Rare Extratesticular Schwannoma Diagnosed in 10-Year-Old Boy
An extremely rare benign nerve sheath tumor, known as an extratesticular schwannoma, was diagnosed in a ten-year-old boy after the appearance of a painless scrotal mass. “Schwannomas, also called neurilemmomas or neurinomas, are benign tumors of the nerve sheath that develop from myelin-forming cells called Schwann cells. They mostly affect the head and neck region, as well as nerves along the flexor surfaces of the upper and lower extremities, with a peak incidence between 20 and 50 years of age…” the researchers wrote.
This rare pediatric condition is detailed in the report Intrascrotal extratesticular schwannoma in a 10-year-old boy: A report of an extremely rare benign tumor, published in Urology Case Reports. The study’s authors are Alhareth Baarimah, Nahid Osman, Ziyad Althobaiti, Mohammed Althobaiti, Bader Alzahrani, and Ashraf Soliman.
The young patient had no significant medical or family history and no history of trauma or infection
As described in the case report, a 10-year-old boy presented to a pediatric urology clinic for evaluation of a painless, slow-growing scrotal mass. “He had no significant medical or family history and no history of trauma or infection.”
Initial ultrasound examination showed that the mass was located outside the testis, but it could not precisely determine the tumor type. Only after complete surgical removal and microscopic tissue examination was it confirmed to be a schwannoma. In this case, the tumor was completely removed, and during 18 months of follow-up, there were no signs of disease recurrence.
To their knowledge, only two similar cases have previously been reported in the literature. As they noted, the first case was described in 2014 by Bergeron et al. and involved a 16-year-old boy diagnosed and treated for an intrascrotal extratesticular schwannoma; the second case was reported by Sevinç et al., involving a 13-year-old patient who was diagnosed and managed using the same therapeutic approach. According to the report, this new case represents the third documented pediatric intrascrotal extratesticular schwannoma and the youngest patient reported to date.
No single radiological technique is diagnostic for schwannoma
This case highlights the importance of considering rare diagnoses in children with scrotal masses and demonstrates the crucial role of histopathological analysis in establishing a definitive diagnosis. “No single radiological technique is diagnostic for schwannoma, because there is no pathognomonic finding for this disease. The standard therapeutic approach is surgical removal. If a lesion is incompletely resected, it can recur, although recurrence of scrotal schwannoma has rarely been described in the literature,” they pointed out.
As the authors concluded, although rare, schwannoma should be considered in the differential diagnosis of pediatric extratesticular masses. Given the wide range of possible benign and malignant lesions in this region, careful preoperative evaluation is essential. Long-term follow-up is recommended because, despite the tumor’s benign nature, incomplete excision may lead to recurrence. Increased awareness of such rare tumors may improve diagnostic accuracy and help prevent overtreatment.
Due to the limited availability of images on this topic, we used an AI-generated illustration for this article.
