Blanchard C, Dam-Hieu P, Zagnoli F, Bellard S
Service de neurologie, hôpital d'instruction des armées Clermont-Tonnerre, rue du Colonel-Fontferrier, 29240 Brest Naval, France.
Rev Med Interne. 2008 Sep;29(9):748-50. doi: 10.1016/j.revmed.2008.01.008. Epub 2008 Mar 5.
Schwannomas are tumors with slowly progressive symptoms, more often painful than associated with neurologic deficits. Involvement of the sciatic nerve mimics chronic sciatic pain due to a herniated disk. If there is no lumbar pain and lumbar MRI is normal, the sciatic nerve must be clinically and radiologically examined all along its course. We report a patient with chronic sciatica in whom physical examination revealed a painful mass with a Tinel sign in her back thigh. MRI showed a multilobular mass along the sciatic nerve. Surgery of this plexiform schwannoma allowed a complete relief from pain.
施万细胞瘤是一种症状缓慢进展的肿瘤，疼痛症状比神经功能缺损更为常见。坐骨神经受累类似于因椎间盘突出引起的慢性坐骨神经痛。如果没有腰痛且腰椎磁共振成像（MRI）正常，则必须对坐骨神经全程进行临床和影像学检查。我们报告了一名患有慢性坐骨神经痛的患者，体格检查发现其大腿后部有一个伴有Tinel征的疼痛性肿块。MRI显示沿坐骨神经有一个多叶状肿块。对该丛状施万细胞瘤进行手术可使疼痛完全缓解。
