POPLITEAL CYSTIC SCHWANNOMA MIMICKING BAKER CYST – AN UNUSUAL CASE PRESENTATION – CASE REPORT

Introduction: Schwannoma is the most common tumor of peripheral nerves. They are usually solitary, encapsulated, homogenous slow growing masses, sometimes associated with pain and paresthesia.We present a case of schwannoma in an unusual location. Case presentation: A 16 year old boy presented to surgical OPD with a slow growing left popliteal swelling for 6 months and neuralgia for 1 month. The swelling decreasing on knee exion. Based on clinical suspicion patient was operated for popliteal cyst. Intraoperatively there was close association with nerve and it was difcult to dissect from nerve. So it was thought of being a nerve tumor. Surgical excision was done. Histopathological examination revealed it to be Cystic Schwannoma. Discussion: Schwannoma is the most common benign neoplasm of peripheral nerves. Cystic degeneration and repeated hemorrhages (10%) can occur sometimes. There are two types of tissues in Schwannoma – Antoni A and Antoni B.Schwannoma varies from 2-20 cm in diameter. It is not localized to any specic area; it can occur anywhere along peripheral nervous system in neck, mediastinum, retroperitoneum, pelvis, upper extremities. It is extremely unusual in lower limb of which tibial nerve is uncommon site. Conclusion: Diagnosis of schwannoma originating from lower extremity peripheral nerves may be delayed because it can be misdiagnosed as Baker's Cyst or the symptoms of the patient can be thought as a result of lumbar disc herniation.Thorough clinical examination and investigations, conrms the diagnosis, as management is different for both.

Cystic Variation of Schwannoma in the Neck: A Rare Presentation

It is uncommon for schwannomas to present as neck swellings. This case presented as painless, cystic and slow growing neck swelling which was excised. Histopathology proved it to be cystic schwannoma. Cystic change occurs in only 4% of all schwannomas. The cystic change renders the schwannoma to mimic second branchial cyst on clinical and radiological examination. Although modality of treatment remains the same which is extracapsular excision, the follow up differs in terms of recurrence.

Understanding Idiopathic Spinal Cord Herniation – A Comprehensive Review of Imaging and Literature

Idiopathic spinal cord herniation (ISCH) is displacement of spinal cord through a dural or arachnoidal defect. Most patients present with back pain or myelopathy, paresthesia, and sensory or motor weakness. Imaging findings include anterior displacement of the cord with possible kink, no filling defect on CT myelography, and no restricted diffusion/mass lesion on magnetic resonance imaging. Abrupt kink in the spinal cord or widened cerebrospinal fluid (CSF) space can be caused by a variety of reasons. The differential considerations include arachnoid web, intradural extramedullary epidermoid or arachnoid cyst, abscess or cystic schwannoma. We discuss the features, imaging, differentials, and treatment of ISCH as a rare cause of such kink in the cord. While reading such cases, a radiologist should include the location, segments involved, cord signal abnormality, visible defect, scalpel sign or C–sign, ventral cord kink, nuclear trail sign, the ventral CSF space preservation, or obliteration and the type.