Patel Darsh, White Stacy
University of Florida, Gainesville, FL 32611, USA.
Interventional Radiology, Nemours Children's Health, 807 Children's Way, Jacksonville, FL 32207, USA.
Radiol Case Rep. 2025 May 12;20(8):3655-3661. doi: 10.1016/j.radcr.2025.04.066. eCollection 2025 Aug.
Schwannomas are benign peripheral nerve sheath tumors arising from Schwann cells and, as a result, can occur anywhere in the body. Intraosseous schwannomas are a rare subset of these tumors that are usually found in the medullary cavities of bones. According to the available literature, the sacrum is a common site of involvement within the spine. Affected patients are typically adults older than 20 years of age with no male or female predilection. We present a 17-year-old female athlete with low back pain and radiculopathy. Initial lumbar spine radiographs and magnetic resonance imaging were reported to be negative. Months later, dedicated imaging studies were performed after an abnormality of the sacrum was suspected during medical evaluation for return to sports. A sacral mass was confirmed. Initial and repeat image-guided biopsies confirmed a benign schwannoma. Detection and diagnosis of sacral intraosseous schwannomas present a challenge in the pediatric population given their rare occurrence. Although their imaging features have been described, intraosseous schwannomas are infrequently included in the list of differential diagnoses. Their nonaggressive imaging features should allow interpreting radiologists to narrow the potential diagnoses, thereby helping clinicians arrive at the correct diagnosis more efficiently.
施万细胞瘤是起源于施万细胞的良性周围神经鞘瘤，因此可发生于身体的任何部位。骨内施万细胞瘤是这类肿瘤中罕见的一种，通常见于骨髓腔内。根据现有文献，骶骨是脊柱中常见的受累部位。受影响的患者通常为20岁以上的成年人，无性别倾向。我们报告一例17岁女性运动员，伴有下腰痛和神经根病。最初的腰椎X线片和磁共振成像报告为阴性。数月后，在因恢复运动进行医学评估怀疑骶骨有异常后，进行了专门的影像学检查。确诊为骶骨肿物。初次及重复影像引导下活检均确诊为良性施万细胞瘤。鉴于骶骨骨内施万细胞瘤在儿科人群中罕见，其检测和诊断具有挑战性。尽管其影像学特征已有描述，但骨内施万细胞瘤很少被列入鉴别诊断清单。其不具侵袭性的影像学特征应能使解读影像的放射科医生缩小潜在诊断范围，从而帮助临床医生更高效地做出正确诊断。
