Intracortical schwannoma of the femur

Schwannomas are benign nerve sheath tumors most commonly found in soft tissue. Intraosseous schwannomas are rare, and account for <0.2 % of primary bone tumors. The typical radiologic findings, a lytic lesion with a thin peripheral rim of sclerosis, are nonspecific. In all reviewed case reports, the diagnosis was made only after microscopic examination. Among previously described intraosseous schwannomas, there have been no reports of tumors arising within cortical bone. It is important to note that while schwannomas are benign tumors, they can be misdiagnosed clinically and radiographically can be potentially mistaken for metastases or other serious skeletal diseases such as osteomyelitis. Tissue sampling is critical for definitive diagnosis as well as to avoid unnecessary treatment. We present the first reported case of an intracortical schwannoma in a 42-year-old man who presented with an incidental radiographic lesion of the diaphyseal femoral cortex.