Imaging Pearls ❯ Adrenal ❯ Schwannoma of the Adrenal Gland
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- ”Schwannomas are benign tumors that originate from Schwann cells in the myelin sheath of peripheral nerves. These typically benign tumors are most often found in the head, neck, and limbs, and, rarely, in the retroperitoneal space . In the adrenal gland, schwannomas make up less than one percent of adrenal tumors , with, as of 2022, approximately 60 cases having been reported in the literature. Patients usually present with nonspecific mild symptoms such as persistent abdominal discomfort or nausea and vomiting secondary to mass effect on adjacent organs, leading to delayed presentation and extensive tumor growth. This results in a more difficult surgical excision of the mass and extensive blood vessel involvement. Furthermore, the nonspecific clinical nature along with the scarcity of literature describing characteristic imaging features render this tumor difficult to distinguish from other benign or malignant entities such as adrenal adenomas, myelolipomas, adrenocortical carcinomas, neuroblastomas, and other non-functioning adrenal tumors (that do not produce catecholamines or steroids). Here, we report the case of a 43-year-old female who was diagnosed with an adrenal schwannoma and underwent complete retroperitoneal resection of the tumor. ”
An incidental large adrenal schwannoma: A case report
Ryan C. Rizk, Mohammad Yasrab ,Linda C. Chu ,Edmund M. Weisberg, Elliot K. Fishman
Radiology Case Reports 1 9 (2024) 3 0 0 8 – 3 0 1 2 - “Although not definitive, adrenal schwanno- mas are thought to arise from the Schwann cell nerve fibers innervating the adrenal medulla, specifically the vagal and phrenic nerves along with the sympathetic trunk. This tumor tends to affect patients between the ages of 20 and 50 years and is more common in females with a female to male ratio of 1.8:1, consistent with our case’s demographic. Most adrenal schwannomas are benign and slow growing but there have been cases of malignancy ( < 1%); however, there is no bi- ological evidence explaining a correlation between tumor size and malignancy potential. As in this case, benign lesions do not present invasive characteristics or metastases and simply displace surrounding organs.”
An incidental large adrenal schwannoma: A case report
Ryan C. Rizk, Mohammad Yasrab ,Linda C. Chu ,Edmund M. Weisberg, Elliot K. Fishman
Radiology Case Reports 1 9 (2024) 3 0 0 8 – 3 0 1 2 - “In a review conducted by Xu et al., the sizes of adrenal schwannoma masses range from 0.6 to 14 cm, with an average diameter of 5.5 cm . Additionally, larger masses ( > 8-10 cm) can present with cystic formation, bleeding, necrosis, and calcification due to secondary degeneration signaling the final stage of long-term tumor growth . Adrenal schwannomas are hypovascular, and the progressive enhancement pattern contributes from the equal involvement of the tissue, septa, and walls of the lesion . In the present case, the tumor was heterogeneously enhancing suggestive of internal hemorrhage and/or necrosis.”
An incidental large adrenal schwannoma: A case report
Ryan C. Rizk, Mohammad Yasrab ,Linda C. Chu ,Edmund M. Weisberg, Elliot K. Fishman
Radiology Case Reports 1 9 (2024) 3 0 0 8 – 3 0 1 2