Median nerve schwannoma

Case contributed by Pavan Borra
Diagnosis almost certain

Presentation

Painful swelling with numbness at forearm for 4 months.

Patient Data

Age: 35 years
Gender: Male
mri

An oval T1 isointense, T2 iso-hyperintense and PD SPAIR hyperintense lesion noted at flexor aspect of the forearm along the course of median nerve proximal to carpal tunnel. The lesion is well defined with a T2 hypointense capsule. No surrounding invasion noted.

Case Discussion

Differential diagnosis of the mass includes schwannoma, neurofibroma, ganglion cyst, malignant tumor, lipoma and xanthoma.

Histopathological examination showed spindle-shaped Schwann cells confirmatory of Schwannoma.

Schwannomas are the most common benign tumors of the neural sheaths of the peripheral nerves. Pain is the most common complaint of schwannomas. Multiple schwannomas may be seen in neurofibromatosis type 1. It is difficult to differentiate schwannoma and neurofibroma on radiological imaging. 

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