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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 709-712
DOI: 10.4103/ajns.AJNS_142_20
Case Report

A rare case of hemorrhagic melanotic schwannoma in a 38-year-old female

Rakesh Biju
Department of Neurosurgery, Waikato Hospital, Hamilton
,
Maria Duignan
Department of Neurosurgery, Waikato Hospital, Hamilton
,
Monish Maharaj
Department of Neurosurgery, Waikato Hospital, Hamilton
,
Fouzia Ziad
1   Department of Pathology, Waikato Hospital, Hamilton
,
Zakier Hussain
Department of Neurosurgery, Waikato Hospital, Hamilton
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Melanotic schwannoma is a rare form of nerve sheath tumor composed of melanin-producing neoplastic Schwann cells. Less than 200 cases have been reported worldwide. The entity has been associated with Carney complex, a rare genetic disorder characterized by multiple benign tumors. A 38-year-old female presented to our unit with sudden-onset lower back pain and radiculopathy triggered by a mechanical injury. Imaging demonstrated a lesion within the left L5/S1 neural exit foramen with remodeling of bony architecture typical of a chronic, benign process. She proceeded for resection and histology revealed a psammomatous melanotic schwannoma. The patient recovered well with improvement in symptomology. Due to the aggressive nature of the disease, she remains under surveillance for local recurrence and distant metastasis. Clinicians should be aware of this malignant entity, despite its possible presentation with radiological features of a chronic, benign process. Unusual characteristics such as hemorrhage should be treated with a high index of suspicion.

Key-words:

Carney complex - melanotic schwannoma - nerve sheath tumor - psammoma bodies

Financial support and sponsorship

Nil.




Publication History

Received: 07 April 2020

Accepted: 02 May 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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