Title: Schwannoma of Brachial Plexus Presenting as Supraclavicular Mass: A Rare Presentation, Evaluation and its Management is a Challenge to Surgeons
Authors: Dr Munireddy.M.V, Dr Pavan.B.K, Dr Bhaskaran.A
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.22
Abstract
Schwannomas, also termed as neurilemmomas, are benign nerve sheath neoplasms that originate from peripheral, cranial or autonomic nerves. Schwannomas originating from the brachial plexus are rare and most of them are benign. The majority present as a slow growing mass. Microscopically, pathological features of these tumors are unique, composed of spindle Schwann cells forming hyper- or hypocellular areas (Antoni A and Antoni B, respectively). A 40 year old women presented with left supraclavicular swelling since 6 years. Patient gives history of numbness in the left upper limb after excessive movements of the limb. On evalution by FNAC, CT scan neck, diagnosis of benign nerve sheath tumour was made. On through evaluation patient underwent excision of tumour. HP report of specimen reveled features of schwannoma. Final diagnosis of schwannoma brachial plexus was made. Hence patient with supraclavicular mass, differential diagnosis of schwannoma should be considered to avoid complications following surgical excision of lesion.
Keywords: Brachial plexus schwannoma, Antoni A- Antoni B cells, Supraclavicular schwannoma, Supraclavicular mass.
References
- Kumar A, Akhtar S. Schwannoma of brachial plexus. Indian J Surg. 2011;73(1):80-1.
- Chen F, Miyahara R, Matsunaga Y, Koyama T. Schwannoma of the brachial plexus presenting as an enlarging cystic mass: report of a case. Ann Thorac Cardiovasc Surg 2008;14:311-3.
- Jaafar, R., et al. (2012) Cervical Schwannoma: Report of Four Cases. Medical Journal of Malaysia, 67, 345-348.
- Chiofalo, M.G., Longo, F., Marone, U., Franco, R., Petrillo, A. and Pezzullo, L. (2009) Cervical Vagal Schwannoma: A Case Report. Acta Otorhinolaryngologica Italica, 29, 33-35.
- Bradley, W. and Midah, R. (2008) Chap 49: Schwannoma. In: Midah, R., Ed., Surgery of Peripheral Nerve: A Case Based Approach, Thieme, New York, 231.
- Binder, D.K., Smith, J.S. and Barbaro, N.M. (2004) Primary Brachial Plexus Tumors: Imaging, Surgical, and Pathological Findings in 25 Patients. Neurosurgical Focus, 16, E11.
- Soltani, A.M., et al. (2013) Neural Sheath Tumors of the Brachial Plexus: A Multidisciplinary Team-Based Approach. Annals of Plastic Surgery, 71, 80-83.
- Huang JH, Samadani U, Zager EL. Brachial plexus region tumors: a review of their history, classification, surgical management and outcomes. Neurosurgery Q. 2003;13:151-61.
- Leu YS, Chang KC. Extracranial Head and Neck Schwannomas: A Review of 8 Years Experience. ActaOtolaryngol 2002; 122: 435-437.
- Fierro N, Morelli A, Del Grammastro A, D’Ermo G, Di Cola G, Annessi M, et al. Posterior mediastinum neoplasms: a case of schwannoma. G Chir 2004;25:35-8.
- Saini S, Dhasmana JP. Apical mass presentation of brachial plexus Schwannoma. Indian J Chest Dis Allied Sci 2006;48:129-31.
- Kumar, A. and Akhtar, S. (2011) Schwannoma of Brachial Plexus. Indian Journal of Surgery, 73, 80-81.