The term ancient schwannoma was introduced by Ackerman and Taylor in their description of 10 benign tumors of the thorax demonstrating extensive hyalinization. Aside from nuclear atypia, additional changes associated with the degenerative process include formation of cysts, stromal edema, xanthomatous change, hemorrhage, accumulation of siderophages, calcification and hyalinization
3,4.
The differential diagnosis of peripheral nerve schwannomas include neurofibroma, malignant peripheral nerve sheath tumor, leiomyoma, lymphadenopathy, vascular anomalies, lipomas, angiomas and dermal nerve sheath myoma 2,6.
Ultrasonography, magnetic resonance and computed tomography were enabled the correct diagnosis of schwannoma. But differential diagnosis of these tumors by imaging modalities can be difficult 6,7. Nuclear medicine may be help for differential diagnosis and distinguish benign schwannoma from malignancy. Previous authors reported that schwannoma could be demonstrated with increased Tc-99m- (V) DMSA 8, F-18-FDG 9, Tl-201 10, I-131-MIBG 11, Tc-99m-diphosphonates 12 activity accumulation but did not uptake Ga-67 8 and Indium-111 octreotide 7.
In conclusion, surgeons should have a current knowledge of the diagnostic possibilities and the treatment options about peripheral nerve tumors such as schwannomas. The ancient schwannoma can be demonstrated with the bone scintigraphy.