Pérez-Sáncheza I*, Ausina-Gómeza S, Izquierdo-Plazasa L and Cerrolaza-Uristoa N
Department of Orthopedic Surgery, Musculoskeletal Tumor Unit, University Hospital of Saint John of Alicante, SpainFulltext PDF
Schwannoma is the most common peripheral nerve sheath tumor. However, its localization in the foot is rare, affecting primarily the posterior tibial nerve. Although it usually occurs as a solitary idiopathic lesion, detection of multiple schwannomas has been described and requires a diagnostic study to rule out neurofibromatosis, given the association between these two entities. We describe the case of a 44-year-old man with multiple schwannomas located along the posterior tibial nerve with no other associated manifestations, presenting as a painful mass, located at the retromalleolar level and with associated hypoesthesia and dysesthesia. Surgical excision was performed, resecting a total of 18 lesions and preserving the complete integrity of the nerve. Histopathological study of the tumors confirmed the diagnosis of schwannoma. Eight months after the operation, the patient was asymptomatic and had no associated major sequela. Although it is not a very common lesion, schwannoma should always be considered in the differential diagnosis of a soft-tissue mass affecting extremities. Surgical enucleation and decompression of the affected nerve are the recommended treatments in this type of tumor, particularly when neurogenic pain is present. This excision must be precise, as preservation of the adjacent nerve fascicles is key to avoid further neurological complications.
Schwannoma; Posterior tibial nerve; Peripheral nerve sheath tumor; Neurofibromatosis; Schwannomatosis; Soft-tissue tumors
Pérez-Sáncheza I, Ausina-Gómeza S, Izquierdo-Plazasa L, Cerrolaza-Uristoa N. Multiple Schwannomas of the Posterior Tibial Nerve: Report of a Rare Case of Schwannomatosis. Ann Surg Case Rep. 2023; 6(1): 1067..