Yan Jiabao, Zhou Ruijun, Liu Bingxin, Xu Yisheng, Cao Xuewei
College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610036, China.
The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
Heliyon. 2023 Jul 6;9(7):e18020. doi: 10.1016/j.heliyon.2023.e18020. eCollection 2023 Jul.
Schwannomas grow slowly, mainly in the head and spine. The extremities schwannomas are rare and easily missed, particularly in patients who also have lumbar disc herniation in addition to sciatic schwannomas. We present a unique case of sciatic schwannoma , which has been considered as a lumbar disease in the past until an MRI of the thigh.
A 43-year-old female complained of pain in her low back and left thigh for 10 years. Physical examination showed that her left thigh was swollen and positive Tinel sign. On MRI, we found a series of tumors suspected of schwannomas at the back of her left thigh. After obtaining the patient's consent, we performed intracapsular excision of her tumors. Histological examination of the tumors were consistent with plexiform schwannomas. The patient recovered well after operation and there was no sign of nerve injury or recurrence after follow-up for 11 months. We searched the Pubmed database and found 31 published reports about sciatic schwannomas.
Sciatic schwannomas usually occur in middle-aged women, and the main symptom is pain. In addition to palpation, we should pay attention to Tinel sign during physical examination. MRI is very helpful for diagnosis, but histological examination is the only way to make a final diagnosis. Intracapsular resection is the best method for the treatment of schwannomas, although there is still the possibility of recurrence after operation.
神经鞘瘤生长缓慢，主要发生于头部和脊柱。四肢神经鞘瘤较为罕见，容易被漏诊，尤其是那些除坐骨神经鞘瘤外还患有腰椎间盘突出症的患者。我们报告一例独特的坐骨神经鞘瘤病例，在进行大腿部磁共振成像（MRI）检查之前，该病例一直被误诊为腰椎疾病。
一名43岁女性，主诉下背部和左大腿疼痛10年。体格检查发现其左大腿肿胀，Tinel征阳性。MRI检查发现左大腿后部有一系列疑似神经鞘瘤的肿瘤。在征得患者同意后，我们对其肿瘤进行了囊内切除。肿瘤组织学检查结果与丛状神经鞘瘤相符。患者术后恢复良好，随访11个月未见神经损伤或复发迹象。我们检索了PubMed数据库，发现31篇关于坐骨神经鞘瘤的已发表报告。
坐骨神经鞘瘤通常发生于中年女性，主要症状为疼痛。体格检查时，除触诊外，还应注意Tinel征。MRI对诊断非常有帮助，但组织学检查是最终确诊的唯一方法。囊内切除是治疗神经鞘瘤的最佳方法，尽管术后仍有复发的可能。
