[A possible cause of misdiagnosis in tumors of the axilla: schwannoma of the brachial plexus].

Università degli Studi di Roma La Sapienza, Facoltà di Medicina e Chirurgia, Italy.
Il Giornale di chirurgia 01/2008; 29(1-2):38-41.
Source: PubMed


The Authors report a rare case of a 57 years old man affected by a left radial nerve schwannoma that occurred as an asymptomatic lesion of the axilla. At clinical examination the lump was undistinguishable from the most common axillary lymphadenopathy. A lymphoadenopathy was erroneously diagnosed with ultrasonography (US). This mistake was due to the low specificity of the instrumental methodology and to the rarity of an asymptomatic schwannoma of the infraclavicular brachial plexus. The neoplasia was excised without using the microscope. In the early post-operative follow up, a "falling" attitude of the wrist, the hand and the fingers appeared, peculiar for a lesion of the radial nerve. Furthermore a hypoaesthesia of the skin of first finger and of the first interosseus space was associated. The sensitive and motor electromyography showed a radial nerve suffering. The "stupor" of the nerve trunk was treated with steroid therapy for 7 days and the patient underwent to some series of neuro-rehabilitative physical therapy for 12 weeks. The postoperative total body CT, showed that the lesion was unique: therefore it was possible to exclude the diagnosis of neurofibromatosis. After 28 months electromyography and axillary US were performed showing the complete resolution of the motor and sensitive deficit and the absence of local recurrence.

Download full-text


Available from: Marcello Picchio, Oct 02, 2015
226 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The radial nerve is a continuation of the posterior cord of the brachial plexus and one of the major nerves that provide motor and sensory innervations to the forearm. MR imaging evaluation of the radial nerve pathology has been described in scattered case reports. Current high-field MR scanners enable high resolution and high contrast imaging of the peripheral nerves. This article reviews the 3 Tesla magnetic resonance neurography imaging of radial nerve anatomy and various pathologies affecting it with relevant case examples.
    Journal of Neuroradiology 07/2011; 38(5):265-74. DOI:10.1016/j.neurad.2011.05.006 · 1.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Schwannomas are benign nerve sheath tumors derived from Schwann cells and are the most common type of peripheral nerve tumor. Schwannomas occur mainly in the extremities, trunk, and head and are rarely manifested in the axilla. Although various solid tumors can develop in the axilla, only a few cases of schwannoma in the axillary cavity have been reported. Herein, we describe the sonographic appearance of a schwannoma arising from the brachial plexus in the axilla. (C) 2011 Wiley Periodicals, Inc. J Clin Ultrasound 39: 477-479, 2011; Published online in Wiley Online Library ( DOI: 10.1002/jcu.20826
    Journal of Clinical Ultrasound 10/2011; 39(8):477-9. DOI:10.1002/jcu.20826 · 0.69 Impact Factor