Peripheral nerve sheath tumor - median nerve

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Right anterior elbow nodule - about 10 years.

Patient Data

Age: 50 years
Gender: Male

The clinically palpable lump is a well-defined lesion (21 x 19 x 15 mm). The median nerve enters and exits the lesion. The lesion displaces a few fascicles of the nerve. The lesion is hypoechoic with few tiny cystic spaces without calcification/ vascularity. There was no median nerve abnormality proximal or distal to the lesion. The brachial artery, distal biceps tendon, brachialis, and pronator teres are normal.

Case Discussion

The patient presented with a long history of anterior elbow nodule without local pain or distal sensory-motor symptoms. The ultrasound shows the lesion originating from the median nerve favoring the peripheral nerve sheath tumor. Eccentric lesion location raises a possibility of schwannoma.

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