Neglected Giant Schwannoma of the Sciatic Nerve. Case Report

Tariq Elemam Awad, Mohamed Hassan Mahmoud

Abstract


Abstract

Background

Schwannomas originating from the sciatic nerve are extremely rare and usually present as a pathological mass in palpable examination or pain located in the thigh. Motor and sensory deficits are observed more often when the size of the tumor is more than 40 mm.

Case Description

A 19-years- old female patient was referred to Suez Canal University Hospital after 6 years of pain and 2 years of improper management. Neurological examination and MRI of the right thigh was done and revealed huge mass attached to the right sciatic nerve. Surgical excision was undertaken, carefully dissecting the lesion from the sciatic nerve. Histopathological examination revealed the tumor to be a schwannoma. The patient had marked postoperative recovery with marked pain reduction and improved neurological deficits.

Conclusions:

Schwannomas of the sciatic nerve are rare tumors eccentrically located on the nerve. Although rare, schwannoma of the sciatic nerve should be systematically suspected if thigh mass or persistent sciatica is reported. Surgical excision has good prognosis.


Keywords


Schwannoma, sciatic nerve, sciatica

References


References

- Dudeney S, O’Farrell D, Bouchier-Hayes D, Byrne J: Extra spinal causes of sciatica. A case report. Spine 23: 494-496, 1998.

- Gabhane SK, Kotwal MN, Bobhate SK: Morphological spectrum of peripheral nerve sheath tumors: A series of 126 cases. Indian J Pathology and Microbiology 52:29-33, 2009

- Ghaly RF: A posterior tibial nerve neurilemoma unrecognized for 10 years: Case report. Neurosurgery 48:668-672, 2001.

- Hamdi MF, Aloui I, Ennouri Kh: Sciatica secondary to sciatic nerve schwannoma. Neurol India 57:685-686, 2009.

- Kasraeian S, Allison DC, Ahlmann ER, Fedenko AN, Menendez LR. A Comparison of Fine-needle Aspiration, Core Biopsy, and Surgical Biopsy in the Diagnosis of Extremity Soft Tissue Masses. Clinical Orthopaedics and Related Research. ; 468(11):2992-3002, 2010.

- Kralick F, Koenigsberg R: Sciatica in a patient with unusual peripheral nerve sheath tumors. Surg Neurol 66:634-637, 2006.

- Kulcu DG, Naderi S: Differential diagnosis of intraspinal and extra spinal non-discogenic sciatica. J Clin Neurosci 15: 1246-1252, 2008

- Nawabi DH, Sinisi M. Schwannoma of the posterior tibial nerve: the problem of delay in diagnosis. J Bone Joint Surg Br; 89:814—6, 2007.

- Omezzine SJ, Zaara B, Ben Ali M, Abid F, Sassi N, Hamza HA: A rare cause of non discal sciatica: Schwannoma of the sciatic nerve. Orthop Traumatol Surg Res 95:543-546, 2009

- Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A: Imaging of peripheral nerve sheath tumors with pathologic correlation: Pictorial review. Eur J Radiol 52:229-239, 2004

- Rekha A, Ravi A: Sciatic nerve schwannoma. Int J Low Extrem Wounds 3:165-167, 2004

- 10. Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ: Peripheral (extracranial) nerve tumors: Correlation of MR imaging and histologic findings. Radiology 183:341-346, 1992

- Tan LA, Bradbury J, Bonnin J, Horn EM: Minimally invasive resection of an extrapelvic sciatic schwannoma. J Clin Neurosci 17:1314-1316, 2010.

- Thiebot J, Laissy JR, Delangre T, Biga N, Liotard A. Benign solitary neurinomas of the sciatic popliteal nerves CT study. Neuroradiology; 33:186—8, 1991.

- Topsakal C, Akdemir I, Tiftikci M, Ozercan I, Aydin Y. Malignant schwannoma of the sciatic nerve originating in a spinal plexiform neurofibroma associated with neurofibromatosis type 1—case report. Neurol Med Chir (Tokyo); 41:551—5, 2001.

- Weiss SW, Glodblum JR: Benign tumors of peripheral nerves and malignant tumors of peripheral nerves. In Enzinger and Weiss Soft Tissue Tumors. Mosby: St.Louis, 2001:1111-332




DOI: http://dx.doi.org/10.15342%2Fijms.v5iR.212

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