Abstract
Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton. To the best of our knowledge, we report the first case of primary intraosseous MPNST involving a midtarsal bone (medial cuneiform). The patient was a 62-year-old female who presented with pain and tenderness but without swelling. Imaging revealed nonspecific findings, and the preoperative computed tomography-guided biopsy findings were consistent with MPNST. The patient was treated with neoadjuvant radiotherapy, followed by wide local excision and allograft reconstruction. At the final follow-up examination (24 months), the graft had been incorporated without evidence of local recurrence or distant disease. The patient with primary intraosseous MPNST of the medial cuneiform described in the present report presented with nonspecific clinical and radiologic findings. Thus, a high index of suspicion and histopathologic examination, including immunohistochemistry, are necessary for an accurate diagnosis.
| Original language | English (US) |
|---|---|
| Journal | Journal of Foot and Ankle Surgery |
| DOIs | |
| State | Accepted/In press - 2016 |
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Keywords
- Allograft
- Arthrodesis
- Bone tumor
- Cancer
- Foot
- Midtarsal
- Sarcoma
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Medial Cuneiform : A Case Report and Review of the Literature. / Muthusamy, Saravanaraja; Conway, Sheila A; Pitcher, J. David; Thomas Temple, H.
In: Journal of Foot and Ankle Surgery, 2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Medial Cuneiform
T2 - A Case Report and Review of the Literature
AU - Muthusamy, Saravanaraja
AU - Conway, Sheila A
AU - Pitcher, J. David
AU - Thomas Temple, H.
PY - 2016
Y1 - 2016
N2 - Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton. To the best of our knowledge, we report the first case of primary intraosseous MPNST involving a midtarsal bone (medial cuneiform). The patient was a 62-year-old female who presented with pain and tenderness but without swelling. Imaging revealed nonspecific findings, and the preoperative computed tomography-guided biopsy findings were consistent with MPNST. The patient was treated with neoadjuvant radiotherapy, followed by wide local excision and allograft reconstruction. At the final follow-up examination (24 months), the graft had been incorporated without evidence of local recurrence or distant disease. The patient with primary intraosseous MPNST of the medial cuneiform described in the present report presented with nonspecific clinical and radiologic findings. Thus, a high index of suspicion and histopathologic examination, including immunohistochemistry, are necessary for an accurate diagnosis.
AB - Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton. To the best of our knowledge, we report the first case of primary intraosseous MPNST involving a midtarsal bone (medial cuneiform). The patient was a 62-year-old female who presented with pain and tenderness but without swelling. Imaging revealed nonspecific findings, and the preoperative computed tomography-guided biopsy findings were consistent with MPNST. The patient was treated with neoadjuvant radiotherapy, followed by wide local excision and allograft reconstruction. At the final follow-up examination (24 months), the graft had been incorporated without evidence of local recurrence or distant disease. The patient with primary intraosseous MPNST of the medial cuneiform described in the present report presented with nonspecific clinical and radiologic findings. Thus, a high index of suspicion and histopathologic examination, including immunohistochemistry, are necessary for an accurate diagnosis.
KW - Allograft
KW - Arthrodesis
KW - Bone tumor
KW - Cancer
KW - Foot
KW - Midtarsal
KW - Sarcoma
UR - http://www.scopus.com/inward/record.url?scp=84978839891&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978839891&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2016.05.013
DO - 10.1053/j.jfas.2016.05.013
M3 - Article
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
SN - 1067-2516
ER -