Di Sante L, Camerota F, Celletti C, Ioppolo F, Santilli V, David E
Physical Medicine and Rehabilitation Division, Umberto I Hospital, "Sapienza" University of Rome, Italy.
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy - Department of Radiology, Oncology and Anatomo-Pathology, "Sapienza" University, Rome, Italy.
Clin Ter. 2015 Nov-Dec;166(6):e381-3. doi: 10.7417/T.2015.1904.
Neurothekeoma is a very rare benign connective tissue tumour that presumably derived from nerve sheath cells. We described the case of a rare localization of neurothekeoma in the upper limb with a strange presentation. A 49 years-old woman presented to the Physical Medicine and Rehabilitation Division of the Umberto I Hospital referring an intensive pain associated to paresthesias at the left forearm lasting from six months. The patient had a history of epicondylitis confirmed with an elbow RMN showing an increased thickness of the tendon insertions on the epicondiloidea region of the elbow. Rehabilitative and physical therapy has been done without symptoms remission. An ultrasound evaluation showed an oval formation well circumscribed in the context of the radial nerve. It was easy to demonstrate the relevance of the radial nerve, following it from the arch of Frohse until the humeral sulcus of the radial nerve. A MRI that showed a mass, mildly hypointense on T1- weighted sequences and hyperintense on T2-weighted images, with nonhomogeneous enhancement post-contrast, attributable to expansionary pathology of the radial nerve. A biopsy was done and the lesion was described as a benign tumor of nerve sheath, i.e., a Neurothekeoma of the radial nerve. Patients was surgically treated, the tumor has been removed and she referred the resolution of symptomatology.
神经鞘黏液瘤是一种非常罕见的良性结缔组织肿瘤,可能起源于神经鞘细胞。我们描述了一例上肢神经鞘黏液瘤罕见定位且表现奇特的病例。一名49岁女性到翁贝托一世医院物理医学与康复科就诊,自述左前臂持续6个月的剧烈疼痛并伴有感觉异常。患者有肱骨外上髁炎病史,肘部磁共振成像(RMN)证实肘部肱骨外上髁区域肌腱附着处增厚。进行了康复和物理治疗,但症状未缓解。超声评估显示在桡神经周围有一个边界清晰的椭圆形结构。很容易追踪桡神经,从弗罗瑟弓一直到桡神经沟。磁共振成像(MRI)显示有一个肿块,在T1加权序列上轻度低信号,在T2加权图像上高信号,增强后不均匀强化,归因于桡神经的扩张性病变。进行了活检,病变被描述为神经鞘良性肿瘤,即桡神经神经鞘黏液瘤。患者接受了手术治疗,肿瘤被切除,她的症状得到缓解。