PMC6189694_01
(a, b) Oblique and lateral plain radiograph of the patient's foot shows lytic lesion with sclerotic rims in the long axis of calcaneus. (c) Coronal T1-weighted MRI image shows hypointense signaling, cortical involvement, and well-defined borders. (d) Sagittal T2-weighted MRI image shows hyperintense signaling and heterogenous appearance.
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T1-weighted images and hyperintense signal on T2-weighted images (Figure 1). The contrast-enhanced MRI was not available for this patient.
(a) Histological examination reveals bundles of elongated cells with spindle-shaped nuclei between mature bone fragments (black arrows) (H&E x10). (b) The hallmark of a schwannoma is the pattern of alternating Antoni A (black arrow) and B (white arrow) areas (H&E x4). (c) Verocay bodies (black arrow), formed by two compact rows of well-aligned nuclei separated by fibrillary cell processes (H&E x4). (d) Thickened hyalinized vessels (black arrow) are irregularly scattered in the lesion which are characteristic of schwannomas (H&E x4). (e) Cytoplasmic and nuclear immunostaining of neoplastic cells with S-100 protein (magnification x10). (f) Ki-67 proliferation index was observed around 5% at the highest level (magnification x10).
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Diffuse expression of S-100 protein was observed with immunohistochemical staining, and Ki-67 proliferation index was observed around 5% at the highest level (Figure 2).
Postoperative lateral plain radiograph of the patient's foot shows radiopacity of the bone grafts at the surgery site.
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Postoperatively, short leg splint was applied until the sutures were removed (Figure 3).