Neurilemmoma (Schwannoma)
Benign nerve sheath tumour of midddle age
Most often found as solitary mass tender to compression
Can be found anywhere from spinal roots to subcutaneous nerves
Imaging diagnosis usually easily established from relationship to the host nerve
Nerve and neural vessels leave the mass with a comet tail or spring onion appearance
May contain cystic areas
Neurifibroma
Usually obvious as associated with Neurofibromatosis
Younger patients than neurilemmoma
Lesion is more integral to host berve than neurilemmoma
Malignant Schwannoma
Half of patients have neurofibromatosis
Usually close to larger nerves
MRI for anatomy, PET for diagnosis of malignancy
Ancient Schwannoma
Large longstanding schwannoma
More complex elements including cystic degeneration and calcification
Benign
MPNST
Most common scanario is malignant degeneration in neurofibromatosis
Enlarging mass
Loss of organised stromal structure
Contrast MRI positive
PET may help detect malignant degeneration
GLOMUS TUMOR
Neuroectodermal tumour
Small lesions with typical clinical presentation
Nailbed lesion with point sensitivity
Cold reaction
Can occur elsewhere, be alert to clinical presentation