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Peripheral nerve sheath tumor of the sciatic nerve

Case contributed by Ivan Turkalj
Diagnosis almost certain

Presentation

Incidentally detected soft tissue mass at duplex scan examination. She denied any discomfort and pain in the region of the lesion. The previous history was unremarkable.

Patient Data

Age: 55 years
Gender: Female

There is a fusiform T1W hypo- and T2W centrally hypo- and peripherally hyperintense lesion (target sign) in the posterior part of the thigh, closely related to the sciatic nerve. The lesion enhances vividly and homogeneously after contrast administration. 

A note is made of minor medial meniscus extrusion and tibial subchondral cyst associated with cartilage degeneration. Also, a small ganglion cyst near the attachment of the lateral head of gastrocnemius muscle is evident.    

Case Discussion

According to clinical and MR findings, a diagnosis of peripheral nerve sheath tumor of the sciatic nerve was made.

An enhancing fusiform mass in continuity with a neurovascular bundle is virtually diagnostic for peripheral nerve sheath tumor. Target sign, as shown in the present case, was previously assumed to be pathognomonic of neurofibroma; however, it has been observed in both neurofibromas and schwannomas and has even been reported in malignant peripheral nerve sheath tumors.  

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