Plexiform or multinodular schwannoma of posterior tibial nerve: case report with review of literature

Authors

  • Prahalad Kumar Singhi Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India
  • Sivakumar Raju Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India
  • Somashekar V. Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India
  • Bharat Kumar Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India
  • Anil Kumar Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203743

Keywords:

Plexiform, Multinodular, Schwannoma, Posterior tibial nerve

Abstract

A schwannoma is a benign tumor that develops from the Schwann cells, which assists conduction of nerve impulses and located in the nerve sheath of peripheral or cranial nerves. Plexiform or multinodular Schwannoma of posterior tibial nerve is a rare presentation, can cause diagnostic dilemma with Lumbosacral radiculopathy, Tarsal tunnel syndrome, Entrapment neuropathy or Chronic regional pain syndrome. Unexplained leg pain, a positive Tinel's sign with or without a palpable swelling and Magnetic Resonance Imaging will clinch the diagnosis after excluding other causes. In symptomatic cases with long standing complaints, surgical resection yields satisfactory outcome. We present an interesting case of plexiform schawannoma along posterior tibial nerve with review of literature.

Author Biographies

Prahalad Kumar Singhi, Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India

Orthopaedics

Sivakumar Raju, Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India

Orthopaedics

Somashekar V., Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamilnadu, India

Orthopaedics

References

Birch R, Bonney G, Wynn Parry CB. The peripheral nervous system and neoplastic disease. In: Surgical disorders of peripheral nerves. Edinburgh: Churchill Livingstone;1998:335-52.

Kim DH, Murovich JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102:246-55.

Nawabi D, Sinisi M. Schwannoma of the posterior tibial nerve: the problem of delay in diagnosis. J Bone Joint Surg Br. 2007;89(6):814-6.

Albert, P., Patel, J., Badawy, K., Weissinger, W., Brenner, M., Bourhill, I., et al. Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings. The Journal of Foot and Ankle Surgery. 2017;56(3), 632-7.

Knight DM, Birch R, Pringle J. Benign solitary schwannomas: a review of 234 cases. J Bone Joint Surg Br. 2007;89:382-7.

Kransdorf M. Benign soft-tissue tumors in a large referral population: Distribution of specific diagnosis by age, sex and location. AJR Am J Roentgenol. 1995;164:395-402.

White NB. Neurilemomas of the extremities J Bone Joint Surg. 1967;49A:1605-10.

Beaman FD, Kransdorf MJ, Menke DM. Schwa-nnoma: radiologic-pathologic correlation. Radio-graphics. 2004;24:1477-81.

Mott RC, Dellon AL. Multiple schwannomas of the foot: case report and strategy for treatment. J Am Podiatr Med Assoc. 2003;93:51-7.

Smith W, Amis J. Neurilemmona of the tibial nerve: a case report. J Bone Joint Surg[Am].1992;74-A: 44 3-4.

Ghaly R. A posterior tibial nerve neurilemmoma unrecognized for 10 years:case report. Neurosurgery. 2001;48:668-72.

Fine SW, McClain SA, Li M: Immunohistochemistry staining for calretinin is useful for differentiating schwannomas from neurofibromas. Am J Clin Pathol. 2004;122:552-9.

Park JY, Park H, Park NJ. Use of calretinin, CD56, and CD34 for differential diagnosis of schwannoma and neurofibroma. The Korean Journal of Pathology. 2011;45:30-5.

Downloads

Published

2020-08-26