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Monday, 27 April 2020

Schwannoma


Schwannoma
Schwannoma

Schwannoma is a benign peripheral nerve sheath tumor. 

Schwannomas are usually solitary.

Cell of origin of Schwannoma - Differentiated Schwann cells.

Pathologically Schwannomas are unique, because  schwannomas do not infiltrate the parent nerve. 

Surgical significance of this unique feature is that schwannoma  can  be  enucleated  in toto by preserving  the adjacent nerve. 

Longitudinal Incision


Schawannoma Enucleation


Thinned Out Nerve Sheath After Enucleation


Histological characteristics of schwannoma – Areas of cellular component (Antoni A) and areas of hypocellular component (Antoni B).
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Most Important Differential Diagnosis of schwannoma is Neurofibroma.

Neurofibromas are usually multiple.

Cell of origin of Neurofibroma- Transformed Schwann cells.

Pathologically neurofibroma infiltrates the parent nerve. 

Surgical significance – Neurofibroma is  resected along with the parent nerve and  nerve  grafting is done  to  preserve the nerve function

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Discussion on Neurofibromatosis

Two Types of Neurofibromatosis- Type 1& Type 2

Type 1 Neurofibromatosis is associated with
Café au lait patches
Lisch nodules
Optic glioma

Type 2 Neurofibromatosis is associated with
Bilateral acoustic neuromas
Meningioma
 Mesothelioma
Glioma multiforme
Carcinoma of Breast
Carcinoma Colorectum,
 Renal Cell Carcinoma
Hepato Cellular Carcinoma
Prostatic Carcinoma
Cutaneous malignancy
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 Image Courtesy- Trivandrum Surgical Club
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