Abstract
Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography), MRI (magnetic resonance imagination), and USG (ultrasound) are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.
Highlights
Benign tumours involving peripheral nerves of the upper extremity are uncommon [1] and they cause difficulties in classification, clinical diagnosis, and treatment
They are the most common tumours of the hand (0.8–2%) [3]. They usually grow slowly and appear as painless swellings for several years before diagnosed [4]. They usually present with solitary swelling along the course of the nerve [1], multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis
MRI revealed a 11 × 9 mm mass located in flexor tendons which has intermediate signal on T1-weighted images and hyperintense signal on T2-fat weighted images (Figure 1)
Summary
Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report. Schwannomas are known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma
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