Lee Byung Chan, Kim Hyun Jin, Choi Yoon La, Jeon Byung Joon, Sung Duk Hyun
Department of Physical and Rehabilitation Medicine.
Department of Pathology and Translational genomics.
Medicine (Baltimore). 2020 May 29;99(22):e20196. doi: 10.1097/MD.0000000000020196.
Leiomyoma of peripheral nerve is a rare condition characterized by neuropathy of affected nerve. We herein report a rare presentation of leiomyoma of radial nerve which presented with wrist drop.
A 37-year-old man visited our clinic with a history of sudden onset weakness of the wrist dorsiflexion/finger extension of the right side.
T2-weighted with fat saturation image of MRI demonstrated a well-defined, intra-neural, round mass of about 0.8 cm × 0.5 cm within the radial nerve. Excision of mass established the pathological diagnosis of intra-neural leiomyoma.
The patient underwent excision of mass and attached nerve tissue, followed his medial antebrachial nerve graft for repair of the defected radial nerve.
As of the 1-year follow-up, no symptoms of recurrence have been observed. Also, the strength of wrist dorsiflexion improved to grade 4/5 CONCLUSION:: This rare case demonstrates the importance of MR imaging to differentiate intra-neural leiomyomas from other benign peripheral nerve sheath tumors. Surgical treatment plays an important role in the treatment of patient with intraneural leiomyoma with neurologic deficits.
周围神经平滑肌瘤是一种罕见疾病，其特征为受累神经出现神经病变。我们在此报告一例罕见的桡神经平滑肌瘤，表现为垂腕。
一名37岁男性因右侧腕背伸/手指伸展突然无力前来我院就诊。
MRI的T2加权脂肪抑制像显示桡神经内有一个边界清晰的、神经内圆形肿块，大小约为0.8厘米×0.5厘米。肿块切除后病理诊断为神经内平滑肌瘤。
患者接受了肿块及相连神经组织的切除，随后进行了前臂内侧神经移植以修复受损的桡神经。
截至1年随访，未观察到复发症状。此外，腕背伸力量改善至4/5级。结论：该罕见病例表明MRI对于鉴别神经内平滑肌瘤与其他良性周围神经鞘瘤的重要性。手术治疗在治疗伴有神经功能缺损的神经内平滑肌瘤患者中起着重要作用。
