Neglected Giant Schwannoma of the Sciatic Nerve. Case Report and Literature Review

Abstract

Background Data: Schwannomas originating from the sciatic nerve are extremely rare and usually present as a pathological mass on palpable examination or pain located in the thigh. Motor and sensory deficits are observed more often with big size lesions. Purpose: To describe a rare case of giant schwannoma of the sciatic nerve with 2 yearsdelay in management. Study Design: Case report and review of the literature.Patients and Methods: A 19-years- old female patient was referred to Suez Canal University Hospital after 6 years of pain and 2 years of improper management. She presented with increasing swelling in the posterior aspect of her right thigh associated with paresthesia and weakness. After neurological examination an MRI of the right thigh was done and revealed huge mass attached to the right sciatic nerve. Results: Surgical excision was undertaken, carefully dissecting the lesion from the sciatic nerve. Histopathological examination revealed a sciatic nerve schwannoma. The patient had marked postoperative recovery with marked pain reduction and improved neurological deficits. Conclusion: Schwannomas of the sciatic nerve are eccentrically located on the nerve. they should be systematically suspected if thigh mass or persistent sciatica is reported. Surgical excision has good prognosis. (2018ESJ157)