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Biliary Rhabdomyosarcoma
Joseph Junewick, MD FACR
over 7 years ago
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Retroperitoneal Schwannoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CT NM
Activities:
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History

13 year old with abdominal pain.


Case Images


Diagnosis

Retroperitoneal Schwannoma

Findings

CT- Macrolobulated hypodense mass deforming but not invading the posterior right lobe of the liver and contiguous with the right kidney and diaphragm.

PET – Axial filtered back projection image and 3D MIP show markedly glucose avid lesion with only minimal heterogeneity.

Discussion

Schwannomas generally have a high FDG avidity. Standardized uptake values (SUVs) vary dependent upon the degree of cellularity but not related to tumor size or tumor proliferation rate (Ki-67 index). Malignant peripheral nerve sheath tumors and other sarcomas show similar glucose uptake, making PET differentiation difficult.

Schwannomas are most commonly observed in the third to fifth decades of life and typically arise from the spinal nerve roots and the cervical, sympathetic, vagus, peroneal, and ulnar nerves in the head, neck, and flexor surfaces of the upper and lower extremities. Most of these tumors are solitary and unassociated with neurofibromatosis 1, although they frequently occur in patients with this disease. They commonly present as nonspecific masses that are associated with a peripheral nerve. Resection is performed only if they are symptomatic, are moderately large, or exhibit rapid growth.

CT and MRI are an effective means of delineating lesions and their relationship to surrounding structures, but CT and MRI are not considered sufficiently accurate to distinguish benign from malignant nerve sheath tumors.

Reference

Beaulieu S, Rubin B, Djang D, et al. Positron Emission Tomography of Schwannomas: Emphasizing Its Potential in Preoperative Planning. AJR 2004; 182:971-974.



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