Takeuchi Mayumi, Matsuzaki Kenji, Nishitani Hiromu, Uehara Hisanori
Department of Radiology, School of Medicine, University of Tokushima, Tokushima 7708503, Japan.
Abdom Imaging. 2008 Mar-Apr;33(2):247-52. doi: 10.1007/s00261-007-9228-y.
The objective of this article is to define the imaging characteristics of ancient schwannoma, which is a rare variant of benign schwannoma with degenerative changes, arising in the female pelvis simulating ovarian tumors.
Eleven surgically proven ancient schwannomas of the female pelvis were evaluated retrospectively on the basis of CT and MR findings.
Typical intra-pelvic schwannoma was a neurologically asymptomatic large mass, which may situate at presacral or lateral pelvic region with the continuity to the nerve or neural foramen. Ancient schwannomas manifested as encapsulated solid masses with random or eccentric cystic areas, or as cystic masses with marginal crescent-shaped or nodular solid components. Hemorrhagic changes and calcifications were often observed on MRI and CT respectively. To detect ipsilateral normal ovary and to demonstrate centripetal displacement of the adjacent rectum or iliac vessels were helpful to diagnose the tumor as an extra-ovarian mass situated at the extraperitoneal region.
Diagnosis of ancient schwannoma before surgical treatment is important and should be made by its characteristic clinical and imaging findings.
本文的目的是明确陈旧性神经鞘瘤的影像学特征，这是一种罕见的良性神经鞘瘤变异型，伴有退行性改变，发生于女性盆腔，易误诊为卵巢肿瘤。
回顾性分析11例经手术证实的女性盆腔陈旧性神经鞘瘤的CT和MR表现。
典型的盆腔神经鞘瘤是一种无神经症状的大肿块，可位于骶前或盆腔外侧区域，与神经或神经孔相连。陈旧性神经鞘瘤表现为有包膜的实性肿块，伴有散在或偏心的囊性区域，或表现为囊性肿块，边缘有新月形或结节状实性成分。MRI和CT上分别常可见出血性改变和钙化。检测同侧正常卵巢并显示相邻直肠或髂血管的向心性移位有助于将肿瘤诊断为位于腹膜外区域的卵巢外肿块。
手术治疗前诊断陈旧性神经鞘瘤很重要，应根据其特征性的临床和影像学表现进行诊断。
