Sacral cellular schwannoma: a clinicopathologic analysis of eight cases / 临床与实验病理学杂志

Purpose To investigate clinicopathologic fea-tures of sacral cellular schwanoma and the difference from sacral conventional schwanoma.Methods Eight cases of sacral cellular schwanoma were collected.Microscopic examination and immunohistochemistry were performed for studying the clinical feature,radiologic appearance,pathologic characteristic,immunophenotyping,differential diagnosis and postoperative prognosis.Results There were 5 females and 3 males,whose mean age was 46.4 years.The majority of patients complained of pain in sacrococcygeal region.Radiographically,there was an endosacral or endosacral and presacal mass.Histologically,cellular schwannoma was composed of spindle cells,arranged in interlacing fascicles without nuclear palisading and Verocay bodies.Antoni A and Antoni B were not seen overtly.The destruction of bone was found.Immunohistochemically,tumor cells were diffusely and strongly positive for S-100 protein and vimentin.The mean of Ki-67 index was 6％.Tumor recurrence of 4 cases occurred several years after initial surgical resection.The mean interval to recurrence was 6.5 years.Conclusion Sacral cellular schwanoma is a rare tumor.Compared with sacral conventional schwanoma,it shows different growth pattern and pathologic features.So pathological diagnosis of the tumor should be noted for clinical follow-up and treatment.

Imaging Findings of Sacral Tumors

The various pathologic conditions detected at CT and MRI and subsumed by the term "sacral tumor" include primary bone tumors, sacral canal tumors and metastases. Among these, metastases are much more common than primary bone tumors, of which chordoma is the most common. Although the imaging findings of sacral tumors are nonspecific, a patient's age and sex, and specific findings such as calcification or fluid-fluid levels, can help radiologists in their differential diagnosis. We describe the imaging findings of primary sacral tumors, emphasizing the MRI findings.

Cystic Teratoma of the Sacrococcygeal Region in Adult: A Case Report

Sacrococcygeal teratoma is the most common solid tumor to occur in neonates, in whom it mostly takes the form of an obvious exophytic mass. They are, however, rarely found in adults. We report the CT and histopathologic findings of an adult cystic teratoma arising from the lower sacrococcygeal region that was discovered incidentally. Unenhanced CT scans showed an oval-shaped, cystic lesion with hyperattenuating content and no contrast enhancement. After surgery, the gross specimen was seen to be a cystic lesion filled with mucin. Microscopy revealed three germ cell layers in the cystic wall and the lesion was confirmed as cystic teratoma.

Granular Cell Tumor of the Presacral Space: A Case Report

Granular cell tumors are rare lesions of probable Schwann cell origin and are composed of oval to fusiform cells with abundant granular eosinophilic cytoplasm. We report ultrasonography, barium enema, computed tomography and magnetic resonance imaging findings in a case of granuar cell tumor in the presacral space in a 34-year-old woman.

Sacrococcygeal Germ Cell Tumors: Differential Features between Benignancy and Malignancy on MR and CT Imaging

PURPOSE: The purpose of this study was to determine differential points between benign and malignants acrococcygeal germ cell tumors (SGCT) on MR and CT imaging. MATERIALS AND METHODS: MR (n=13) and CT images (n=9)of 19 patients with surgically-proven SGCT (12 benign, 7 malignant) were retrospectively reviewed with regard totumor features and associated findings, as well as to clinical features including age at presentation and ratio of the sexes. Tumor features in cluded location, size, components (ratio of the enhancing solid portion, presence of fatty components, calcification and necrosis), signal intensity and the presence of an encircling low-signal rimon MR. Associated findings included the presence of sacrococcygeal bony defect and effects of the tumor on adjacent structures (anterior displacement of the bladder and rectum, local invasion). RESULTS: Benign SGCT showed early presentation (mean age, 4.7months), a predominantly (over half total volume) external location(58%)and a cystic composition(100%) and the presence of encircling low-signal rim on MR(80%). Malignant SGCT showed late presentation beyond infancy(mean age, 21.7months), a predominantly internal location(86%) and a enhancing solid composition(86%), the presence of tumoral necrosis(71%) and local invasion of adjacent structures(71%). The significant(p<.05) differential points were age at presentation, location, ratio of enhancing solid portions, the presence of tumoral necrosis, the presence of an encircling low-signal rim on MR and local invasion. CONCLUSION: There are certain differential points between benign and malignant SGCT on MR and CT imaging, and an appreciation of these would be helpful for the planning of treatment.