Imaging and surgical approach for a schwannoma of the hand

Zardi, Enrico Maria; Vadalà, Gianluca; Buzzulini, Francesca; Laghi, Andréa; Afeltra, Antonella; Denaro, Vincenzo; Papapietro, Nicola

doi:10.1007/s10396-013-0495-7

Cited by 4 publications

(4 citation statements)

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“…In the T2-weighted image, schwannoma appears bright with a heterogeneous hyperintensity. A lower intensity signal at the core of the mass (bull's eye or target sign) may also be observed in schwannoma and in another peripheral nerve sheath tumor, neurofibroma [2] , [7] , [10] . In our case, the MRI findings strongly supported a peripheral nerve sheath tumor diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…It is considered the most common form of peripheral nerve sheath tumor. However, its occurrence is rare (only accounts for less than 5 % of all soft tissue tumors) and mostly encountered during the third and sixth decades of life [1] , [2] . Clinical identification and treatment of schwannomas is challenging since these tumors can manifest as a painless growth for years before they are discovered.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent schwannoma of digital nerve on both hands: A very rare case report

Karna

Kinanta

Aprilya

2023

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recurrent schwannoma of digital nerve on both hands: A very rare case report

Karna

Kinanta

Aprilya

2023

International Journal of Surgery Case Reports

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“…Simon et al demonstrated that high-resolution ultrasonography (HRUS) correctly differentiated tumor and motor fascicles when compared with intraoperative electrophysiologic monitoring. 9 Differentiating between PNS and VM with HRUS is difficult as blood can often be stagnant in slow-flow VMs. However, Zardi et al demonstrate the benefit of power flow sonography in identifying "red" and "blue" vascular signal spots that indicate vascularity which is present in PNSs but absent in VMs.…”

mentioning

confidence: 99%

“…However, Zardi et al demonstrate the benefit of power flow sonography in identifying "red" and "blue" vascular signal spots that indicate vascularity which is present in PNSs but absent in VMs. 9 Likewise, VMs will demonstrate compressibility given even light pressure from a US scanner head, whereas PNS are not compressible with scanner head pressure. MRI with tractography demonstrated good correspondence with both HRUS and intraoperative electrophysiologic monitoring.…”

mentioning

confidence: 99%

A Vascular Malformation Presenting as a Peripheral Nerve Sheath Tumor

Parmar

Haldeman

Amaefuna

et al. 2016

J Brachial Plex Peripher Nerve Inj

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A 50-year-old man presented with a left axillary mass that had been palpable for the previous 2 years. He had experienced pain in the left shoulder and chest wall area for the previous 3 years. He reported his pain was 5 to 6 out of 10 on the visual analog scale. He denied any weakness, numbness, or tingling of the arm.Physical exam revealed a firm, ovoid mass on the inside of the left upper arm. The mass was slightly tender to palpation. The mass was more mobile in the horizontal direction than the vertical. The overlying skin looked normal with no discoloration or discharge. No other swellings were noted in the body. We elicited a positive Tinel sign with ulnar distribution tingling. Physical exam otherwise was unremarkable.Magnetic resonance imaging (MRI) with and without contrast demonstrated a T1 hypointense, T2 hyperintense homogeneously enhancing mass within the left upper arm (►Fig. 1). The mass was mildly lobulated, but well circumscribed, and measured 4.2 cm craniocaudal Â 2.1 cm transverse Â 2.2 cm anteroposterior. It was located between the triceps and coracobrachialis/biceps muscles, just posterior to the neurovascular bundle of the upper extremity. It appeared that the mass was arising exophytically from the ulnar nerve, and it was presumed to be a schwannoma.We elected to remove the mass given the patient's pain. The median, ulnar, and medial antebrachial cutaneous nerves, as well as the brachial artery, were identified during our dissection (►Fig. 2). There was no nerve that was contributing to the mass. A branch of the brachial vein, however, was seen entering the mass at the more cephalad end. This was carefully dissected and appeared to be a neck. At this point, we identified that this mass appeared to be a venous malformation (VM). Thus, the contributing vein was ligated and the VM was removed. Gross examination of a cross-section revealed blood clots. Histology confirmed a VM and demonstrated no nervous tissue (►Fig. 3). DiscussionVenous Malformations, thin-walled vascular dilations of various sizes, are the most common type of vascular malformation. The incidence of VM is estimated to be between 1/10,000 and 1/5,000 and the prevalence is thought to be Keywords ► brachial plexus ► nerve sheath tumor ► peripheral nerve schwannoma ► venous malformation AbstractWe present the case of a venous malformation (VM) masquerading as a schwannoma. VMs are thin-walled vascular dilations of various sizes that typically present as soft, compressible, blue masses that are associated with pain or dysesthesia. VMs are commonly found in the head and neck as well as the distal extremities. Notably, slow-flow VMs are hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging, and enhance markedly with contrast. However, VMs tend to be poorly circumscribed and fraught with venous lakes and phleboliths. Conservative therapy and sclerotherapy are the primary treatment options. In this case report, we present a VM presenting near the neurovascular bundle of the upper extremity axilla. Our case is uniqu...

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Visualization of extensor tendon of little finger: evaluation using ultrasonic probe narrow aperture method

Eto

2019

Jpn J Med Ultrasonics

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Imaging and surgical approach for a schwannoma of the hand

Cited by 4 publications

References 10 publications

Recurrent schwannoma of digital nerve on both hands: A very rare case report

Recurrent schwannoma of digital nerve on both hands: A very rare case report

A Vascular Malformation Presenting as a Peripheral Nerve Sheath Tumor

Visualization of extensor tendon of little finger: evaluation using ultrasonic probe narrow aperture method

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