Nerve sheath tumour - malignant - sacrum

Case contributed by A.Prof Frank Gaillard

Presentation

Right leg swelling and saddle anaesthesia.

Patient Data

Age: Adult
Modality: CT

CT demonstrates a large destructive mass involving the right side of the sacrum and pelvis and extending into the psoas muscle anteriorly. It also extends through the iliac blade anteriorly and into the gluteal muscles. The right common and external iliac veins are thrombosed with thrombus extending to the inferior aspect of the IVC. 

Case Discussion

The patient went on to have CT guided core biopsies of the lesion 

Histology

Microscopic Description: Sections show several core biopsies involved by malignant spindle cell neoplasm. The tumour cells are arranged in vaguely fascicular pattern. Mitotic figures are easily identified. A subendothelial infiltrative arrangement of tumour cells is evident in some areas. 

Final Diagnosis:  Sacral mass, core biopsies: malignant peripheral nerve sheath tumor, high grade. 

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Case Information

rID: 5219
Case created: 18th Dec 2008
Last edited: 7th Dec 2015
Tag: pelvis
Inclusion in quiz mode: Included

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