Case analysis: Typical imaging manifestations, pathological basis, and differential diagnosis of retroperitoneal Schwannoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SHU Qiang ^1,2 , SHI Hui ³ ,  LU Chunyan ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Medical Imaging, People’s Hospital of Longhui County, Shaoyang City, Hunan Province 422200, P. R. China;
3. Department of Ultrasound Imaging, People’s Hospital of Longhui County, Shaoyang City, Hunan Province 422200, P. R. China;

Corresponding?author：

LU Chunyan, Email: luchunyan@wchscu.cn

Keywords：

retroperitoneal; Schwannoma; imaging manifestation; pathological basis

DOI：

10.7507/1007-9424.202408134

Video：

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Schwannoma originating in the retroperitoneal space is relatively rare. The author reported a case of retroperitoneal Schwannoma confirmed by surgery and pathology, presented the typical CT and MRI manifestations of Schwannoma——“target signs”, described the pathophysiological mechanism and image differential diagnosis of the disease, so as to strengthen readers’ understanding of the typical signs of Schwannoma and improve the correct diagnosis rate of the disease.

Citation： SHU Qiang, SHI Hui, LU Chunyan. Case analysis: Typical imaging manifestations, pathological basis, and differential diagnosis of retroperitoneal Schwannoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(3): 300-304. doi: 10.7507/1007-9424.202408134 Copy

1.	Dede M, Yagci G, Yenen MC, et al. Retroperitoneal benign Schwannoma: report of three cases and analysis of clinico-radiologic findings. Tohoku J Exp Med, 2003, 200(2): 93-97.
2.	Patocskai EJ, Tabatabaian M, Thomas MJ. Cellular Schwannoma: a rare presacral tumour. Can J Surg, 2002, 45(2): 141-144.
3.	楊金煜, 唐明杰, 張冠新, 等. 腹膜后神經鞘瘤的臨床分析(附3例報道). 中國普外基礎與臨床雜志, 2012, 19(11): 1242.
4.	Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurgery, 2021, 88(3): 443-456.
5.	Helbing DL, Schulz A, Morrison H. Pathomechanisms in Schwannoma development and progression. Oncogene, 2020, 39(32): 5421-5429.
6.	Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
7.	Rajiah P, Sinha R, Cuevas C, et al. Imaging of uncommon retroperitoneal masses. Radiographics, 2011, 31(4): 949-976.
8.	Koga H, Matsumoto S, Manabe J, et al. Definition of the target sign and its use for the diagnosis of Schwannomas. Clin Orthop Relat Res, 2007, 464: 224-229.
9.	Bhargava R, Parham DM, Lasater OE, et al. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol, 1997, 27(2): 124-129.
10.	Ko SF, Ng SH, Lee TY, et al. MR imaging of thoracic neurilemmomas. Magn Reson Imaging, 1997, 15(5): 525-533.
11.	Suh JS, Abenoza P, Galloway HR, et al. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology, 1992, 183(2): 341-346.
12.	Varma DG, Moulopoulos A, Sara AS, et al. MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr, 1992, 16(3): 448-453.
13.	Al-Dasuqi K, Irshaid L, Mathur M. Radiologic-pathologic correlation of primary retroperitoneal neoplasms. Radiographics, 2020, 40(6): 1631-1657.
14.	鐘婧嬌, 詹茜, 張雪鳳, 等. 胰腺神經鞘瘤三例的影像學特征并文獻復習. 中華胰腺病雜志, 2020, 20(1): 33-40.
15.	郭海南, 張君祥, 石小強, 等. 腹膜后副神經節瘤39例臨床分析. 中華普通外科雜志, 2023, 38(12): 894-899.
16.	Marko J, Wolfman DJ. Retroperitoneal leiomyosarcoma from the radiologic pathology archives. Radiographics, 2018, 38(5): 1403-1420.
17.	高金莉. 富于細胞性神經鞘瘤2例臨床病理分析. 臨床與實驗病理學雜志, 2012, 28(3): 341-342.
18.	于泳, 龔沈初, 王睿婷, 等. 14例腸道神經鞘瘤的影像學表現. 復旦學報(醫學版), 2024, 51(1): 62-68.
19.	張世輝, 宋濤, 杜曉龍, 等. 左前臂富細胞性神經鞘瘤I例. 美中國際創傷雜志, 2019, 18(1): 55-56.
20.	Lee NJ, Hruban RH, Fishman EK. Abdominal schwannomas: review of imaging findings and pathology. Abdom Radiol (NY), 2017, 42(7): 1864-1870.
21.	周玲, 李軍, 王江濤, 等. 局灶性透明血管型Castleman病的影像學表現與病理特點. 醫學影像學雜志, 2018, 28(9): 1493-1496.
22.	曾道兵, 趙新湘, 常嬋, 等. 腹盆部局灶性Castleman 病的MRI特征及誤診分析. 臨床放射學雜志, 2017, 36(10): 1446-1450.
23.	田彤彤, 胡曉華, 楊國美, 等. 腹部不典型神經鞘瘤的CT表現與病理對照. 臨床放射學雜志, 2014, 33(10): 1555-1559.
24.	田彤彤, 楊國美, 胡曉華, 等. 腹膜后囊性神經鞘瘤CT表現. 實用放射學雜志, 2014, 30(6): 1061-1062, 1070.

