case_images: PMC11380823_01
case_images: Peripheral lesions of brother sibling on (a) first visit showing lesions (red triangles) in the left femoral (left, T2-weighted coronal magnetic resonance imaging [MRI]) and left sciatic nerve (right, T2-weighted coronal MRI) regions which histology showed to be consistent with schwannoma, followed by (b) second visit showing lesions (red triangles) in the left supraclavicular (left, T2-weighted coronal MRI), left shoulder (middle, T1-weighted no contrast MRI), and right paraspinal (right, T1-weighted with contrast MRI) regions which histology showed to be consistent with schwannoma.
case_images: SNI-15-285-g001.jpg
case_images: PMC11380823_01_SNI-15-285-g001.jpg
case_images: F1
case_images: Recent pelvic magnetic resonance imaging (MRI) demonstrated a left femoral mass and left sciatic nerve lesion [Figure 1a]. MRI revealed a stable left sciatic nerve lesion, a new right-sided thoracic lesion, and a new left-sided brachial plexus lesion [Figure 1b].
case_images: Surgical and histological results from visit 2 for the brother sibling showing surgical specimens for (a) the left supraclavicular lesion, (b) the right paraspinal and left shoulder lesions, as well as Hematoxylin and eosin (H&E) histology for the specimen demonstrating schwannoma at both (c) x20 and (d) x200 magnification.
case_images: SNI-15-285-g002.jpg
case_images: PMC11380823_01_SNI-15-285-g002.jpg
case_images: F2
case_images: He then underwent resection of the left brachial plexus and multiple posterior back lesions [Figure 2a and b]. Pathology confirmed that all these lesions were schwannomas [Figure 2c and d], and genetic analysis was positive for a pathogenic variant of the LZTR1 gene associated with LZTR1-related schwannomatosis.
case_images: PMC11380823_02
case_images: Peripheral lesion of sister sibling in the right ankle (red triangle) on T1-weighted magnetic resonance imaging with contrast on (a) axial, (b) sagittal, and (c) coronal axes initially thought to be a ganglion cyst, but histology proved to be schwannoma.
case_images: SNI-15-285-g003.jpg
case_images: PMC11380823_02_SNI-15-285-g003.jpg
case_images: F3
case_images: MRI of her right ankle demonstrated a one-centimeter subcutaneous tumor lateral to the lateral malleolus associated with the tibial sensory nerve, likely representing a schwannoma [Figure 3a-c].
case_images: PMC11380823_03