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Schwannoma of the Ulnar Nerve in the Elbow: A Case Report

  • Kim, Doo-Sup (Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University) ;
  • Rah, Jung-Ho (Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University) ;
  • Chung, Hoe-Jeong (Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University) ;
  • Shin, John Junghun (Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University) ;
  • Hong, Kyung-Jin (Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University)
  • Received : 2013.11.18
  • Accepted : 2014.06.15
  • Published : 2014.12.30

Abstract

Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its $2{\times}2{\times}3cm$ capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.

Keywords

References

  1. Holdsworth BJ. Nerve tumours in the upper limb. A clinical review. J Hand Surg Br. 1985;10(2):236-8. https://doi.org/10.1016/0266-7681(85)90026-9
  2. Perrotta R, Virzi D, Tarico MS, Napoli P. An unusual case of symptomatic Schwannoma on the elbow. Br J Neurosurg. 2011;25(2):306-7. https://doi.org/10.3109/02688697.2010.508845
  3. Tang CY, Fung B, Fok M, Zhu J. Schwannoma in the upper limbs. Biomed Res Int. 2013;2013:167196.
  4. White NB. Neurilemomas of the extremities. J Bone Joint Surg Am. 1967;49(8):1605-10. https://doi.org/10.2106/00004623-196749080-00013
  5. Kececi Y, Gurler T, Gundogan H, Bilkay U, Cagdas A. Benign giant schwannoma located in the upper arm. Ann Plast Surg. 1997;39(1):100-2. https://doi.org/10.1097/00000637-199707000-00019
  6. Kang HJ, Shin SJ, Kang ES. Schwannomas of the upper extremity. J Hand Surg Br. 2000;25(6):604-7. https://doi.org/10.1054/jhsb.2000.0472
  7. Hoglund M. Ultrasound diagnosis of soft-tissue tumours in the hand and forearm. A prospective study. Acta Radiol. 1997;38(4 Pt 1):508-13.
  8. Fornage BD. Peripheral nerves of the extremities: imaging with US. Radiology. 1988;167(1):179-82. https://doi.org/10.1148/radiology.167.1.3279453
  9. Hems TE, Burge PD, Wilson DJ. The role of magnetic resonance imaging in the management of peripheral nerve tumours. J Hand Surg Br. 1997;22(1):57-60.
  10. Donner TR, Voorhies RM, Kline DG. Neural sheath tumors of major nerves. J Neurosurg. 1994;81(3):362-73. https://doi.org/10.3171/jns.1994.81.3.0362