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Recurrent retroperitoneal Schwannomas displaying different differentiation from primary tumor: case report and literature review.

Li ZQ, Wang HY, Li J, Teng L - World J Surg Oncol (2010)

Bottom Line: Radical dissection of the tumors along with the sacrifice of adjacent sigmoid colon and left kidney failed to provide a cure for this patient.Distinct immunohistochemical staining results of the tumors at recurrence indicate their potential of smooth-muscle like differentiation.Radical excision of the tumors may provide benefit for their local recurrences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cancer Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

ABSTRACT

Background: Retroperitoneal Schwannomas are uncommonly found in the retroperitoneum and few of them show malignant transformation and invasion. Local recurrence are common in malignant Schwannomas with very few reports of tumor distinct differentiation at recurrences.

Case presentation: We report here a rare case of retroperitoneal schwannoma with multiple origins from retroperitoneum and pelvic wall. Pathological examination confirmed the case as a schwannoma with malignant transformation. Radical dissection of the tumors along with the sacrifice of adjacent sigmoid colon and left kidney failed to provide a cure for this patient. Due to tumor recurrence, a second and a third surgery of radical excision were performed 6 months and 17 months later after the first surgery, respectively. Histopathologic analysis identified that the recurrent tumors were different from the original schwannoma because of their smooth muscle-like differentiation.

Conclusion: Malignant schwannomas are uncommon sarcomas with a high incidence of local recurrence. Distinct immunohistochemical staining results of the tumors at recurrence indicate their potential of smooth-muscle like differentiation. Radical excision of the tumors may provide benefit for their local recurrences.

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Immunohistochemical features of S-100 and desmin staining in the primary retroperitoneal mass (A and B) and recurrent masses (C and D). The spindle cells of the largest primary mass were positive for S-100 protein (1+) (A) and negative for desmin (B). The spindle cell component of the recurrent mass was negative for S-100 staining (C), while showed strong immunoreactivity to desmin (D). (Original magnification200×).
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Figure 6: Immunohistochemical features of S-100 and desmin staining in the primary retroperitoneal mass (A and B) and recurrent masses (C and D). The spindle cells of the largest primary mass were positive for S-100 protein (1+) (A) and negative for desmin (B). The spindle cell component of the recurrent mass was negative for S-100 staining (C), while showed strong immunoreactivity to desmin (D). (Original magnification200×).

Mentions: Immunohistochemical studies were performed using a panel of antibodies, including S-100, Desmin, CK, EMA, CD117 and SMA (Dako, CA, USA). All specimens from the three surgical resection were negative for CK, EMA, CD117 and SMA staining. Interestingly, the spindle cells in the first resected specimen were positive for S-100 (Fig. 6A) but negative for Desmin (Fig. 6B). In contrast, specimens from the later two operation were negative for S-100 (Fig. 6C) but strongly positive for desmin (Fig. 6D). These findings suggested diverse differentiation of the schwannoma at recurrences.


Recurrent retroperitoneal Schwannomas displaying different differentiation from primary tumor: case report and literature review.

Li ZQ, Wang HY, Li J, Teng L - World J Surg Oncol (2010)

Immunohistochemical features of S-100 and desmin staining in the primary retroperitoneal mass (A and B) and recurrent masses (C and D). The spindle cells of the largest primary mass were positive for S-100 protein (1+) (A) and negative for desmin (B). The spindle cell component of the recurrent mass was negative for S-100 staining (C), while showed strong immunoreactivity to desmin (D). (Original magnification200×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2927596&req=5

Figure 6: Immunohistochemical features of S-100 and desmin staining in the primary retroperitoneal mass (A and B) and recurrent masses (C and D). The spindle cells of the largest primary mass were positive for S-100 protein (1+) (A) and negative for desmin (B). The spindle cell component of the recurrent mass was negative for S-100 staining (C), while showed strong immunoreactivity to desmin (D). (Original magnification200×).
Mentions: Immunohistochemical studies were performed using a panel of antibodies, including S-100, Desmin, CK, EMA, CD117 and SMA (Dako, CA, USA). All specimens from the three surgical resection were negative for CK, EMA, CD117 and SMA staining. Interestingly, the spindle cells in the first resected specimen were positive for S-100 (Fig. 6A) but negative for Desmin (Fig. 6B). In contrast, specimens from the later two operation were negative for S-100 (Fig. 6C) but strongly positive for desmin (Fig. 6D). These findings suggested diverse differentiation of the schwannoma at recurrences.

Bottom Line: Radical dissection of the tumors along with the sacrifice of adjacent sigmoid colon and left kidney failed to provide a cure for this patient.Distinct immunohistochemical staining results of the tumors at recurrence indicate their potential of smooth-muscle like differentiation.Radical excision of the tumors may provide benefit for their local recurrences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cancer Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

ABSTRACT

Background: Retroperitoneal Schwannomas are uncommonly found in the retroperitoneum and few of them show malignant transformation and invasion. Local recurrence are common in malignant Schwannomas with very few reports of tumor distinct differentiation at recurrences.

Case presentation: We report here a rare case of retroperitoneal schwannoma with multiple origins from retroperitoneum and pelvic wall. Pathological examination confirmed the case as a schwannoma with malignant transformation. Radical dissection of the tumors along with the sacrifice of adjacent sigmoid colon and left kidney failed to provide a cure for this patient. Due to tumor recurrence, a second and a third surgery of radical excision were performed 6 months and 17 months later after the first surgery, respectively. Histopathologic analysis identified that the recurrent tumors were different from the original schwannoma because of their smooth muscle-like differentiation.

Conclusion: Malignant schwannomas are uncommon sarcomas with a high incidence of local recurrence. Distinct immunohistochemical staining results of the tumors at recurrence indicate their potential of smooth-muscle like differentiation. Radical excision of the tumors may provide benefit for their local recurrences.

Show MeSH
Related in: MedlinePlus