Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2018; 6(5): 88-93
Published online May 16, 2018. doi: 10.12998/wjcc.v6.i5.88
Magnetic resonance imaging findings for differential diagnosis of perianal plexiform schwannoma: Case report and review of the literature
Xue-Liang Sun, Ke Wen, Zhi-Zhong Xu, Xiao-Peng Wang
Xue-Liang Sun, Ke Wen, Zhi-Zhong Xu, Xiao-Peng Wang, Department of Colorectal Surgery, the Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine, Suzhou 215000, Jiangsu Province, China
Author contributions: Sun XL designed the study and wrote the manuscript; Sun XL, Wang XP, and Wen K performed the operation; Sun XL and Xu ZZ collected the clinical data; Sun XL and Wang XP were involved in editing of the manuscript and provided financial support.
Supported by Suzhou Municipal Science and Technology Bureau, No. SYSD2017126.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Peng Wang, MD, Professor of Surgery, Chief Doctor, Department of Colorectal Surgery, the Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine, Yangsu Road No.18, Suzhou 215000, Jiangsu Province, China. wxpeng2004@163.com
Telephone: +86-512-67872805 Fax: +86-512-65225929
Received: January 15, 2018
Peer-review started: January 15, 2018
First decision: February 28, 2018
Revised: March 4, 2018
Accepted: April 1, 2018
Article in press: April 1, 2018
Published online: May 16, 2018
Abstract

Plexiform schwannoma is an extremely rare variant of schwannoma, accounting for approximately 5% of cases. Due to the rarity and lack of typical symptoms, signs and radiological images, a definite diagnosis of plexiform schwannoma may not be made by clinicians prior to biopsy. In the present study, we report the first case (to our knowledge) of perianal plexiform schwannoma arising from the overlapped skin of the ischioanal fossa, and we propose an intratumorally nonenhanced circumferential capsule dividing the tumour into multiple homogeneously enhanced nodules as a magnetic resonance imaging feature to aid in the differential diagnosis of plexiform schwannoma from ancient schwannoma, cavernous haemangioma, liposarcoma and plexiform neurofibroma.

Keywords: Plexiform schwannoma; Magnetic resonance imaging; Perianal; Bascom cleft lift; Diagnosis

Core tip: Plexiform schwannoma is an extremely rare variant of schwannoma, without typical symptoms, signs and radiological images. Hence, a definite diagnosis of plexiform schwannoma may not be made by clinicians prior to biopsy. In this work, to our knowledge, we report the first case of perianal plexiform schwannoma arising from the overlapped skin of ischioanal fossa, and we propose an intratumorally nonenhanced circumferential capsule dividing the tumour into multiple homogeneously enhanced nodules as an magnetic resonance imaging feature to aid in the differential diagnosis of plexiform schwannoma from common nodular lesions, such as ancient schwannoma, cavernous haemangioma, liposarcoma and plexiform neurofibroma.