NEURORADIOLOGYPeripheral Nerve Sheath Tumors of Head and Neck: Imaging-Based Review of World Health Organization ClassificationAbdel Razek, Ahmed Abdel Khalek MD∗; Gamaleldin, Omneya A. MD†; Elsebaie, Nermeen A. MD†Author Information From the ∗Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura †Department of Radiology, Alexandria Faculty of Medicine, Alexandria, Egypt. Received for publication June 18, 2020; accepted September 9, 2020. Correspondence to: Ahmed Abdel Khalek Abdel Razek, MD, Department of Diagnostic Radiology, Mansoura Faculty of Medicine, 60 Elgomheryia St, Mansoura 3512, Egypt (e-mail: [email protected]). The authors declare no conflict of interest. Journal of Computer Assisted Tomography: 11/12 2020 - Volume 44 - Issue 6 - p 928-940 doi: 10.1097/RCT.0000000000001109 Buy Metrics Abstract We aim to review the imaging appearance of peripheral nerve sheath tumors (PNSTs) of head and neck according to updated fourth edition of World Health Organization classification. Peripheral nerve sheath tumor can be sporadic or associated with neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. Schwannoma is the most common benign PNST that can be intracranial or extracranial and appears heterogeneous reflecting its histologic composition. Melanotic schwannoma is a different entity with high prediction of malignancy; it shows hypointense signal on T2-weighted image. Neurofibroma can present by localized, plexiform, or diffuse lesion. It usually appears homogeneous or shows a characteristic target sign. Perineurioma can be intraneural seen with the nerve fiber or extraneural appearing as a mass. Solitary circumscribed neuroma and neurothekeoma commonly present as dermal lesions. Nerve sheath myxoma may exhibit high signal on T1 weighted image. Benign triton tumors can be central, aggressive lesion, or peripheral nonaggressive lesion. Granular cell tumor shows hypointense signal on T2 weighted image. Neuroglial heterotopia most commonly occurs in the nasal cavity. Ectopic meningioma arises from ectopic arachnoid cells in the neck. In hybrid PNST, combined histological features of benign PNST occur in the same lesion. Malignant PNSTs are rare with an aggressive pattern. Computed tomography and magnetic resonance imaging are complementary studies to determine the location and extent of the tumor. Advanced magnetic resonance sequences, namely, diffusion-weighted imaging and dynamic contrast enhancement, can help in differentiation of benign from malignant PNST. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.