Al Lahham Salim, Aljassem Ghanem, Omari Rand Y, Alyazji Zaki, Sada Ruba, Asnaf Ayman, Abuelgasim Mutaz
Plastic and Reconstructive Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Hand Reconstruction and Microsurgery, Ganga Hospital, Ganga, India.
Plast Reconstr Surg Glob Open. 2022 May 23;10(5):e4341. doi: 10.1097/GOX.0000000000004341. eCollection 2022 May.
Nerve sheath tumors comprise 5% of soft tissue masses of the upper limb in adults. Neurofibromas are divided into three types: localized, diffuse, and plexi- form. The diffuse type is rare and is typically found in the head and neck region. We present a rare case of diffuse type neurofibroma found in the forearm, presented to our clinic as a slowly enlarging mass of the left forearm of 3 years duration. The lesion was suspicious in the magnetic resonance imaging, and biopsy revealed diffuse type neurofibroma. We opted for total excision of the lesion that was found to be not possible due to involvement of the major nerves. The final pathology report showed no malignancy. Nerve tumors of the upper limb can be either benign or malignant. Neurofibroma associated with neurofibromatosis has malignant potential. The diffuse type is rare, and it most commonly occurs in the head and neck region. It has a low malignant transformation rate. Magnetic resonance imaging is the diagnostic modality of choice; however, it can be inconclusive. Biopsy should be taken to confirm the diagnosis and plan for management. Our case was managed by near total excision in order to preserve the major forearm nerves because of high clinical suspicion.
神经鞘瘤占成人上肢软组织肿块的5%。神经纤维瘤分为三种类型:局限性、弥漫性和丛状。弥漫型罕见,通常见于头颈部区域。我们报告一例罕见的发生于前臂的弥漫型神经纤维瘤,该患者因左前臂缓慢增大的肿块3年就诊于我院。磁共振成像检查该病变可疑,活检显示为弥漫型神经纤维瘤。我们选择对该病变进行完整切除,但因主要神经受累而未能成功。最终病理报告显示无恶性病变。上肢神经肿瘤可为良性或恶性。与神经纤维瘤病相关的神经纤维瘤有恶变潜能。弥漫型罕见,最常见于头颈部区域。其恶变率低。磁共振成像是首选的诊断方法;然而,其结果可能不明确。应进行活检以确诊并制定治疗方案。由于高度怀疑,我们的病例采用了近全切除以保留前臂主要神经的方法进行治疗。