• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.511-519
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• 2020

Purpose: Schwannoma is a benign tumor that occurs mainly in the peripheral nerve. If the tumor is large or is in areas other than the nerves, it is likely to be mistaken for malignant soft tissue tumors. The authors reviewed 50 cases of giant schwannomas and assessed the distribution of the primary locations, clinical symptoms, radiological and pathological diagnosis, and diagnostic accuracy. Materials and Methods: Of the 214 pathologically confirmed schwannomas, 50 cases with a maximum diameter of 5 cm or more were extracted. The entire cohort was classified into three subgroups (major peripheral nerve, intramuscular, bone) according to the primary location, and the anatomical locations were specified. Results: When the entire cohort was classified according to the primary location, 14 tumors occurred in the major peripheral nerve, 31 cases in the muscle, and 5 cases in the bone. The mean size of the tumor in the entire cohort was 7.0 cm, and the intramuscular subgroup had the largest size with 8.0 cm. The radiological diagnosis revealed 33 out of 50 cases to be benign schwannoma (66.0%), 15 cases as low-grade malignancy (30.0%), and the remaining two cases (4.0%) as a suspicious tuberculosis abscess and tenosynovial giant cell tumor, respectively. On the clinical symptoms, Tinel sign was the most common in the peripheral nerve group with 78.6% (11/14), while 93.5% of the intramuscular group had palpation of the mass with a mean duration of 66.6 months. In the bone group, one out of five cases was reported as a low-grade malignancy. Two cases of postoperative complications were encountered; one was bleeding after tumor excision, which required hemostasis, and the other was peroneal nerve palsy after surgery. Conclusion: When assessing the large-sized soft tissue tumors in the muscles, the possibility of a benign schwannoma should be considered if 1) there is a long period of mass palpation and 2) non-specific findings in MRI. Preoperative pathology confirmation with a biopsy can help reduce the risk of overtreatment.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.77-83
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• 1995

Malignant fibrous histiocytoma was classified as fibrosarcoma, liposarcoma, rhabdomyosarcoma in times past and it was first introduced in 1963 to refer to a group of soft tissue tumors and reported in bone in 1972. It was postulated that the origin of tumor cell was derived from histiocytes that could assume the appearance and function of fibroblasts("facultative fibroblasts") at first. But, recently the immunohistochemical studies suggested origin from a primitive mesenchymal cell. The malignant fibrous histiocytoma were commonly misdiagnosed as other tumors such as myxoid liposarcoma, pleomorphic rhabdomyosarcoma, osteogenic sarcoma, leiomyosarcoma, malignant schwannoma, giant cell tumor, hemangiopericytoma, dermatofibrosarcoma protuberans due to the broad morphologic spectrum. The seventeen cases of the malignant fibrous histiocytomas diagnosed at Hanyang University Hospital since 1979 were reviwed, and the suggestions are as follows : 1. No fundamental histologic differences between the MFHs of soft tissues and bones. 2. The other tumors must be excluded in order to diagnose MFH due to wide histologic variety of MFH. 3. The review of the initial tissue slide was necessary for adequate diagnosis because the recurrent MFHs showed different histologic findings from original tumors.