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DOI: 10.1055/s-0044-1796657
Brachial Plexus Schwannoma: Case Report and Literature Review
Schwannoma do Plexo Braquial: Relato de Caso e revisão da literatura
Abstract
Schwannomas are mostly benign and solitary tumors that originate from Schwann cells. Macroscopically, they appear as rounded masses with a smooth surface. Schwannomas rarely affect the brachial plexus, accounting for approximately 5% of all cases of schwannomas, presenting a challenge for surgeons. The objective of this article is to describe a case report of a brachial plexus schwannoma in a hospital located in the Northeast of Brazil. A 49-year-old male patient presented pain resulting from the appearance of a left anterior cervical bulging with progressive growth. On physical examination, he had a Medical Research Council (MRC) score of 3 in left arm abduction and paresthesia in the left lateral forearm and arm. On magnetic resonance imaging (MRI), the lesion arises from the C4-C5 junction, measuring 5.9 × 5.4 × 5.5 cm, and the electroneuromyography showed chronic pre-ganglionic involvement of C5 to C7 bilaterally. A left cervicotomy was performed with a horizontal incision at the level of the laryngeal eminence. Brachial plexus lesions with progressive growth tend to be managed surgically. This diagnosis hypothesis should be considered in patients presenting progressive neck bulging in inspection during physical examination. This is an easy and cheap method of suspicion that can be used by health professionals.
Resumo
Os schwanomas são, em sua maioria, tumores benignos e solitários originados das células de Schwann. Macroscopicamente, aparecem como massas arredondadas com superfície lisa. Os schwannomas raramente afetam o plexo braquial, sendo responsáveis por aproximadamente 5% de todos os casos de schwanomas, representando um desafio para os cirurgiões. O objetivo deste artigo é descrever um relato de caso de schwanoma do plexo braquial em um hospital localizado no Nordeste do Brasil. Paciente do sexo masculino, 49 anos, apresentava dor decorrente do aparecimento de abaulamento cervical anterior esquerdo com crescimento progressivo. Ao exame físico, apresentava pontuação 3 do Medical Research Council (MRC) na abdução do braço esquerdo e parestesia na lateral do antebraço e braço esquerdo. Na ressonância magnética (RM), a lesão surge da junção C4-C5, medindo 5,9 × 5,4 × 5,5 cm e a eletroneuromiografia mostrou envolvimento pré-ganglionar crônico de C5 a C7 bilateralmente. Foi realizada cervicotomia esquerda com incisão horizontal ao nível da eminência laríngea. Lesões do plexo braquial com crescimento progressivo tendem a ser tratadas cirurgicamente. Essa hipótese diagnóstica deve ser considerada em pacientes que apresentam abaulamento progressivo do pescoço na inspeção durante o exame físico. Este é um método de suspeita fácil e barato que pode ser utilizado por profissionais de saúde.
Publication History
Received: 01 June 2024
Accepted: 18 October 2024
Article published online:
11 December 2024
© 2024. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Hamdaoui J, Elkamch H, Gharib N, El Mazouz S, Abbassi A, Hafidi J. Schwannoma of the radial nerve: a case report. Pan Afr Med J 2022; 43: 139
- 2 Go MH, Kim SH, Cho KH. Brachial plexus tumors in a consecutive series of twenty one patients. J Korean Neurosurg Soc 2012; 52 (02) 138-143
- 3 Dosemane D, Kabekkodu S, Jaipuria B, Sreedharan S, Shenoy V. Extracranial non-vestibular head and neck schwannomas: a case series with the review of literature. Braz J Otorhinolaryngol 2022; 88 (Suppl 4) S9-S17
- 4 Tang CY, Fung B, Fok M, Zhu J. Schwannoma in the upper limbs. BioMed Res Int 2013; 2013: 167196
- 5 Sandoval-Macias R, Ortiz-Sanchez ID, Remirez-Castellanos AL. et al. Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas. BMC Res Notes 2021; 14 (01) 278 . Published 2021 Jul 21.
- 6 Lusk MD, Kline DG, Garcia CA. Tumors of the brachial plexus. Neurosurgery 1987; 21 (04) 439-453
- 7 Kumar A, Akhtar S. Schwannoma of brachial plexus. Indian J Surg 2011; 73 (01) 80-81
- 8 Kohyama S, Hara Y, Nishiura Y, Hara T, Nakagawa T, Ochiai N. A giant plexiform schwannoma of the brachial plexus: case report. J Brachial Plex Peripher Nerve Inj 2011; 6 (01) 9
- 9 Lee HJ, Kim JH, Rhee SH, Gong HS, Baek GH. Is surgery for brachial plexus schwannomas safe and effective?. Clin Orthop Relat Res 2014; 472 (06) 1893-1898
- 10 Rashid M, Salahuddin O, Yousaf S, Qazi UA, Yousaf K. Schwannoma of the brachial plexus; report of two cases involving the C7 root. J Brachial Plex Peripher Nerve Inj 2013; 8 (01) 12