Ancient Schwannoma with perivascular pseudorosettes in a young adult: A case report

Abstract

Ancient schwannoma is a benign, long standing Schwann cell tumor. It is commonly seen in the middle age and elderly age population, associated with secondary degenerative changes. When these changes are extensive, neuroblastoma and perivascular pseudo-rosettes may be seen. Here we represent a case of a 28 year female with a subcutaneous swelling left elbow. Grossly, single, oval, capsulated tumor measuring (3X1.5) cm received. Cut section showed variegated appearance with areas of hemorrhage and cystic change. Clinicohistopathological features and differential diagnosis revealed a case of ancient schwannoma with perivascular pseudo-rosettes. Due to these unusual morphologic features, a diagnostic confusion has occurred with sarcoma, especially malignant peripheral nerve sheath tumor. So careful observation of the mitotic activity and necrosis is recommended to rule out malignancy.