Peripheral nerve sheath tumors. Benign or malignant? The role of MRI and ultrasonography in a case report.
A 31-year-old male patient admitted to another hospital for investigation of a localized painful hump in the medial surface of his left leg. The clinical examination revealed a painful palpable lump in the medial surface of left thigh that was initially thought to be a hematoma due to a history of recent trauma. However, an ultrasound was requested to exclude deep venous thrombosis (DVT). The US examination revealed a heterogeneous, fusiform lesion with elongated proximal and distal projections in close proximity to superficial femoral artery and vein and could not definitely exclude the DVT hypothesis. In a second ultrasound examination performed in our department, a neurogenic origin of the lesion was proposed. A consequent MRI examination confirmed the presence of a fusiform tumor in the anatomic path of the saphenous nerve. This was further confirmed intraoperatively, and pathologically was diagnosed as a malignant peripheral nerve sheath tumor (MPNST). In this present study the role of ultrasonography, the correlation between MRI and ultrasonographic findings are discussed and a review of the literature is presented.
Department of Radiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Alexandros
A
Chatzistefanou
Michalis
M
Mantatzis
Savas
S
Deftereos
Paraskevi
P
Mintzopoulou
Panos
P
Prassopoulos
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis*; D009442:Neurilemmoma / Q000175:diagnosis*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods*