Ancient schwannoma involving the median nerve: a case report and review of the literature (original) (raw)

Schwannoma of the Median Nerve at Mid Forearm Level

Journal of orthopaedic case reports

Schwannomas are also known as neurilemmoma that usually originate from Schwann cells located in the peripheral nerve sheaths. It usually occurs in the age group of 20 to 70 years. These are the commonest tumors of the peripheral nerves, 5% of which occur in the adults and 19% of the tumors occur in upper extremities. Schwannomas are generally presented as an asymptomatic mass. Discomfort may be the only presenting complaint of the patient. Paresthesia may be elicited on tapping the swelling. Magnetic resonanceimaging, and ultrasound are helpful in the diagnosis. Surgical removal is usually curative. A 28-year-old male came to our hospital for a lump located at the volar side of the right mid forearm for 10 years with discomfort and paresthesia in median nerve distribution of hand which appeared in last two years. Total excision was performed for the lesion. Histopathological examination of the mass revealed typical features of schwannoma. At two months follow-up, the patient was sym...

Schwannoma of the Median Nerve: Diagnosis Sometimes Delayed

Clinical Medicine Insights: Case Reports, 2014

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.

Lobulated Schwannoma of the Median Nerve

Journal of Computer Assisted Tomography, 2005

The authors report an unusual case of volar wrist swelling with the appearance of a simple ganglion on magnetic resonance imaging (MRI); however, operative and histologic examination identified the swelling as an ancient schwannoma. Ancient schwannomas mostly present as a solitary tumor. A lobulated tumor in this location has not been described previously. The pathologic findings of these uncommon tumors and the difficulties encountered in accurate preoperative diagnosis are discussed.

Unusual median nerve schwannoma: a case presentation

2014

Peripheral nerve sheath tumors are common soft tissue neoplasms and their characterization is often challenging. Although the surgical pathology defines some typical entities, some degree of controversy regarding the classification of these tumors still exists. Newer imagistic and histopathological techniques are crucial for their accurate diagnosis and grading. We present an unusual case of median nerve schwannoma in a young patient, discussing the clinical, surgical and pathological elements, including immunohistochemistry.

Giant Schwannoma of the Median Nerve: A Case Report and Literature Review

Asian Journal of Oncology

Peripheral nerve sheath tumors (PNST) develop sporadically or are associated with genetic disorders and affect individuals mainly between the third and sixth decades of life. PNST affect one or multiple fascicles. The benign ones have slow and painless growth, preceding in years the diagnosis. Diagnosis is often confused with other soft tissue tumors, such as fibroids and lipomas. We present a rare case of giant schwannoma of the median nerve. The patient had a progressive local growth with minimal neurological impairment.

Median nerve schwannoma. A case report

Zenodo (CERN European Organization for Nuclear Research), 2023

he composition of peripheral nerves primarily consists of axons, which are elongated structures responsible for transmitting nerve impulses. These axons exhibit two distinct characteristics in terms of their myelination status. Some axons possess a myelin sheath, a protective covering that enhances the speed and efficiency of nerve signal conduction. Conversely, other axons lack this myelin sheath and are considered non-myelinated. Surrounding both myelinated and non-myelinated axons are specialized cells known as Schwann cells, which provide support and insulation. Additionally, the axons and Schwann cells are enveloped by a connective tissue layer called the endoneurium, which further contributes to the structural integrity of peripheral nerves. The organization of nerve fibers involves their arrangement in fascicles, which are encased by the perineurium. Additionally, the peripheral nerve sheath is formed by the epineurium encompassing the nerve trunk. Partial and complete tears can potentially lead to the formation of posttraumatic neuromas, which are characterized by a hyperplastic and disorganized proliferation of cells. These neuromas are considered as an adaptive response by the body in an attempt to regenerate the damaged nerves. These neoplasms are infrequent in occurrence and arise from Schwann cells. Typically, they exhibit a predominantly benign clinical course. Schwannomas, initially documented by Virchow and Verocay in 1910, were officially designated as such by

Median Nerve Schwannoma of the Hand and Wrist: 3 Cases

The Open Orthopaedics Journal

Tumors of the median nerve are difficult to diagnose and median nerve schwannomas are rare. During a ten-year period, we treated eleven median nerve schwannomas found on the hand (nine) and wrist (two). All the tumors were treated by enucleation under loupe magnification and tourniquet application. All had a favorable result at a mean follow up of five years. We present three of our most typical cases, with schwannomas found on the wrist, palm and thumb. We also review the literature offering a wider view on the pathology, diagnosis and treatment of schwannomas in general.

Median nerve schwannoma: A case and review of literature

Asian Journal of Neurosurgery, 2015

Incidence is similar between both genders and the tumor is the most common in 3 rd and 6 th decades. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness, and fatigue may take place with the increasing sizes of the tumor; however it is unusual for a schwannoma to exceed three centimeters in diameter (d) Electromyography, magnetic resonance imaging (MRI), and ultrasonography are helpful in the diagnosis. Surgical removal is usually curative.

Degenerated (Ancient) Schwannomas: Unraveling Unusual Locations and Treatment Management

Genel tıp dergisi, 2024

Introduction: Schwannomas, originating from Schwann cells in peripheral nerve sheaths, exhibit diverse clinical manifestations and unpredictable behavior. Among them, ancient schwannomas, with distinctive degenerative features, present in atypical locations and pose diagnostic challenges. This study explores their unique characteristics and implications for diagnosis and management. Material and Methods: The study was designed as a retrospective analysis of 7 adult patients aged ≥18 years diagnosed with paraspinal, presacral, sacral, or para-aortic tumors, and all histologically confirmed as ancient schwannomas. Data for analysis were collected from patients treated and followed up at Ankara City Hospital between April 2017 and December 2022. Ethical approval and informed consent were obtained before inclusion in the study. Results: The most common symptoms included the presence of a local lump (71,4%) and localized or radiating pain (57,1%). Notably, one patient (14,2%) was incidentally diagnosed during the evaluation process. Surgical intervention played a crucial role in the management of these tumors, with 71,4% of patients underwent complete resection while 28,5% underwent subtotal resection. Tumor recurrence occurred in 42,8% of cases, prompting the administration of radiotherapy as part of the treatment strategy. Imaging findings, particularly on MRI, played a crucial role in the accurate identification of ancient schwannomas. These tumors displayed isointensity on T1weighted images and heterogeneous hyperintensity on T2-weighted images, along with distinctive heterogeneous contrast enhancement. Conclusion: Ancient schwannomas exhibit unique histological features and distinctive MRI characteristics, differentiating them from other nerve sheath tumors. Early diagnosis and complete surgical resection offer favorable outcomes. Awareness of this entity is essential for managing peripheral nerve sheath tumors effectively.