Schwannoma of brachial plexus

Case contributed by Dr Domagoj Kretic

Presentation

Presented as a lump in elderly woman, situated in her 3rd neck region on the right side.

Patient Data

Age: 65 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

MRI

mri

T1WI and T2WI transversal, together with T2 TIRM sequence are showing high signal lesion connected to brachial plexus, its C4-C5 root.

Ultrasound and Color Doppler

ultrasound

Hypoechogenic node, with dimension of 1.8 x 2 cm, situated in 3rd neck region on the right side. The lesion demonstrated vascularity on color Doppler. 

Node is fairly vascularized.

Case Discussion

Ultrasound and Color Doppler was performed and the conclusion was enlarged lymph node or other differentials. After FNAC cytologist made a diagnosis of neurilemmoma or schwannoma of peripheral nerve. 

MRI was performed with result of 1.8 x 2 cm large node adjacent to C4/C5 root of brachial plexus, with slight increase in signal on T1WI, compared to other neural tissue. TIRM coronal scans show very high signal lesion. After surgery histopathology confirmed FNAC diagnosis : Neurilemmoma or Schwannoma of Brachial plexus.

Surgery was performed, with removing lesion and saving most of brachial plexus. However some disability or inability to do certain moves with right hand, together with MMS weakened.

Interesting fact: Patient felt paresthesia during FNAC.

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