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Case Report Open Access

Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases

  • Authors:
    • Shilong Wang
    • Kaixiang Zhang
    • Xiangwu Lin
    • Feilai Xie
    • Jian Yang
    • Jie Li
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine (900th Hospital), Fuzhou, Fujian 350025, P.R. China, Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian 350025, P.R. China, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
    Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 304
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    Published online on: May 19, 2026
       https://doi.org/10.3892/ol.2026.15659
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Abstract

Schwannomas are neurogenic tumours originating from Schwann cells, and the vast majority of the tumours are benign lesions. Schwannomas are most commonly found in the head, neck and extremities; however, those occurring in the pelvis are rare. Due to the lack of specific clinical manifestations and radiographic features, pelvic schwannomas are difficult to detect and differentiate at an early stage. Cases of pelvic schwannomas coexisting with colorectal cancer have rarely been reported in both domestic and international literature. The current study presents two cases of pelvic schwannomas that were misdiagnosed as colorectal cancer metastases. Both lesions were initially identified as metastatic colorectal cancer during preoperative evaluation and were subsequently confirmed as schwannomas by postoperative pathological examination. This report analyses the causes of misdiagnosis, summarises the key distinguishing features between pelvic schwannomas and colorectal cancer metastases, and proposes a diagnostic algorithm for patients with colorectal cancer and pelvic masses of uncertain origin, with the aim of providing practical guidance for clinical practice.
View Figures

Figure 1

PET-CT images of pelvic schwannoma in
case 1, and CT and MRI of pelvic schwannoma in case 2. (A) PET-CT
image (case 1): A round, low-density mass (CT value, 27 HU) (red
arrow) measuring 5.4×4.8 cm is evident on the right pelvic wall,
exhibiting clear margins, intact perimetrium, no apparent
haemorrhage, necrosis or calcification, homogeneous density, and no
significant enhancement on contrast-enhanced images. PET imaging
demonstrates slightly increased metabolism (SUVmax,
2.8). (B) Contrast-enhanced CT image (case 2): A rounded mass (red
arrow) with mixed density is observed on the right pelvic wall,
featuring internal calcifications and mild-to-moderate
heterogeneous enhancement after contrast administration. (C)
T2-weighted fat-suppressed MRI (case 2): A nodular mass (3.2×3.4
cm) (red arrow) is noted in the right pelvic obturator region,
appearing slightly hyperintense with heterogeneous signal
intensity. (D) Contrast-enhanced MRI (case 2): The mass (red arrow)
in the right pelvic obturator region displays heterogeneous
enhancement post-contrast, with scattered punctate low-signal areas
observed centrally. PET-CT, positron emission tomography-computed
tomography; MRI, magnetic resonance imaging; SUVmax,
maximum standardised uptake value.

Figure 2

Microscopic views and
immunohistochemical staining of pathological specimens from sigmoid
colon carcinoma and pelvic schwannoma (case 1). (A) Sigmoid colon
adenocarcinoma (H&E stain; ×40 magnification). (B)
Low-magnification view of pelvic schwannoma showing well-defined
borders and encapsulation (H&E stain; ×40 magnification). (C)
Medium-magnification view of pelvic schwannoma: Antoni A areas (red
arrow) and Antoni B areas (yellow arrow) are visible (H&E
stain; ×200 magnification). (D) Immunohistochemical staining of
pelvic schwannoma demonstrating positive expression of S-100
protein.

Figure 3

Diagnostic flowchart for evaluating
patients with colorectal cancer presenting with pelvic masses of
uncertain origin. MDT, multidisciplinary team; PET-CT, positron
emission tomography-computed tomography; MRI, magnetic resonance
imaging.
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Spandidos Publications style
Wang S, Zhang K, Lin X, Xie F, Yang J and Li J: Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases. Oncol Lett 32: 304, 2026.
APA
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., & Li, J. (2026). Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases. Oncology Letters, 32, 304. https://doi.org/10.3892/ol.2026.15659
MLA
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., Li, J."Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases". Oncology Letters 32.1 (2026): 304.
Chicago
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., Li, J."Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases". Oncology Letters 32, no. 1 (2026): 304. https://doi.org/10.3892/ol.2026.15659
Copy and paste a formatted citation
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Spandidos Publications style
Wang S, Zhang K, Lin X, Xie F, Yang J and Li J: Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases. Oncol Lett 32: 304, 2026.
APA
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., & Li, J. (2026). Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases. Oncology Letters, 32, 304. https://doi.org/10.3892/ol.2026.15659
MLA
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., Li, J."Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases". Oncology Letters 32.1 (2026): 304.
Chicago
Wang, S., Zhang, K., Lin, X., Xie, F., Yang, J., Li, J."Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases". Oncology Letters 32, no. 1 (2026): 304. https://doi.org/10.3892/ol.2026.15659
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