A Rare Cause of Sciatica: Sciatic Nerve Schwannoma - A Case Report

Abstract

Herein we report a rare case of a sciatic nerve schwannoma causing in a 63-year-old female. A sciatic localization is rare accounting for <1% of all schwannomas. They often lead to misdiagnosis or delayed diagnosis owing to confusion with other common causes of sciatica, such as lumbar herniated disc or spinal stenosis. Magnetic Resonance Image (MRI) is a gold diagnostic tool, and the final diagnosis is made by the histological examination. A standard surgical technique with guidance by neurophysiologic monitoring allows in most of the cases an uncomplicated removal of the tumor. Although being a rare occurrence, a thorough clinical and radiological evaluation of the sciatic nerve should be taken into consideration whenever sciatica is not otherwise explained.

Successful enucleation of a large sciatic schwannoma with intraoperative neurostimulation-guided dissection: a case report

“…Since the middle portion of the sciatic nerve is not a location where nerve entrapment syndrome commonly occurs, the surgical approach is not familiar to neurosurgeons, and it is difficult to find detailed techniques in the literature [4,8]. Because the tumor in this patient was large, sufficient proximal and distal exposure including the middle portion of the sciatic nerve was required.…”

“…Patients with a peripheral nerve schwannoma may exhibit Tinel's sign which is the paresthesia in the distal distribution of the affected nerve upon tapping. In the periphery, it occurs more commonly in the upper extremities than in the lower extremities, and among them, sciatic schwannomas are rarely reported [3,4]. In addition, approach to the sciatic nerve is not familiar to neurosurgeons because it is not a common site for nerve entrapment syndrome or injury.…”