Cutaneous Schwannomas: Clinical Manifestations, Diagnosis and Management: A Review

This review aims to present an overview on Cutaneous Schwannomas, their clinical manifestations, diagnostic modalities, and management. To our best knowledge, this is the most extensive review on cutaneous schwannomas, offering specialized physicians a reference on the topic through a comprehensive summary of literature findings.

With a variable clinical presentation and a broad differential diagnosis, specific testing modalities such as ultrasonography, histological examination and immunohistochemistry have been studied for their diagnostic value in differentiating cutaneous schwannomas from other similar-looking skin lesions.

Cutaneous schwannomas are the most common benign peripheral nerve sheath tumor; they are skin-colored nodules often found on the head and neck region but can be found elsewhere and are usually asymptomatic. Cutaneous schwannomas are usually encapsulated, exhibit Antoni type A and B tissue patterns and are S-100 protein positive. Using different modalities, including ultrasound, histological and immunochemical studies, cutaneous schwannomas can be diagnosed and differentiated from other similarly presenting tumors. Histologically, cutaneous schwannomas can be divided into classic schwannoma, cellular schwannoma, schwannoma with degenerative changes, plexiform schwannoma, epithelioid cell schwannoma, reticular/microcystic schwannoma, and schwannomas with uncommon characteristics. While several treatment options are available, surgical excision remains the preferred choice.