2026, Number 2
Radial nerve schwannoma
Full text
10.35366/122621
Language: English/Spanish [Versión en español]
References: 5
Page: 150-152
PDF size: 764.78 Kb.
ABSTRACT
Introduction: Schwannomas are benign nerve sheath tumors that are rare in the radial nerve. Case report: a 62-year-old man presented with a mass in the distal right radius with a 5-year history of progression and associated paresthesias. Ultrasound revealed a well-defined, heterogeneous, and vascularized lesion. Surgical resection was performed without complications, and histopathology confirmed a schwannoma. Conclusion: due to its slow growth and encapsulated nature, the ideal treatment is complete excision. This case highlights the importance of early diagnosis and appropriate surgical management to prevent neurological sequelae.INTRODUCTION
Schwannomas are benign tumors originating from the nerve sheath of peripheral nerves. They represent 15% of all soft tissue tumors,1 being the most common among peripheral nerve tumors,2 with an incidence of 2–5%.1,3-5 Their localization in the radial nerve is uncommon, accounting for only 7% of schwannoma cases.3,4 Diagnosis is based on clinical evaluation and radiological studies such as ultrasound and non-contrast magnetic resonance imaging.1-5
CASE PRESENTATION
A 62-year-old previously healthy male presented with a tumor in the distal radius region of the right upper extremity of five years' duration; he reported paresthesias and hypoalgesia in the thumb. On physical examination, a well-defined tumor in the anterolateral region of the distal radius was observed, measuring approximately 6 cm in length by 4 cm in width, with a solid consistency (Figure 1).
A wrist ultrasound was requested, which revealed a solid lesion on the radial aspect of the right wrist, with well-defined borders, a heterogeneous appearance, and vascular supply provided by feeding branches of the radial artery and vein, without evidence of intra-articular extension.
Surgical resection of the tumor was performed (Figure 2); via histopathology, a schwannoma was diagnosed (Figure 3).
Eight weeks after surgery, the patient presented complete neurological recovery.
SURGICAL TECHNIQUE
An 8 cm longitudinal approach was performed on the anterior aspect of the distal third of the forearm. Dissection was carried out by layers, isolating the radial artery and the sensory branch of the radial nerve. The tumor was exposed, presenting well-defined borders and showing no intra-articular extension. Careful resection was carried out, dissecting the lesion from the adjacent muscle and tendon layers. En bloc excision was performed, ensuring complete removal with no macroscopic remnants; the surgical specimen was sent for histopathological analysis. Finally, the surgical bed was checked, and layered closure was performed.
DISCUSSION
Schwannomas or neurilemomas are benign, encapsulated, slow-growing tumors originating from Schwann cells. They are the most common among peripheral nerve tumors, presenting as single lesions in 90–95% of cases; the remainder are multiple.2,5 They represent 5% of upper limb tumors, of which only 7% affect the radial nerve,3,4 making this case remarkable. No race or sex predominance has been identified.4
Diagnosis is clinical and via imaging. The presentation includes pain, paresthesias, and Tinel's sign in up to 68% of patients. Due to their slow growth, they rarely cause motor deficits, allowing for progressive nerve adaptation.2-5 The imaging studies used are ultrasound and magnetic resonance imaging.1-5
When a schwannoma is suspected, the treatment of choice is surgical resection, given its eccentric and non-infiltrating growth. The diagnosis is subsequently confirmed via histopathological study.1-5
CONCLUSIONS
Radial nerve schwannoma, although rare, should be considered in the differential diagnosis of upper limb tumors, as its early identification and timely surgical resection allow for effective management and the prevention of neurological sequelae.
REFERENCES
AFFILIATIONS
1 Facultad de Medicina. Universidad Nacional Autónoma de México. Ciudad de México, México.
2 Médico General.
3 Hospital Angeles Lomas. Jesús del Monte, Estado de México, México.
4 Departamento de Ortopedia y Traumatología.
5 Estudiante de Medicina.
6 Anestesiología.
ORCID:
7 0009-0000-6419-4033
8 0000-0003-1178-1319
9 0009-0005-9094-6768
10 0009-0008-5016-2194
11 0000-0002-5429-066X
12 0009-0007-5895-7621
13 0009-0007-5386-1217
If you wish to consult the supplementary data for this article, please contact editorial.actamedica@saludangeles.mx
CORRESPONDENCE
Gabriel Fraind Maya. Correo electrónico: fraind29@gmail.comReceived: 2025-02-25. Accepted: 2025-05-28.