A case of ancient schwannoma of arm with profuse vascularity.

Abstract Case report:A 70-year old female had right arm swelling of 10 years duration, of 5 cm size, and with prominent vessels. She had sphenoid tumor earlier, underwent transnasal decompression and it was diagnosed as ossifying fibroma. Contrast enhanced magnetic resonance imaging showed a cystic swelling with thick peripheral enhancement, abutting the brachial artery. The differential diagnoses were soft tissue sarcoma , hemangioma, and schwannoma. Excision was done en toto, after cauterising the arterioles around. Histopathology report came as ancient schwannoma. S100 was positive. Discussion: Ancient schwannomas are long standing tumors with degenerative changes such as cystic necrosis, hemorrhage, xanthomatous change, fibrosis, perivascular hyalinization, calcification and nuclear pleomorphism. The currently understood reason for degeneration in ancient schwannoma is the insufficiency of vascular supply during the growth of the tumor. This is a report of an ancient schwannoma of arm with profuse vascularity. The histopathological findings showed congested blood vessels in addition to the features of ancient schwannoma. The patient had ossifying fibroma of sphenoid also, which may be an association.