Diagnostic challenge in parathyroid imaging: incidental schwannoma mimicking primary hyperparathyroidism on ¹⁸F-fluorocholine PET/CT

Introduction

Schwannomas, or neurilemomas, are non-malignant tumors arising from Schwann cells, which are responsible for producing the myelin sheath around nerves. Typically these tumors are well-encapsulated, slow-growing and most commonly located in the head and neck regions [1]. Occurrence in the mediastinum or abdominal cavity is relatively rare. Even though they are mostly benign, their clinical presentation may vary depending on their size and anatomical location, potentially leading to compressive symptoms. Diagnosis is typically established through a combination of clinical evaluation and imaging modalities, including magnetic resonance imaging (MRI) and computed tomography (CT), complemented by electrophysiological studies and histopathological confirmation via biopsy.

Publikationsverlauf

Eingereicht: 28. Juni 2025

Angenommen: 14. Juli 2025

Artikel online veröffentlicht:
22. August 2025

• References

• 1 Farce J, Lussignol I, Barrau CN. et al. Intracavernous schwannoma characterized with ¹⁸F-FDG, 68Ga-DOTATOC, and ¹⁸F-choline PET. Clin Nucl Med 2022; 47 (02) e120-e122
• 2 Pasini Nemir E, Fares S, Rogić I. et al. ¹⁸F-fluorocholine PET/CT imaging in primary hyperparathyroidism after negative or inconclusive cervical ultrasonography and 99mTc-MIBI scintigraphy. Jpn J Radiol 2025; 43 (04) 687-695
• 3 Broos WAM, Knol RJJ, van der Zant FM. et al. Incidental findings on ¹⁸F-fluorocholine PET/CT for parathyroid imaging. World J Nucl Med 2022; 21 (03) 192-199
• 4 Shawgi M, Ali T, Scott M. et al. 99m-Technetium sestamibi uptake in a gastric schwannoma. World J Nucl Med 2018; 17 (01) 49-51
• 5 Amrane K, Le Meur C, Alemany P. et al. Case report: Thoracic schwannoma as a diagnostic pitfall in both ¹⁸F-choline PET/CT and ¹⁸F-FDG PET/CT. Front Oncol 2024; 14: 1467344