Sciatic Nerve Schwannoma: A Case Report

Mansukhani, Sameer Ajit; Butala, Rajendraprasad; Shetty, Sunil; Khedekar, Ravindra G.

doi:10.1177/230949901502300232

Cited by 13 publications

(7 citation statements)

References 7 publications

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“…The radicular type of leg pain is typically attributed to a degenerative spinal pathology, hence even in the presence of typical pain, diagnosing a schwannoma is often delayed. Therefore, a whole limb imaging study, preferably an MRI scan recommended for patients, who are having the characteristic symptoms of neural pathology while the preliminary investigation findings rule out any degenerative spinal pathology (5,6). Nevertheless, in our case, the benign peripheral nerve sheath tumour (PNST) was incidentally diagnosed during a vascular doppler study.…”

Section: Discussionmentioning

confidence: 80%

Common peroneal nerve schwannoma, a rare cause of sciatica - Case report & review of literature

Kodikara

Gamage²

2020

Sri Lanka Anat. Jnl

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Section: Discussionmentioning

confidence: 80%

Common peroneal nerve schwannoma, a rare cause of sciatica - Case report & review of literature

Kodikara

Gamage²

2020

Sri Lanka Anat. Jnl

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“…It often induces symptoms of radicular pain, and sensory or motor disturbances [12]. When involving the sciatic nerve, it can be asymptomatic or may present with sciatica or neurological deficits [13].…”

Section: Discussionmentioning

confidence: 99%

Long Completely Cystic Sciatic Schwannoma: A Rare Case

et al. 2021

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Schwannomas are the most common peripheral nerve sheath tumors. Benign schwannomas with malignant transformation are rarely reported. Most common schwannomas occur in the head and neck region. Sciatic schwannomas are rare, as are completely cystic schwannomas. Sciatic nerve schwannomas represent less than 1% of all schwannomas. Benign tumors in the sciatic nerve consist of 60% neurofibromas and 38% schwannomas. In general, a schwannoma induces chronic symptoms. It can be misleading, sometimes mimicking degenerative spinal pathology due to disc herniation. Schwannoma involving the sciatic nerve can be asymptomatic or may present with sciatica or neurological deficits. Most schwannomas are solid or heterogeneous tumors, and completely cystic schwannomas are rare. The differential diagnoses of nondiscogenic sciatica include lumbar disc herniation, tumor, abscess, hematoma, facet syndrome, lumbar instability, sacroiliitis, piriformis syndrome, and sciatic neuritis. We report a rare case of a long completely cystic sciatic schwannoma in the left foraminal L5–S1 zone extending to the left ischial groove with chronic sciatica that was diagnosed radiologically with a combination of conventional MRI and MR neurography and confirmed histopathologically by surgical resection. The patient previously had conservative therapy, but the complaints were not reduced. Nonsurgical therapy is considered the first choice, and surgical therapy is indicated in cases that do not respond to conservative therapy, with recurrent cysts, severe pain, or neurological deficits.

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“…On rare occasions, a sciatic nerve tumour can also cause similar clinical manifestations. Filler et al reported that among patients with sciatica of non-disc origin, the incidence rate of pain caused by sciatic nerve tumours was 1.7% [ 16 , 17 ]. As previously reported in the literature [ 4 – 6 , 10 , 11 ], the reason for misdiagnosis as LDH is the lack of mastering of the exact physical examination method and an overdependence on the radiological examination.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic pitfalls of lumbar disc herniation---- malignant sciatic nerve tumour: two case reports and literature review

Zhao

Wei

Wan

et al. 2021

BMC Musculoskelet Disord

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Background Sciatica pain is a typical symptom of lumbar disc herniation (LDH), but some neurogenic and malignant tumours surrounding the sciatic nerve can also cause similar symptoms. These tumours are often misdiagnosed or even mistreated as LDH in clinical practice. Case presentation In our clinical practice, we found two patients with malignant tumours who were misdiagnosed with LDH. One patient complained of pain and numbness in the right lower limb. The primary diagnosis was LDH, and the patient underwent posterior lumbar interbody fusion surgery. After the operation, the symptoms were not alleviated. Then, diffuse large B-cell lymphoma involving the soft tissue and the sciatic nerve was identified. Another patient who manifested with radiating pain in the right lower limb was diagnosed with LDH at Chengde Central Hospital. He received regular conservative treatment for approximately 6 months, but his symptoms were not relieved, and then he was referred to our hospital. A malignant peripheral nerve sheath tumour (MPNST) of the sciatic nerve was diagnosed, and he received cisplatin (DDP) chemohyperthermia. Conclusions Descriptions of tumour lesions involving the sciatic nerve and misdiagnosed as LDH in the literature are rare. In the reported literature, 7 patients were misdiagnosed with LDH, and all patients presented with sciatica. Among them, 4 patients only received surgical treatment, 1 patient only underwent neurolysis, and 2 patients received both surgical and chemotherapy treatment. Their low incidence and similar clinical manifestations to LDH make malignant tumours involving the sciatic nerve easy to misdiagnose. When the clinical symptoms and signs are inconsistent with the imaging findings, we need to be aware of non-discogenic sciatica, including tumours involving the sciatic nerve. Furthermore, tumours that grow near the exit of the sciatic notch may be misdiagnosed because of their deeper location and because they are covered with gluteal muscles. Sometimes sciatica caused by sciatic nerve tumours is only distal, without any radicular distribution. This pain is more severe than that caused by LDH, and this pain is not related to the position of the lumbar spine. Thus, it is beneficial to perform a detailed physical examination of the sciatic nerve to avoid this kind of misdiagnosis.

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Sciatic Nerve Schwannoma: A Case Report

Cited by 13 publications

References 7 publications

Common peroneal nerve schwannoma, a rare cause of sciatica - Case report & review of literature

Common peroneal nerve schwannoma, a rare cause of sciatica - Case report & review of literature

Long Completely Cystic Sciatic Schwannoma: A Rare Case

The diagnostic pitfalls of lumbar disc herniation---- malignant sciatic nerve tumour: two case reports and literature review

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