Abstract
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.
Highlights
Peripheral Nerve Sheath Tumors (PNST) are uncommon, comprising less than 5% of the soft tissue tumors of the upper limb [1]
The most common amongst them are neurilemmomas, known as Schwannomas, that are derived from Schwan cells and are more common in the hand and wrist [2] and neurofibromas, comprised of cells of mixed origin, that seem to be more common in the brachial plexus [3]
Schwannomas are usually solitary tumors arising from the Schwann cells that support the peripheral nerve fibers
Summary
Peripheral Nerve Sheath Tumors (PNST) are uncommon, comprising less than 5% of the soft tissue tumors of the upper limb [1]. The most common amongst them are neurilemmomas, known as Schwannomas, that are derived from Schwan cells and are more common in the hand and wrist [2] and neurofibromas, comprised of cells of mixed origin, that seem to be more common in the brachial plexus [3]. Schwannomas are benign in the vast majority of cases and malignant transformation or relapse post-excision is almost non-existent [5, 6]. They are usually asymptomatic in the early stages, and are not noticed, until they either become palpable, or develop nerve compression [7]. During a ten-year period, we treated eleven schwannomas of the median nerve found on the hand (nine) and wrist (two)
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