N Dhivya, Ramasamy Shilpa, K Suganthi
Department of Histopathology and Cytology, Apollo Hospitals, Chennai, IND.
Cureus. 2025 Mar 18;17(3):e80789. doi: 10.7759/cureus.80789. eCollection 2025 Mar.
Schwannomas are rare peripheral nerve sheath tumours involving the head, neck and extremities. Heart, lung, orbit and kidney are some of the rare sites for schwannoma involvement. Here, we present a 55-year-old patient with no specific complaints, who was detected to have a complex solid cystic mass in the lower pole of the left kidney. In contrast-enhanced computed tomography, the lesion was highly suggestive of malignancy. The patient underwent a laparoscopic radical nephrectomy. Grossly, the tumour was well-circumscribed and delineated from surrounding renal parenchyma. Microscopic examination revealed variably cellular spindle cell neoplasm arranged in palisades with intervening myxoid and cystic change. On immunohistochemistry, S100 and SOX10 were diffusely positive, consistent with schwannoma. We report this case for its rarity and to emphasize the fact that clinical and imaging findings are non-specific for this entity as it mimics the common renal neoplasms. Histopathology with supportive immunohistochemistry clinches the diagnosis.
施万细胞瘤是一种罕见的周围神经鞘瘤,可累及头、颈和四肢。心脏、肺、眼眶和肾脏是施万细胞瘤累及的一些罕见部位。在此,我们报告一名55岁无特殊主诉的患者,其左肾下极发现一个复杂的实性囊性肿块。在增强计算机断层扫描中,该病变高度提示为恶性。患者接受了腹腔镜根治性肾切除术。大体上,肿瘤边界清楚,与周围肾实质分界清晰。显微镜检查显示为细胞形态不一的梭形细胞瘤,呈栅栏状排列,其间有黏液样变和囊性变。免疫组织化学检查显示,S100和SOX10弥漫性阳性,符合施万细胞瘤。我们报告该病例是因其罕见性,并强调该实体的临床和影像学表现不具有特异性,因为它可模仿常见的肾肿瘤。组织病理学检查及支持性免疫组织化学检查可确诊。