Intercostal nerve neurilemmoma

Intercostal nerve neurilemmomas, also known as intercostal nerve schwannoma or neurinoma, are nerve sheath encapsulated tumors affecting intercostal nerves.

Please refer to the article on schwannomas for a broad discussion about these tumors.

Epidemiology

They account for <10% of primary neural tumors that arise in the chest (majority arise from the mediastinum ). They occur commonly occur between 20 and 50 years of age .

Clinical presentation

Most patients tend to be asymptomatic as lesions are slow-growing . Some patients may have pain .

Pathology

Please refer to the general article on schwannomas.

Radiographic features 

Lesions are usually solid well-circumscribed masses with homogeneous contrast enhancement. They are usually single but can rarely be multiple .

CT

Solid nodules iso to slightly hyperdense showing homogeneous enhancement.

MRI
  • T1: iso or slightly hyperintense compared to the adjacent muscles
  • T2: hyperintense compared to the adjacent muscles
  • T1 C+ (Gd): homogenous contrast enhancement

History and etymolgoy

Neurilemmoma is derived from the Greek word eilēma meaning covering, translating to "nerve covering mass".

Differential diagnosis 

On imaging consider localized pleural masses including:

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