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Pathological Fracture in the Metatarsal Bone Due to an Intraosseous Schwannoma: A Case Report

Year: 2025

Type: article

Abstract: Intraosseous schwannomas (IOSs) are uncommon benign tumors arising from nerve sheath cells. Schwannomas occurring in the metatarsal bones are extremely uncommon. This case report describes a young adult with a progressively enlarging mass in the foot, which led to limited mobility and ultimately resulted in a pathological fracture of the first metatarsal bone. Imaging studies revealed a diffuse, lytic lesion accompanied by surrounding soft tissue swelling. Histopathological evaluation confirmed the diagnosis of a schwannoma. Notably, this case highlights a key diagnostic challenge: its radiological and immunohistochemical features can be ambiguous. Although findings such as an elevated Ki-67 index suggested potential low-grade malignant transformation, retained H3K27me3 expression and an indolent clinical course confirmed the benign nature of the lesion. This case underscores the diagnostic complexity of ambiguous skeletal lesions and emphasizes the necessity of integrating clinical, radiological, and pathological assessments to achieve an accurate diagnosis and guide management. Reporting this case in the literature should help enhance awareness of rare variants of IOSs and advocate for the adoption of an integrated clinical-radiological-pathological workflow when managing ambiguous skeletal lesions.

Source: Cureus

DOI: 10.7759/cureus.95134

Authors: Lu Shen, Lingling Song, Zhaoshu Huang, Yining Xiang, Deqing Song

Institutions: Guiyang Medical University, Affiliated Hospital of Guizhou Medical University

Language: English

Topic: Neurofibromatosis and Schwannoma Cases

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415427192