Published: 2020-07-23

Benign peripheral nerve sheath tumor-varied clinical presentation

Saravana Kumar, Divya Kumar


Peripheral nerve sheath tumors (PNST) are a group of heterogeneous, often benign and a rare condition that originates from the neuroectodermal or neural crest and display features that mirror the elements of the nerve. Schwannomas are one such peripheral nerve sheath tumors which entirely are made up of benign neoplastic Schwann cells. The objective of this case report is to highlight the diverse clinical presentations of these swellings. In this presentation, reporting three cases of PNST in which two presented with neurological symptoms of paraesthesia and pain and one who was asymptomatic swelling over his neck. All of whom were diagnosed with an alternate soft tissue swelling post clinical examination and taken up for excision as there were no significant clinical evidence for imaging. Intra-operatively we noted that all were closely related to the peripheral nerve of that anatomical region. Histopathological study revealed it to be PNST. PNST and schwannoma in particular although an entity that is not so common to come across in the surgical clinic we need to have and high indices of suspicion when associated close to peripheral nerves and symptomatic of a nerve involvement as we discuss here below.


Schwannoma, Nerve sheath tumors, Neurilemmoma

Full Text:



Jiang S, Shen H, Lu H. Multiple schwannomas of the digital nerves and common palmar digital nerves: An unusual case report of multiple schwannomas in one hand. Medicine (Baltimore). 2019;98(10):e14605.

Adani R, Baccarani A, Guidi E, Tarallo L. Schwannomas of the upper extremity: Diagnosis and treatment. Chir Organi Mov. 2008;92:85-8.

Dasgupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign solitary schwannomas (neurilemomas). Cancer. 1969;24:355-66.

Kuo YL, Yao WJ, Chiu HY. Role of sonography in the preoperative assessment of neurilemmoma. J Clin Ultrasound. 2005;33:87-9.

Hirai T, Kobayashi H, Akiyama T, Okuma T, Oka H, Shinoda Y, et al. Predictive factors for complications after surgical treatment for schwannomas of the extremities. BMC Musculoskelet Disord. 2019;20:166.

Goldblum JR, Folpe AL, Sharon W. Enzinger and Weiss’s soft tissue tumors. 6th ed. Philadelphia, PA: Saunders/Elsevier. 2013: 813-829.

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.

Kececi Y, Gurler T, Gundogan H, Bilkay U, Cagdas A. Benign schwannomas located in the upper arm. Ann Plast Surg. 1997;39:100-2.

Rockwell G, Achilleas T, Salama S. Schwannoma of the hand and wrist. Plast Reconstr Surg. 2003;111(3):1227-32.

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

Knight DMA, Birch R, Pringle J. Benign solitary schwannoma. J Bone Joint Surg Br. 2007;89(3):382-7.

Kim SM, Seo SW, Lee JY, Sung KS. Surgical outcome of schwannomas arising from major peripheral nerves in the lower limb. Int Orthop. 2012;36(8):1721-5.

Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24:1477-81.