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Schwannoma : Intro & Gross

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Introduction: Schwannoma is a slow-growing, encapsulated benign peripheral nerve sheath tumor. It is usually seen a sporadic solitary tumor (90% of cases) between the ages of 20 and 50 years. The remainder are associated with Neurofibromatosis 2 (approx. 3% of cases), schwannomatosis (2% of cases), or multiple meningiomas with or without NF2 (5% of cases). Schwannomas may rarely arise in the setting of Neurofibromatosis 1.

Locations: The most common locations are head, neck, upper and lower extremities, posterior mediastinum, and retroperitoneum. The nerves commonly affected include spinal roots, cervical, sympathetic, vagus, peroneal, and ulnar nerves. Schwannomas are small (usually < 5 cm) and asymptomatic; however, those arising in the posterior mediastinum can become quite large and produce neurologic symptoms.

Grossly, schwannomas appear well-circumscribed and encapsulated. The cut surface is yellow-white or gray. The secondary changes such as hemorrhage, cystic change, and calcification are more likely to be seen in the larger tumors arising in the retroperitoneum or posterior mediastinum. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com

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