Case Report (2)
The differential diagnosis included giant-cell tumor, fibrohistiocytoma, X histiocytosis, aneurysmatic bone cyst, enchondroma.
A resection biopsy of the tumor was carried out last September using a posterior approach and the lost tissue was replaced with autologous bone.
Surgery revealed a 6.5 x 3 x 3 cm. white-yellowish mass (figs. 7 & 8) confined to the soft tissues in the bony part which were very difficult to resect because of the sinuosity of the area, and because the deepest part of the tumor was adhered to the bone.
It was pathologically diagnosed as a neurilemmoma -a nervous tissue tumor arising from the Schwann cells-. Its macroscopic appearance is that of a round tumor with a well-delimited capsule. Microscopic observation shows the presence of two different sets of cells. In one of the sets, the cells were arranged in nodules which had elongated ovoid nuclei in the form of a palisade immersed in a dense interstitial substance which led to the formation of Verocay bodies (fig. 9) (Antoni type A zones).
In the other set, the cells were arranged more irregularly and had a myxoid matrix with a laxer structure (fig. 10) (Antoni type B zones).
Six months after the surgery there have been no recurrences and the bone graft is attached. A MNR scan is pending.
NEURILEMMOMA INVOLVEMENT OF THE RADIUS
Diapositiva 3