schwannomas: Schwannomatosis or neurofibromatosis type 2? J Neurosurg 1998;89:36-41.  Back to cited text no. 1    
2.Inow M, Maruyama K, Furuhota Y, Kasahara D, Tanaka I, Takemura: Cellular Schwannoma of the lung. Nippon Kyobu Geka Gakkai Zasshi 1992;40:1951-4.  Back to cited text no. 2    
3.Chang C, Fan Y, Bai C, Chemg S. Schwannoma mimicking lung cancer metastases demonstrated by PET-CT. Clin Nucl Med 2006;31:644-5.  Back to cited text no. 3    
4.Garg S, Mathew M, Goel T. Adrenal Schwannoma: A case report and review of literature. Indian J Pathol Microbiol 2007;50:587-8.  Back to cited text no. 4    
5.Lau SK, Spagnolo DV, Weiss LM. Schwannoma of the adrenal gland: A report of 2 cases. Am J Surg Pathol 2006;30:630-4.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]

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Correspondence Address:
Mary Mathew
Department of Pathology, Kasturba Medical College, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.42531

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  [Figure 1], [Figure 2]



 

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