Clinical presentation and physical examination

Abstract

The main points to assimilate concerning the presentation of peripheral nerve tumors are their subtle features, few symptoms, and even fewer signs. It is no surprise that most lesions become apparent only when a mass becomes palpable. Pain, paresthesia, and a positive Tinel's sign are sometimes the only features, with the paresthesia being variable and unreliable as a clinical entity. Loss of profound sensory function and motor function is generally a late feature. When patients present with progressive pain and significant sensory and any motor deficits, these signs suggest that a more sinister lesion is present. It cannot be overstressed that the stigmata of neurocutaneous disorders should be sought in all patients with suspected peripheral nerve tumors. Similarly, the presence of such stigmata in a patient presenting with vague paresthetic symptoms in a nerve distribution should make the clinician suspect and investigate for an underlying nerve tumor.