1. Dede M, Yagci G, Yenen MC, et al. Retroperitoneal benign Schwannoma: report of three cases and analysis of clinico-radiologic findings. Tohoku J Exp Med, 2003, 200(2): 93-97.
2. Patocskai EJ, Tabatabaian M, Thomas MJ. Cellular Schwannoma: a rare presacral tumour. Can J Surg, 2002, 45(2): 141-144.
3. 楊金煜, 唐明杰, 張冠新, 等. 腹膜后神經鞘瘤的臨床分析(附3例報道). 中國普外基礎與臨床雜志, 2012, 19(11): 1242.
4. Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurgery, 2021, 88(3): 443-456.
5. Helbing DL, Schulz A, Morrison H. Pathomechanisms in Schwannoma development and progression. Oncogene, 2020, 39(32): 5421-5429.
6. Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
7. Rajiah P, Sinha R, Cuevas C, et al. Imaging of uncommon retroperitoneal masses. Radiographics, 2011, 31(4): 949-976.
8. Koga H, Matsumoto S, Manabe J, et al. Definition of the target sign and its use for the diagnosis of Schwannomas. Clin Orthop Relat Res, 2007, 464: 224-229.
9. Bhargava R, Parham DM, Lasater OE, et al. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol, 1997, 27(2): 124-129.
10. Ko SF, Ng SH, Lee TY, et al. MR imaging of thoracic neurilemmomas. Magn Reson Imaging, 1997, 15(5): 525-533.
11. Suh JS, Abenoza P, Galloway HR, et al. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology, 1992, 183(2): 341-346.
12. Varma DG, Moulopoulos A, Sara AS, et al. MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr, 1992, 16(3): 448-453.
13. Al-Dasuqi K, Irshaid L, Mathur M. Radiologic-pathologic correlation of primary retroperitoneal neoplasms. Radiographics, 2020, 40(6): 1631-1657.
14. 鐘婧嬌, 詹茜, 張雪鳳, 等. 胰腺神經鞘瘤三例的影像學特征并文獻復習. 中華胰腺病雜志, 2020, 20(1): 33-40.
15. 郭海南, 張君祥, 石小強, 等. 腹膜后副神經節瘤39例臨床分析. 中華普通外科雜志, 2023, 38(12): 894-899.
16. Marko J, Wolfman DJ. Retroperitoneal leiomyosarcoma from the radiologic pathology archives. Radiographics, 2018, 38(5): 1403-1420.
17. 高金莉. 富于細胞性神經鞘瘤2例臨床病理分析. 臨床與實驗病理學雜志, 2012, 28(3): 341-342.
18. 于泳, 龔沈初, 王睿婷, 等. 14例腸道神經鞘瘤的影像學表現. 復旦學報(醫學版), 2024, 51(1): 62-68.
19. 張世輝, 宋濤, 杜曉龍, 等. 左前臂富細胞性神經鞘瘤I例. 美中國際創傷雜志, 2019, 18(1): 55-56.
20. Lee NJ, Hruban RH, Fishman EK. Abdominal schwannomas: review of imaging findings and pathology. Abdom Radiol (NY), 2017, 42(7): 1864-1870.
21. 周玲, 李軍, 王江濤, 等. 局灶性透明血管型Castleman病的影像學表現與病理特點. 醫學影像學雜志, 2018, 28(9): 1493-1496.
22. 曾道兵, 趙新湘, 常嬋, 等. 腹盆部局灶性Castleman 病的MRI特征及誤診分析. 臨床放射學雜志, 2017, 36(10): 1446-1450.
23. 田彤彤, 胡曉華, 楊國美, 等. 腹部不典型神經鞘瘤的CT表現與病理對照. 臨床放射學雜志, 2014, 33(10): 1555-1559.
24. 田彤彤, 楊國美, 胡曉華, 等. 腹膜后囊性神經鞘瘤CT表現. 實用放射學雜志, 2014, 30(6): 1061-1062, 1070.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Case analysis: Typical imaging manifestations, pathological basis, and differential diagnosis of retroperitoneal Schwannoma

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