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Sciatic nerve schwannoma

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Ongoing left iliac fossa pain; ultrasound scan 2-3 months ago showed a hemorrhagic cyst in the left ovary.

Patient Data

Age: 45 years
Gender: Female
mri

A 3.6cm heterogeneous well defined mass is seen in the posterior left hemipelvis. This shows mixed signal on T2, low signal on T1 and avid enhancement with minor internal cystic changes. It traverses the left sciatic notch arising from the sciatic nerve.

Simple cysts on the left ovary measuring up to 3cm. The right ovary is unremarkable. Normal appearances of the uterus, endometrium, cervix and vagina. No lymphadenopathy. No ascites. The upper abdomen is unremarkable.

Case Discussion

The appearances are in keeping with a schwannoma of the left sciatic nerve.

A CT-KUB 11 years earlier showed this lesion and it was unchanged in size confirming its benign nature.

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