Recurrent schwannoma of digital nerve on both hands: A very rare case report.

INTRODUCTION AND IMPORTANCE

Schwannoma is the most common benign tumor of peripheral nerves and usually occurs solitary with a very low risk of recurrence. Schwannoma of the hand, particularly involving the digital nerve, is sporadic and most commonly leads to a misdiagnosis due to its rarity. Histopathology remains the gold standard diagnostic, however, with a thorough physical examination and radiologic imaging, this benign tumor can be managed well with the preservation of nerve function.

CASE PRESENTATION

We reported a rare case of digital nerve schwannomas on the bilateral hands of a 52-year-old white male with one recurrent mass on the right hand despite a previously complete debulking of the mass.

CLINICAL DISCUSSION

Intraoperatively, we removed lobulated whitish-yellow masses and left the nerve origin of the tumor intact (common palmar digital nerve and ulnar-side digital nerve). The histopathology supported the diagnosis of schwannoma. At the one-year follow-up, there is no recurrence and the patient remains asymptomatic.

CONCLUSION

Determining differential diagnosis by both clinical and preoperative imaging is essential, especially in the case of recurrence and multiple tumorous lesions. Malignancy or malignant degeneration should still be kept in mind. Complete removal is needed to prevent recurrence followed by a long-term follow-up.