Karthik K, Aarthi S, Gordon-Dixon Ayeshah
Queen Elizabeth Hospital, London, United Kingdom.
Department of Orthopaedic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
J Knee Surg. 2013 Dec;26 Suppl 1:S30-3. doi: 10.1055/s-0031-1280975. Epub 2011 Jun 21.
Tumors of the peripheral nerve sheath including schwannomas are known for their rarity and can present with neurological deficit. We report an interesting case of schwannoma of the infrapatellar branch of saphenous nerve presenting with anteromedial knee pain and proximal tibial metaphyseal defect. A 26-year-old man presented with pain and swelling (for the past 2 months) in the anteromedial aspect of knee. Investigations revealed scalloping lesion in the anteromedial aspect of proximal tibia with sclerosed margins. Surgical exploration identified an encapsulated tumor lying over the defect in the proximal tibial metaphysis. Histopathological examination confirmed benign schwannoma and the patient became symptom-free after the surgery. Schwannoma of the infrapatellar branch of saphenous nerve can present with anteromedial knee pain. In patients with an eccentrically placed metaphyseal defect of the anteromedial tibia with sclerosed smooth margins, the possibility of nerve sheath tumors should always be considered.
包括神经鞘瘤在内的周围神经鞘肿瘤较为罕见，可伴有神经功能缺损。我们报告了一例有趣的隐神经髌下支神经鞘瘤病例，表现为膝前内侧疼痛和胫骨近端干骺端缺损。一名26岁男性因膝前内侧疼痛和肿胀（持续2个月）就诊。检查发现胫骨近端前内侧有扇贝样病变，边缘硬化。手术探查发现一个包膜完整的肿瘤位于胫骨近端干骺端缺损处。组织病理学检查证实为良性神经鞘瘤，术后患者症状消失。隐神经髌下支神经鞘瘤可表现为膝前内侧疼痛。对于胫骨前内侧干骺端有偏心性缺损且边缘硬化光滑的患者，应始终考虑神经鞘瘤的可能性。
