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Schwannoma of the median nerve: diagnosis sometimes delayed.

Boufettal M, Azouz M, Rhanim A, Abouzahir M, Mahfoud M, Bardouni AE, Berrada MS, Yaacoubi ME - Clin Med Insights Case Rep (2014)

Bottom Line: Schwannoma is a tumor that develops from nerve sheath.The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays.This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

View Article: PubMed Central - PubMed

Affiliation: Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco.

ABSTRACT
Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

No MeSH data available.


Related in: MedlinePlus

Operative view: oval-shaped capsulated mass in eccentric position along the MN.
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f2-ccrep-7-2014-071: Operative view: oval-shaped capsulated mass in eccentric position along the MN.

Mentions: A 26-year-old man presented with a mass at the anterior side of his forearm. On clinical examination, there was a painless solid mass 4 cm in length, little sensitive to pressure, firmly attached to deeper tissues. Percussion over the mass produced a Tinel’s-like sensation along the MN. The pain was not severe enough to disturb sleep or to hinder physical activities. The patient reported that he first palpated a nodule four years ago that grew up very slowly to the current size. There was no family history of neurofibromatosis and no associated clinical features. The ultrasound showed that the mass was subcutaneous although limited and homogeneous measuring 3 cm in diameter. An MRI examination revealed a 3-cm long, well-circumscribed mass in close proximity to the neurovascular bundle of the upper extremity of the forearm, which had hyperintense signal on T2-weighted images. The appearance was compatible with a tumor of nervous origin (Fig. 1A–C, arrow). A longitudinal incision centered over the tumor bulk was performed (Fig. 2). Surgical exploration brought to light an encapsulated tumor firmly attached to the MN, which was easily resected. Histological examination of the tumor showed the characteristic pattern of benign schwannoma: non-nucleated fibrillar areas lined by a palisade of Schwann cell nuclei (Fig. 3). At 10 months follow-up, the wound healed well with no pain or sensorimotor deficit.


Schwannoma of the median nerve: diagnosis sometimes delayed.

Boufettal M, Azouz M, Rhanim A, Abouzahir M, Mahfoud M, Bardouni AE, Berrada MS, Yaacoubi ME - Clin Med Insights Case Rep (2014)

Operative view: oval-shaped capsulated mass in eccentric position along the MN.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4125423&req=5

f2-ccrep-7-2014-071: Operative view: oval-shaped capsulated mass in eccentric position along the MN.
Mentions: A 26-year-old man presented with a mass at the anterior side of his forearm. On clinical examination, there was a painless solid mass 4 cm in length, little sensitive to pressure, firmly attached to deeper tissues. Percussion over the mass produced a Tinel’s-like sensation along the MN. The pain was not severe enough to disturb sleep or to hinder physical activities. The patient reported that he first palpated a nodule four years ago that grew up very slowly to the current size. There was no family history of neurofibromatosis and no associated clinical features. The ultrasound showed that the mass was subcutaneous although limited and homogeneous measuring 3 cm in diameter. An MRI examination revealed a 3-cm long, well-circumscribed mass in close proximity to the neurovascular bundle of the upper extremity of the forearm, which had hyperintense signal on T2-weighted images. The appearance was compatible with a tumor of nervous origin (Fig. 1A–C, arrow). A longitudinal incision centered over the tumor bulk was performed (Fig. 2). Surgical exploration brought to light an encapsulated tumor firmly attached to the MN, which was easily resected. Histological examination of the tumor showed the characteristic pattern of benign schwannoma: non-nucleated fibrillar areas lined by a palisade of Schwann cell nuclei (Fig. 3). At 10 months follow-up, the wound healed well with no pain or sensorimotor deficit.

Bottom Line: Schwannoma is a tumor that develops from nerve sheath.The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays.This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

View Article: PubMed Central - PubMed

Affiliation: Orthopedic Surgery Department, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco.

ABSTRACT
Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

No MeSH data available.


Related in: MedlinePlus