title: Case report--ancient schwannoma of the scrotum.
abstract: BACKGROUND
  Scrotal schwannoma is a rare neoplasm and poses a diagnostic challenge to urologists. This article describes a rare case of ancient scrotal schwannoma and reviews the current modality of investigation and treatment of this tumour.
  
  
  METHODS
  A 28 year old man presented with a 3-month history of an asymptomatic scrotal swelling. Ultrasonography and computer topography revealed an intra-scrotal and extra-testicular mass without local invasion. Surgical excision was undertaken and histology was an ancient schwannoma of the scrotum.
  
  
  CONCLUSIONS
  Schwannoma is a benign encapsulating neoplasm with an overall low incidence, occurring mostly in the head and neck region and seldom in the scrotum. Histology shows two distinctive patterns, Antoni type A and B areas. Variations of schwannoma such as cellular, ancient, glandular and epithelioid are observed based on the appearances. Ancient schwannoma exhibits pleomorphism without mitosis as the result of cellular degeneration, which can lead to an erroneous diagnosis of malignancy. Imaging modalities are non-specific for schwannomas, but can define tumour size, site and extension. The mainstay treatment is complete excision, although local recurrence may occur in large and incompletely excised lesions. Malignant change is exceedingly rare.
authors.affiliation: Surgical Directorate, Warrington Hospital, Lovely Lane, Warrington, UK. pete@peterchan.org.uk
authors.forename: Peter T
authors.initials: PT
authors.lastname: Chan
authors.forename: Sankalp
authors.initials: S
authors.lastname: Tripathi
authors.forename: Su E
authors.initials: SE
authors.lastname: Low
authors.forename: Lee Q
authors.initials: LQ
authors.lastname: Robinson
mesh_terms: D000328:Adult; D005834:Genital Neoplasms, Male / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000175:diagnosis* / Q000628:therapy*; D012611:Scrotum