Intraosseousschwannoma: A Case Report and Review


  • Vijayasree V
  • Padma Sunethri
  • Sathyanarayana V
  • Nalini Kumari P


Bony schwannoma is a rare benign tumour derived from Schwann cells of nerve fibres in the bone. It accounts for less than 1% of bony benign tumour, and prone to occur in the sacrum and mandible, occurrence in scapula is very rare. Here we report a 50-year-old woman with the chief complaint of pain in the left scapula. Imaging examination showed a giant, irregular, swelling lesion with distinct border involving the left scapula, extending into the left shoulder glenoid and pressing the surrounding soft tissues. Needle biopsy showed that the tumour was composed of spindle cells with S-100 protein positive, mimicking a benign neurogenic tumour. Then a complete excision was performed by removing the tumour and the surrounding tissues including partial left shoulder glenoid. Histologically, Antoni type A areas were the predominant microscopic pattern with occasional alternation by Antoni type B areas. Immunohistochemistry found that the neoplastic cells were scatteredly positive for S-100 protein. All these features suggest a diagnosis of an intraosseousschwannoma of the left scapula. Follow-up of the patient for ten months found no recurrence or sign of other tumours following complete tumour resection without any adjuvant therapy. In conclusion, this case of giant intraosseousschwannoma of the scapula is a rare benign bony tumour, and its diagnosis combined with clinical, imaging and pre-operative needle biopsy is important to guide further therapy, and avoid overtreatment.


Guerrissi JO. Solitary benign schwannomas in major nerve systems of the head and neck. J Craniofac Surg (2009). 20(3): 957–961.

Fierro ND, Ermo G, Di Cola G, Gallinaro LS, Galassi G, Galassi G. Posterior mediastinal schwannoma. Asian Cardiovasc Thorac Ann (2003). 11(1): 72–73.

Ida CM, Scheithauer BW, Yapicier O, Carney JA, Wenger DE, Inwards CY, Bertoni F, Spinner RJ, Unni KK. Primaryschwannoma of the bone: aclinicopa- thologic and radiologic study of 17 cases. Am J Surg Pathol (2011). 35(7): 989–97.

Ozturk C, Mirzanli C, Karatoprak O, Tezer M, Aydogan M, Hamzaoglu A. Giant sacral schwannoma: a case report and review of the literature. Acta Orthop Belg (2009). 75(5): 705–710.

Buric N, Jovanovic G, Pesic Z, Krasic D, Radovanovic Z, Mihailovic D, Tijanic M. Mandible schwannoma (neurilemmoma) presenting as periapical lesion. Dentomaxillofac Radiol (2009). 38(5): 178–181.

Choudry Q, Younis F, Smith RB. Intraosseouss- chwannoma of D12 thoracic vertebra: diagnosis and surgical management with 5-year follow-up. Eur Spine J (2007). 16(Suppl 3): 283–286.

Palocaren T, Walter NM, Madhuri V, Gibikote S. Schwannoma of the fibula. J Bone Joint Surg Br (2008). 90(6): 803–805.

Goyal R, Saikia UN, Vashishta RK, Gulati G, Sharma RK: Intraosseousschwannoma of the frontal bone. Orthopedics (2008). 31(3): 281.

Takatera H, Takiuchi H, Namiki M, Takaha M, Ohnishi S, Sonoda T. Retroperitoneal schwannoma. Urology (1986). 28(6): 529–31.

Rattier B, Desrousseaux B, Dereux HJ, Atat I, Ampe J: Benign retroperitoneal pelvic schwannoma. Apropos of 2 cases. !!–HYPERLINK “http://www.ncbi.nlm.nih. gov/pubmed/2361968” o “Journal de chirurgie.” J Chir (Paris)⊥ (1990). 127(4): 209–12.

Felix EL, Wood DK, Das Gupta TK. Tumors of the retroperitoneum. Curr Probl Cancer (1981). 6(1): 1–47.

Asaumi J, Konouchi H, Kishi K. Schwannoma of the upper lip: ultrasound, CT, and MRI findings. J Oral Maxillofac Surg (2000). 58(10): 1173–5. http://

Almeyda R, Kothari P, Chau H, Cumberworth V. Submandibular neurilemmoma; a dagnosticdilemma. J Laryngol Otol (2004). 118(2): 156–158.

de la Monte SM, Dorfman HD, Chandra R, Malawer M. Intraosseousschwannoma: histologic features, ultrastructure, and review of the literature. Hum Pathol (1984). 15(6): 551–558.

Belli E, Becelli R, Matteini C, Iannetti G. Schwannoma of the mandible. J Craniofac Surg (1997). 8(5): 413– 416.

Wright BA, Jackson D. Neural tumors of the oral cavity. A review of the spectrum of benign and malignant oral tumors of the oral cavity and jaws. Oral Surg Oral Med Oral Pathol (1980). 49(6): 509–22.

Kitamura M, Wada N, Nagata S, Iizuka N, Jin YF, Tomoeda M, Yuki M, Naka N, Araki N, Yutani C, Tomita Y. Malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart: a case report. Diagn Pathol (2010). 5: 2.

Ohno J, Iwahashi T, Ozasa R, Okamura K, Taniguchi K. Solitary neurofibroma of the gingiva with prominent differentiation of Meissner bodies: a case report. Diagn Pathol (2010). 5: 61.

Tavasoly A, Javanbakht J, Khaki F, Hosseini E, Bahrami A, Hassan MA, Mirabad M. Ulnar malignant peripheral nerve sheath tumourdiagnosis in a mixed- breed dog as a model to study human: histologic, immunohistochemical, and clinicopathologic study. Diagn Pathol (2013). 8: 86.

Woodruff JM, Selig AM, Crowley K, Allen PW. Schwannoma (neurilemoma) with malignant transformation. A rare, distinctive peripheral nervetumor. Am J Surg Pathol (1994). 18(9): 882–95.

McMenamin ME, Fletcher CD. Expanding the spectrum of malignantchange in schwannomas: epithelioid malignant change, epithelioidmalignant peripheral nerve sheath tumor, and epithelioid angiosarcoma: a study of 17 cases. Am J Surg Pathol (2001). 25(1): 13–25.

Hamakawa H, Kayahara H, Sumida T, Tanioka H. Mandibular malignant schwannoma with multiple spinal metastases: a case report and a review of the literature. J Oral Maxillofac Surg (1998). 56(10): 1191– 1196.






Case Report