Schwannomas of the Upper Extremity

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Journal of the Korean Society for Surgery of the Hand 2002;7(1):95-100.
Published online January 1, 2002.

Sang Soo Kim, Dong Chul Kim, Dae Moo Shim, Yun Hong Choi, Young Cheon Na

상지에 발생한 신경초종

김상수, 김동철, 심대무, 최윤홍, 나영천

Abstract

Schwannoma, also referred to as neurilemoma, is an encapsulated benign soft tissue tumor arising from the schwann cells of the nerve sheath and is the most common tumor of peripheral nerves. Solitary schwannoma cause virtually identical symptoms and signs of neurofibroma. So it is very difficult to distinguish between solitary schwannoma and other solitary soft tissue tumors such as neurofibroma or ganglion correctly before surgical excision because there are no clinically distinct pathognomonic features of schwannoma to discriminate from these kinds of soft tissue tumors. The aim of this paper was to review a series of schwannomas in the upper extremity and assess their clinical characteristics, morphological and histological features of schwannomas and complications after excision of mass retrospectively. Twelve patients with schwannoma of the upper extremity who were treated with surgical excision and biopsy of mass at Wonkwang university hospital between 1989 and 2001 were analyzed retrospectively. All patients visited our department for evaluation of palpable soft tissue mass of upper extremity. Four schwannomas were tender and eleven were mobile mass. Neurologic manifestation including Tinel’s sign was observed in seven tumors. All of schwannomas were on flexor surface of the upper extremity. Nine of the schwannomas involved the arm above the elbow joint, one the forearm, two the wrist and the hand. Out of 12 tumors, six of the schwannomas originated from median nerve sheath, two from the ulnar nerve, four from the radial nerve or its division. There was no any neurologic complications and evidence of recurrence of schwannoma after excision in all cases.

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