Nerve sheath tumor - malignant - sacrum

Case contributed by Assoc Prof Frank Gaillard


Right leg swelling and saddle anesthesia.

Patient Data

Age: Adult

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 


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

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

PlayAdd to Share

Case information

rID: 5219
Published: 18th Dec 2008
Last edited: 13th Aug 2019
Tag: pelvis
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.