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Year : 2009  |  Volume : 52  |  Issue : 2  |  Page : 281-282
Giant appendicular schwannoma in a child

1 Department of Pathology, IHBAS, Delhi, India
2 Department of Paediatric Surgery, Pt.B.D.S., PGIMS, Rohtak, India
3 Department of Obstetrics Gynaecology, Pt.B.D.S., PGIMS, Rohtak, India
4 Department of Neurology, IHBAS, Delhi, India

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How to cite this article:
Gupta A, Rattan K N, Gupta A, Banerjee D. Giant appendicular schwannoma in a child. Indian J Pathol Microbiol 2009;52:281-2

How to cite this URL:
Gupta A, Rattan K N, Gupta A, Banerjee D. Giant appendicular schwannoma in a child. Indian J Pathol Microbiol [serial online] 2009 [cited 2022 Sep 25];52:281-2. Available from:


We came across a rare case of appendicular schwannoma in a child that prompted us for presentation.

A 12-year-old male child presented with a history of mass and pain in the lower abdomen since 1 year. On examination, a large mobile mass was palpated in the right lower abdomen. Ultrasound examination revealed a hyperechoic mass in the right lower abdomen. Computerized tomography (CT) demonstrated a highly enhancing well-defined mass in the right lower abdomen measuring 10cm in diameter [Figure 1a]. The mass showed prominent blood vessels all over its surface. Ultrasound-guided fine needle aspiration cytology (FNAC) was performed from the mass, which showed some clusters of spindle-shaped cells against a myxomatous background. Grossly, the tumor was well encapsulated, nodular, 10 9cm and attached to the tip of the appendix [Figure 1b]. The cut surface was solid grayish white and lobulated. Histological examination revealed dense cellular areas arranged in sheets and whorls (Antoni A type pattern) alternating with more loosely structured area (Antoni B type pattern). Additionally, the tumor showed a large number of blood vessels and inflammatory cell infiltrate [Figure 2]. Immunohistochemically, the tumor showed strong positivity for S-100 protein. Thus, a final diagnosis of benign appendicular schwannoma was made. The post-operative period was uneventful and the patient was doing well after surgery.

Schwannoma is a benign neurogenic tumor arising from the sheath of the peripheral nerves. [1] Although it is a frequent tumor, it is seldom found in the abdomen. [2],[3] Only few cases of lesser omentum, greater omentum and mesenteric schwannoma have been reported so far. [4],[5]

Abdominal schwannoma may cause diagnostic problems because clinical symptoms are misleading or uncharacteristic even if the tumor is large. Although clinical imaging includes plain film radiography, ultrasound and selective angiography, CT scan and magnetic resonance imaging remain the imaging modalities of choice. In summary, schwannoma of the appendix may present as abdominal mass without producing much symptoms and making its pre-operative diagnosis difficult. This case is a pointer to the unusual site of presentation of benign schwannoma. Because of a paucity of literature in this younger age group, this case is being reported here.

   References Top

1.Russel DS, Rubinstein LJ. Pathology of the tumors of the nervous system. 3 rd ed. Baltimore, MD: William and Wilkins; 1971.  Back to cited text no. 1    
2.Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign solitary schwannoma (neurilemoma). Cancer 1969;24:355-66.  Back to cited text no. 2    
3.Enzinger FM, Weiss SW, editors. Benign tumors of peripheral nerves. In: Soft tissue tumors. 3 rd ed. St. Louis: W Mosby; 1995, 829-63.  Back to cited text no. 3    
4.Bankier AA, Stanek C, Hubsch P. Case report: Benign solitary schwanoma of the greater omentum: A rare cause of acute intraperitoneal bleeding - diagnosis by CT. Clin Radiol 1996;51:517-8.  Back to cited text no. 4    
5.Murakami R, Tajima H, Kobayashi Y. Mesenteric schwanoma. Eur Radiol 1998;8:277-9.  Back to cited text no. 5    

Correspondence Address:
Anshu Gupta
1408/13, Opp. Model School, Civil Road, Rohtak - 124 001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.48950

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  [Figure 1a], [Figure 1b], [Figure 2]

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